小学生劝导父母戒烟的可行性研究

检验通过小学生来劝导父母戒烟这种方法的可行性并评价其效果。我们于１９９９ 年１ 月，在北大附小开展一项名为“我向父母献爱心”的活动，对北大附小３７０ 名小学生通过上课的方式进行吸烟有害宣传，并发放戒烟材料给其家长，督促其父母戒烟，对成功者予以奖励。主要结果：１ ． 调查表明６７ ％ 的家长吸烟，其中４９ ％ 在家里吸。２ ． 活动中有７４ ％ 的吸烟家长中有戒烟愿望。３ ．４ 周后实际戒烟率为１０ ．３ ％ ，与其他方法相比，该方法的效果比较好，宣传面广、简单易行，值得推广     

北京'96国际戒烟竞赛2年随访结果分析

戒烟竞赛是一项较鼓励成人吸烟者戒烟的方法。１９８０年起源于美国的社区心血管病项目和芬兰的北卡项目。经证明,这种竞赛是帮助较多的人停止吸烟的较符合成本效益的鼓励戒烟的方法。ＷＨＯ欧洲区１９９４年开展了有１３个国家参加的多国戒烟竞赛运动。１年后随访１５％...     

38例吸烟者血小板粘附性和聚集性测定及其用α—甲基多巴戒烟疗效观察

本报道38例男性吸烟血小板粘附性和聚集性的测定结果。用玻球法之粘附率为：受核组(n=33)33.82±2.89％，对照组(n=64)34.90±5．95％；用ADP(ZgM)诱发之最大聚集率(AMR)为：受核组(n=38)61．25±8．36％，对照组(n=64)52．89±8．24％，两结果均高于正常对照组(P<0．01和<0．05)．用甲基多巴戒烟治疗观察有一定效果。同时对吸烟危害，吸烟与血小板功能，以及用α-甲基多巴戒烟机理等问题做了某些探讨。     

戒烟5年后疾病风险明显下降

你都到中年．医生建议你戒烟。你可能会想，现在戒烟还有用吗？我都吸烟吸了好几十年了。关于戒烟，有一个原则。那就是：戒烟永远不会太迟．当然，越早戒掉越好。因为有研究显示，在戒烟后的5年内．心血管疾病的风险会大幅度的下降．并且随着时间推移．风险程度可进一步下降。戒烟20年后，除了肺癌以外的各种疾病死亡率跟从来不吸烟的人基本一样．     

心脑血管病和糖尿病住院患者吸烟及戒烟状况调查及干预措施探讨

目的 调查因心脑血管病和糖尿病住院患者吸烟状况及其戒烟意愿,探讨医师戒烟干预措施及其效果.方法 对2011年2月至6月在北京同仁医院心内科、神经内科和内分泌科住院的1 237例患者进行吸烟和戒烟状况问卷调查,其中心血管病患者592例,脑血管患者291例,糖尿病患者354例.针对现吸烟患者(n =345)进行戒烟干预,并按随机原则分为常规干预组(n=172)和强化干预组(n=173).通过电话随访出院后6个月时的吸烟和戒烟状况.结果 心脑血管病和糖尿病住院患者总吸烟率为47.0％(582/1 237),现吸烟率为27.9％(345/1 237).经过住院期间对现吸烟患者进行戒烟干预,患者戒烟意愿向戒烟行动期转变.在6个月随访中,303例接受电话随访患者总戒烟率为30.0％,强化干预组戒烟率(45.8％)高于常规干预组(21.3％),P＜0.05.结论 心脑血管病和糖尿病住院患者吸烟率高,对烟草危害认知度较低.对住院患者采用强化干预措施有助于提高戒烟率.     

住院吸烟患者的戒烟干预效果评价

目的本研究以住院吸烟患者为研究对象,探讨戒烟干预的效果。方法选择2010年12月—2012年11月呼吸科、心血管内科两科室的住院吸烟患者共240例,将其随机分为2组,对照组(简短戒烟建议)120例,干预组(强化戒烟干预)120例。进行统一问卷调查,采用面对面强化式戒烟心理辅导及简单口头忠告两种不同干预方式,并在出院后进行6个月内的电话随访,并跟踪戒烟状况和戒断症状,据自报的戒断情况,确定时点戒烟率、持续戒烟率,判断戒烟干预的效果。结果强化干预组出院后1个月、3个月、6个月的时点戒烟率以及6个月的持续戒烟率明显高于对照组,差异有统计学意义(P<0.05);且部分戒断症状如焦虑或紧张、体质量增加、渴望吸烟的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论对住院吸烟患者实施戒烟干预,尤其是在与吸烟密切相关性疾病的科室,可行且有效;强化戒烟干预较简单戒烟干预更有效。     

