吸烟、戒烟对睡眠呼吸暂停低通气综合征影响的临床研究

目的 探讨吸烟、戒烟与阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea hypopnea syndrom,OSAHS）的关系和影响.方法 将100例OSAHS患者根据是否吸烟分为：吸烟组和不吸烟组.选取呼吸暂停低通气指数（apnea hypopnea index,AHI）、平均血氧饱和度 SaO2 mean（%）等数据作为评价病情变化的依据,同时监测患者吸烟的烟龄、吸烟量的多少,进行统计学处理和相关分析.对吸烟组患者进行戒烟干预,并对比分析成功戒烟者3个月前后AHI、SaO2 mean（%）的变化.结果 吸烟组AHI显著高于不吸烟组,吸烟组患者平均血氧饱和度低于不吸烟组患者,吸烟量和烟龄是影响分析结果的主要因素.吸烟组患者戒烟后AHI和SaO2 mean（%）有明显改善（P＜0.01）;戒烟联合系统连续的睡眠时经鼻CPAP治疗,病情改善更为明显.结论 OSAHS吸烟组患者的睡眠呼吸障碍程度均比非吸烟组严重,戒烟对改善OSAHS病情有积极的作用.     

慢性心衰患者吸烟及戒烟依从性影响因素的临床研究

目的临床研究慢性心衰患者吸烟及戒烟依从性的影响因素。方法选取我院有吸烟史的慢性心衰患者200例,本研究采用问卷方式进行调查,研究所用量表综合了Fager-strom尼古丁依赖性评分表及2006年中国国际戒烟竞赛随访调查表的内容,并结合慢性心衰患者情况进行调整。结果对慢性心衰患者吸烟及戒烟依从性影响因素进行分析研究,可明显提高戒烟率,文化程度高,依从性相对较好,已戒烟者占80％;文化程度低,依从性相对较差,戒烟者只有20％,家庭成员支持戒烟的比例,戒烟者为85％,高于家庭成员不支持戒烟的比例55％。讨论戒烟是慢性心衰患者最有力的干预方法之一,帮助患者戒烟成为慢性心衰诊治工作不可缺少的部分。烟草依赖是一种慢性成瘾性疾病,具有高复发的特点,自行戒烟率低,必须将烟草依赖作为一种慢性病对待,予以评估并反复干预。     

认知疗法对不同文化程度慢性阻塞性肺病患者戒烟效果的影响

目的：观察认知疗法对慢性阻塞性肺病（ COPD）患者戒烟效果的影响。方法2010-2012年在或曾在本院住院并且诊断为COPD的老年吸烟患者370例,将患者随机分为两组,干预组和对照组各185例,各组再按照文化程度差异分为小学及以下组、中学组、专科及以上三组,干预组予认知疗法＋药物治疗,对照组仅予药物治疗,入组1年后对两组患者戒烟成功率及焦虑表现进行比较。结果1年后干预组4例失访,3例死亡;对照组6例失访,4例死亡。小学及以下戒烟成功率低于中学、专科及以上,差异有统计学意义（ P﹤0.05）。入组时干预组焦虑自评量表（SAS）评分为（60.50±1.25）分,对照组 SAS 评分（60.64±1.36）分,两组比较差异无统计学意义（ P ﹥0.05）;1年后干预组SAS评分（50.85±1.16）分,对照组（60.79±1.42）分,两组比较差异有统计学意义（ P﹤0.05）。结论认知疗法可有效增加中学及以上文化水平COPD患者的戒烟成功率。     

戒烟和吸烟对门诊初治培阳肺结核患者的影响

目的：探讨吸烟和戒烟对门诊初治培阳肺结核患者治疗结果的影响。方法102例门诊吸烟初治培阳肺结核患者分为吸烟组和戒烟组,吸烟组根据吸烟指数再分为两个亚组（第1组,200年支≤吸烟指数〈800年支,28例;第2组,吸烟指数≥800年支,26例）,对两组患者的2个月末痰菌培养的痰菌阴转率对比分析。结果吸烟组2个月末痰菌培养阴转率（87.0%）,明显低于戒烟组（95.8%）,两组相比差异具有统计学意义（P〈0.05）。吸烟指数≥800年支组痰培养阴转率（80.7%）明显低于吸烟指数200年支≤吸烟指数〈800年支组（92.8%）,两组相比差异具有统计学意义（P〈0.05）。结论吸烟是使门诊初治培阳肺结核患者2个月痰菌培阳性率增高的重要因素,并影响化疗效果。提倡戒烟是减少肺结核传染源、保护易感人群的简单而有效的方法。     

戒烟和防止被动吸烟的护理干预对慢性阻塞性肺疾病患者肺功能的影响

目的调查吸烟和戒烟的慢性阻塞性肺疾病（COPD）稳定期患者肺功能的改变,提倡不吸烟者不吸烟,吸烟者早期戒烟。方法选择2005年10月至2006年12月在吉林大学第四医院呼吸内科诊治视为COPD稳定期患者,行问卷调查、肺功能测定,分为24例对照者（吸烟组）和27例干预组（戒烟组）。结论戒烟组肺功能指标明显好于吸烟组。     

75例成年男性戒烟后肺功能改善情况分析

目的：观察成年健康男性吸烟者戒烟前后呼出气一氧化碳含量以及肺功能的变化。方法选择75名主动有意戒烟的健康成年男性吸烟者作为研究对象观察12个月,给予戒烟咨询,随访观察受试者戒烟前、戒烟1年后,呼出气一氧化碳（CO）含量以及肺功能的结果,进行分析。结果75名受试者中仅46名受试者成功戒烟,这46名全部完成1年的研究,参与结果分析。其中23名戒烟失败,6名吸烟量明显减少。戒烟1年后呼出气CO含量的减少和BMI的增加,差异有统计学意义（P〈0.01）。戒烟1年后FEV1、FVC、FEV1/FVC、MMEF、V25、V50和戒烟失败组对比均有不同程度的改善,其改善程度和戒烟失败组比较差异具有统计学意义（P〈0.01）,和26例不吸烟组对比改变差异无统计学意义（P〉0.05）。结论通过随访研究得出,吸烟者呼出气中一氧化碳是用于评价戒烟效果的主要生物学指标。戒烟可以轻度升高FEV1,逆转FEV1降低的速度,同时小气道的功能明显恢复。     

戒烟对冠状动脉粥样硬化性心脏病患者预后的影响

目的了解戒烟对冠心病患者预后的影响。方法将PCI术前吸烟的冠心病患者分为2组，1组为PCI术后戒烟者138例，1组为PCI术后仍吸烟者138例。随访24个月。观察2组主要不良心脑血管事件（MACCE）、心因性死亡率及因冠心病再住院率。结果PCI术后戒烟组主要不良心脑血管事件（MACCE）、心因性死亡率及因冠心病再住院率分别为4．3％，1．4％，7．2％。PCI术后吸烟组主要不良心脑血管事件（MACCE）、心因性死亡率及因冠心病再住院率分别为10．1％，5．1％，19．6％，2组比较P〈0．05。结论冠心病患者通过戒烟能降低主要不良心脑血管事件（MACCE）、心因性死亡率及因冠心病再住院率。戒烟能改善冠心病患者的预后。     

某基层医院男性心血管病患者戒烟影响因素调查

目的 调查分析某医院男性心血管病患者戒烟影响因素,为有效的帮助患者戒烟提供依据。方法 采用方便取样法收集192例二级甲等医院男性心血管病住院患者为调查对象。调查表内容包括一般资料、戒烟与吸烟相关情况、尼古丁依赖量表（FTND）和戒烟影响因素调查。数据纳入SPSS 16.0软件进行录入和统计分析。结果 本组192例患者目前所处戒烟阶段与尼古丁依赖评分呈负相关（r=-0.611,P <0.001）,与戒烟愿望呈正相关（r=0.284,P <0.001）,与戒烟难度呈负相关（r=-0.199,P=0.006）,与戒烟信心呈正相关（r=0.408,P <0.001）。结论 患者对尼古丁的依赖性越低,戒烟愿望越强烈,认为戒烟难度越低,戒烟信心越大,患者实施戒烟行为及成功的概率越高。     

C-反应蛋白对慢性阻塞性肺病患者的影响

目的 分析吸烟与否对慢性阻塞性肺疾病急性加重期患者血中C-反应蛋白及白细胞(WBC)计数的影响.方法 将我院门诊及住院处自2006年12月至2010年11月期间收治的111例慢性阻塞性肺疾病急性加重期患者根据吸烟史将其分成吸烟组33例、戒烟组36例及无烟组42例,对患者的血清CRP进行测定,并计数外周血白细胞(WBC).结果 三组患者间的CRP浓度与WBC计数结果比较,差异均不显著(P均>0.05),不具有统计学意义.三组患者CRP上升率对比差异不显著(P=0.226,OR=1.21),即吸烟(包括戒烟者在内)对慢性阻塞性肺疾病急性加重期患者血清CRP上升没有影响.慢性阻塞性肺疾病急性加重期患者血中CRP浓度与WBC计数表现为正相关关系(r=0.302,P<0.05).结论 吸烟、戒烟及非吸烟的慢性阻塞性肺疾病急性加重期患者CRP均无显著差异,CRP同吸烟与否无关,但与感染有一定的关联.     

冠心病PCI术后患者应用伐尼克兰戒烟的疗效观察与护理

目的 观察冠心病PCI术后患者应用伐尼克兰戒烟的疗效.方法48例冠心病行PCI术的吸烟患者分为观察组和对照组各24例,对照组给予常规宣教,观察组在常规宣教的基础上在专业医护人员指导下服用伐尼克兰,应用护理干预促进戒烟.结果 应用伐尼克兰后的冠心病PCI术后患者戒烟率达到91.6％,效果令人满意.结论 应用伐尼克兰对提高...     

Project EX--a teen smoking cessation initial study in Wuhan, China

The increasing smoking prevalence in China indicates a need for effective smoking cessation programs, yet, to our knowledge, no studies have evaluated the effects of smoking cessation programs among Chinese adolescents. A group of 46 10th-grade-level cigarette smokers from two schools in Wuhan, China, were provided with Project EX, an eight-session school-based clinic smoking cessation program developed in the United States. Efforts of translation of the Project EX curriculum, verification of translation, curriculum modification, and cultural adaptation were made to adapt the curriculum to the local culture. The 46 smokers represented 71% of all the self-reported 30-day smokers among 622 10th graders at these two schools. Only one student dropped out from the clinic program. Four-month follow-up data indicated a 10.5% 30-day quit rate and a 14.3% 7-day quit rate. The students who did not quit smoking reported a 16% reduction in daily cigarette consumption at posttest and a 33% reduction at 4-month follow-up. Use of a 2 1/2-week prebaseline-to-baseline clinic assessment indicated a clinic cohort nonassisted quit rate of 3%. These data provided evidence that Project EX can be adapted in another country, such as China; can be very well received; and can lead to promising results on cessation.     

Time perspective as a determinant of smoking cessation in four countries: Direct and mediated effects from the International Tobacco Control (ITC) 4-Country Surveys

Background

Future oriented time perspective predicts a number of important health behaviors and outcomes, including smoking cessation. However, it is not known how future orientation exerts its effects on such outcomes, and no large scale cross-national studies have examined the question prospectively. The aim of the current investigation was to examine the relationship between time perspective and success in smoking cessation, and social cognitive mediators of the association.

Methods

The ITC-4 is a multi-wave, four country survey (Australia, Canada, United States, United Kingdom) of current smokers (N = 9772); the survey includes baseline measurements of time perspective, intentions, quit attempts, and self-reported quit status at follow-up over 8 years. We examined the predictive power of time perspective for smoking cessation, as mediated through strength of quit intentions and prior history of quit attempts.

Results

Findings indicated that those smokers with a stronger future orientation at baseline were more likely to have successfully quit at follow-up. This effect was partially explained by intention-mediated effects of future orientation on quit attempts.

Conclusions

Future orientation predicts smoking cessation across four English-speaking countries; the cessation-facilitating effects of future orientation may be primarily due to future oriented individuals' motivated and sustained involvement in the quit cycle over time.     

Integrating smoking cessation into substance use disorder treatment for military veterans: Measurement and treatment engagement efforts

Military personnel and veterans smoke at higher rates than the general population, compromising physical performance readiness and health (Committee on Smoking Cessation in Military and Veteran Populations & Institute of Medicine, 2009). While efforts are being made within both the Department of Defense and the Veterans' Administration (VA) hospitals to prevent onset, change the smoking culture, and promote smoking cessation; smoking rates are increasing among combat deployed service members, and smoking rates are particularly high among veterans with mental health and other substance use disorders (McFall, 2006). Recent research supports making smoking cessation widely available and integrated with other forms of care (Gierisch et al., 2012; McFall et al., 2010). This paper describes the efforts of one VA substance use disorder (SUD) treatment program to integrate smoking cessation in routine care, including assessment of tobacco use and motivation and intention to quit via the proposed Nic-BAM assessment. Our team was 100% successful in incorporating the Nic-BAM into our regular assessment of treatment program participants. This suggests that staff members are amenable to assessing for tobacco addiction alongside other substance addictions. Although smoking did not decrease according to the Nic-BAM, an increase in the use of nicotine-replacement products suggests that participants are willing to initiate a quit attempt during SUD treatment. The availability of new evidence-based approaches for integration of tobacco cessation with mental health and SUD treatment may help to enhance programmatic efforts. Environmental changes are needed to fully incorporate tobacco recovery into SUD programming, and additional resources may include peer support specialists.     

A comparison of mandated versus volunteer adolescent participants in youth tobacco cessation programs

A national evaluation of community-based youth cessation programs delivered in group format provided the opportunity to compare mandated and volunteer program participants on demographics, smoking patterns, other health behaviors and motivation to quit. A total of 857 youth participants completed surveys prior to the start of their treatment program. Mandated youth comprised 24% of the sample (n=202). Both bivariate and multivariate comparisons were conducted. Mandated participants reported lower levels of stress, higher extrinsic motivation and lower intrinsic motivation to quit, and were more likely to be in the earlier (precontemplation) stage of readiness to quit. Mandated and volunteer smokers did not differ in their smoking patterns, school-related smoking behaviors, or binge drinking. Rates of smoking, school problems, and binge drinking were higher among cessation program participants than in general samples of youth. Programs with mixed voluntary-mandatory participation may benefit from extra attention to motivational issues.     

Smoking trajectories,health, and mortality across the adult lifespan

This study extends research on the association between smoking behavior and chronic disease by following a cohort from the time of initiation of regular smoking patterns into old age and by examining the association of lifetime smoking trajectories with chronic disease and mortality. Participants consisted of 232 males selected from the Harvard classes of 1942–1944 and followed biennially through 2003. Five distinct smoking trajectories were identified based on the age at which participants quit daily smoking. Participants following smoking trajectories with later cessation had a higher likelihood of developing lung disease and lived shorter lives than those who quit smoking at an earlier age. This study confirms that the earlier a smoker quits, the greater the health benefits, and that these benefits are observed even decades after smoking cessation. Additionally, by showing different survival rates between trajectory groups 25 and 40 years after quitting, the results run counter to previous work that has found no difference in mortality between smokers and non-smokers 15 years after cessation.     

Motivation to quit as a mediator of tobacco cessation among at-risk youth

The purpose of this study is twofold: 1) to evaluate the effects of a smoking cessation clinic (Project EX) on changing motivation to quit smoking, and 2) to assess differences in quit rates based on these changes in motivation. Student smokers in 18 continuation high schools in the Los Angeles county area were invited to participate in a tobacco cessation clinic designed to enhance motivation to quit tobacco use. The 18 schools were randomly assigned to one of three conditions. Compared to students in the control group, students who participated in the program conditions were more likely to express higher motivation to quit tobacco use. Higher motivation was also significantly related to higher quit rates. Motivation to quit as defined by constituents of the energy/direction model of motivation appears to be a plausible mediator of cessation program effects.     

Smoking cessation among Chinese young smokers: Does gender and age difference matters and what are the predictors?

This study assessed the gender and age differences in smoking cessation among the Chinese youth and identified factors associated with quitting smoking. This was a clinic based cross-sectional study with longitudinal components among 129 Chinese young smokers. All services in the clinic including one week's supply of nicotine replacement therapy (NRT) were free. We used structured questionnaires at baseline and at 1, 3 and 12 months. The analysis was by intention-to-treat basis. At 12 month follow up, the 7 day point prevalence quit rate (abstinence from tobacco smoking during the 7 days preceding the follow up) was 19% (25/129) and 36% (25/69) among all the attendees and among those who were successfully followed up, respectively. There was no significant gender or age differences in the quitting outcome but females and the older youth reported more withdrawal symptoms. Not reporting any withdrawal symptoms at 3 months follow up and adherence to use NRT for at least 4 weeks were significant predictors of quitting. A clinic-based smoking cessation service among Chinese young smokers produced an acceptable quit rate with no gender and age difference, indicating that a more general quit smoking approach could be taken for the youth.