100例吸烟的呼吸系统疾病住院患者吸烟状态调查报告

目的 :了解目前呼吸科住院患者对于吸烟问题的认识及戒烟状况。方法 :由专科护士对于2 0 0 2年 2月至 5月在我院呼吸科住院的吸烟患者进行问卷调查。结果 :10 0名吸烟的住院患者中 72人实施过戒烟 ,其中戒烟 1年以上者 6 2人 (86 % ) ,戒烟失败 10人 ,余 2 8人中从未打算戒烟 19人 ,有过戒烟打算但从未实施者 6人 ,减量吸烟 3人 ,成功戒烟中医生起主导作用的只有 2 3人 (37 1% )。结论 :本组调查吸烟住院患者戒烟成功率较高 ,但是仍有 2 8%的人 ,尽管他们已患与吸烟有关的疾病但仍未戒烟。因此应充分发挥医生在患者戒烟中的作用     

内分泌科门诊糖尿病患者吸烟现况调查

目的 了解糖尿病患者的吸烟和戒烟状况以及对于吸烟与疾病关系的认知情况,分析目前仍在吸烟患者戒烟失败的原因,为指导戒烟治疗提供依据.方法 由呼吸科专科医师根据事先设计的调查问卷,对2010年7月至2010年9月我院内分泌科门诊就诊的糖尿病患者进行问卷调查.结果 共调查患者270例,男性67.8％,平均年龄(64.3±10.8)岁.吸烟者41.1％,被动吸烟者29.3％,其中目前吸烟者19.6％,曾经吸烟者21.5％.19.3％伴发其他疾病.目前吸烟者中,71.7％知晓所患疾病与吸烟相关,43.4％曾尝试戒烟.所有吸烟患者接受过医师戒烟劝告的为78.4％,戒烟成功患者中77.6％经医师劝导戒烟.目前吸烟患者接受过医师戒烟劝告的为79.2％,其中59.5％认为医师的劝告和建议对其戒烟有帮助.结论 糖尿病患者目前吸烟率仍较高.研究结果提示需要加强对糖尿病患者戒烟的宣教,医师劝导戒烟的方式和内容还需改善.     

124名呼吸科门诊吸烟患者吸烟问题问卷调查结果

目的 :调查呼吸专科门诊吸烟患者戒烟意向和状态。方法 :根据事先设计的表格由呼吸专科医师对 12 4名我院呼吸科门诊就诊的吸烟患者进行问卷调查。结果 :1 12 4名吸烟者中 12 3人(99 2 % )知道吸烟有害健康 ,85人 (6 8 5 % )患有与吸烟相关疾病。 2 31人从未想过要戒烟 ,2 0人虽然想过戒烟但一直没有实施 ,两者合计占 41 1%。 73人实行过戒烟 ,但其中 5 2人没有成功 ,仅 2 1人戒烟时间≥ 1年。 3 72人曾经接受过来自医生的戒烟建议 ,但是多为简单劝告缺少具体指导 ,效果不理想。结论 :吸烟是引起COPD的重要原因。必须高度重视控烟工作 ,今后应深入开展吸烟有害健康的宣传 ,并注意说明吸烟危害人体健康的特点 ,同时应摸索出一些符合国情并为吸烟者乐于接受 ,易于实行的戒烟方法。在这个过程中医务人员应当发挥其主导作用。     

基于互联网+的全程管理在门诊戒烟患者中的应用

<正>我国是最大的烟草生产国、消费国、受害国,现有烟民3.16亿,吸烟率27. 7%[1],2010年至2015年吸烟人数增加1 500万,平均每天吸烟22支,较1980年增加50%,每年有100多万人、相当于每天约3 000人死于烟草使用[2]。中国卫生健康委员会推动实施健康中国战略,以治病为中心转成以人民健康为中心,把戒烟纳入进来,颁布了相关控烟政策,并在全国范围内成立了中国戒烟联盟,联合各媒体宣传报道,越来越多的人们意识到吸烟的危害,越来越多的人们尝试戒烟。研究表明,仅凭毅力戒烟者中,只有不到3%的吸烟者能在戒烟后维持一年不吸烟,且吸烟者在戒烟成功之前,平均会尝试6～9次戒烟,复吸很常见。对于大部分吸烟者,     

Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1-year follow-up study

Aim   To examine the percentage of Japanese adult smokers who make quit attempts and succeed in smoking cessation over a 1-year period, and to identify predictors of attempts to stop and successful smoking cessation.
Design and setting   This study used Ipsos JSR Company's access panel, whose sampling framework is based on the Basic Resident Register in Japan. We tracked and monitored a selected sample of smokers who were at least 20 years of age through a baseline postal questionnaire survey in 2005 and a follow-up survey 1 year later.
Participants   The original response rate was 72.1% (1874 of 2600 smokers). There were 1627 current smokers in the baseline survey, and of those, 1358 were followed-up 1 year later.
Findings   Among the current smokers, 23.0% reported that they had attempted to quit smoking at least once in the past year. Of those who made quit attempts, 25.6% had achieved 1-week abstinence successfully and 13.5% reported having achieved sustained 6-month abstinence successfully at the time of the follow-up survey. The predictors associated with quit attempts were non-daily smoker, higher motivation to quit and previous attempts to stop smoking. Among smokers who made quit attempts, only 13.5% used nicotine replacement therapy. Higher nicotine dependence was associated with lower probability of success in quitting.
Conclusions   Japanese smokers attempt to quit at a lower rate than smokers in the United Kingdom and United States, but factors that predict attempts (primarily markers of motivation) and success of attempts (primarily dependence) are similar to those found in western samples.     

Prospective predictors of quitting behaviours among adult smokers in six cities in China: findings from the International Tobacco Control (ITC) China Survey

Aims To examine predictors of quitting behaviours among adult smokers in China, in light of existing knowledge from previous research in four western countries and two southeast Asian countries. Design Face‐to‐face interviews were carried out with smokers in 2006 using the International Tobacco Control (ITC) China Survey, with follow‐up about 16 months later. A stratified multi‐stage cluster sampling design was employed. Setting Beijing and five other cities in China. Participants A total of 4732 smokers were first surveyed in 2006. Of these, 3863 were re‐contacted in 2007, with a retention rate of 81.6%. Measurements Baseline measures of socio‐demographics, dependence and interest in quitting were used prospectively to predict both making quit attempts and staying quit among those who attempted. Findings Overall, 25.3% Chinese smokers reported having made at least one quit attempt between waves 1 and 2; of these, 21.7% were still stopped at wave 2. Independent predictors of making quit attempts included having higher quitting self‐efficacy, previous quit attempts, more immediate intentions to quit, longer time to first cigarette upon waking, negative opinion of smoking and having smoking restrictions at home. Independent predictors of staying quit were being older, having longer previous abstinence from smoking and having more immediate quitting intentions. Conclusions Predictors of Chinese smokers' quitting behaviours are somewhat different to those found in previous research from other countries. Nicotine dependence and self‐efficacy seem to be more important for attempts than for staying quit in China, and quitting intentions are related to both attempts and staying quit.     

Training physicians in counseling about smoking cessation. A randomized trial of the "Quit for Life" program

STUDY OBJECTIVE: To test whether physicians who receive a continuing education program ("Quit for Life") about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking cessation among their patients who smoke. DESIGN: Randomized trial with blinded assessment of principal outcomes. SETTING: Four health maintenance organization medical centers in northern California. SUBJECTS: Eighty-one internists assigned by blinded randomization to receive training (40) or serve as controls (41). Consecutive samples of smokers visiting each physician (mean, 25.6 patients per experimental and 25.2 per control physician). INTERVENTIONS: Internists received 3 hours of training about how to help smokers quit. Physicians and their office staff also were given self-help booklets to distribute free to smokers and were urged to use a system of stickers on charts to remind physicians to counsel smokers about quitting. MEASUREMENTS AND MAIN RESULTS: On the basis of telephone interviews with patients after visiting the physician, we determined that internists who attended the Quit for Life program discussed smoking with more patients who smoked, spent more time counseling them about smoking, helped more patients set dates to quit smoking, gave out more self-help booklets, and made more follow-up appointments to discuss smoking than did internists in the control group. One year later, the rate of biochemically confirmed, long-term (greater than or equal to 9 months) abstinence from smoking was 1% higher among all patients of trained internists than among patients of controls (95% CI, -0.1% to +2.3%), and 2.2% (+0.2% to +4.3%) higher among the patients who most wanted to quit smoking. CONCLUSIONS: This continuing education program substantially changed the way physicians counseled smokers. As a result, a few more patients who wanted to quit smoking achieved long-term abstinence.     

Promoting smoking cessation among the elderly: what are the predictors of intention to quit and successful quitting?

PURPOSE: To assess the predictors of smoking cessation and intention to quit among the Chinese elderly smokers. DESIGN: A cross-sectional survey of elderly smokers. Setting: Shamsuipo district, Hong Kong. Subject: A total of 1,318 elderly were interviewed (response rate = 83%). Measures: A structured questionnaire was used for data collection. The questionnaire sought information on the subject's sociodemographic background and smoking habits. The predictors for successful quitting and intention to quit were assessed by chi-square tests and multiple logistic regression. RESULTS: Of the respondents, 20.2% were current smokers, 25.4% were ex-smokers, and 54.4% were never smokers. Of the smoker (current and ex-smokers) respondents, 55.7% (335/601) had successfully quit at the time of enumeration. The predictors of quitting were living with others, receiving assistance for mobility, being nondrinkers, smoking for shorter duration, and smoking more cigarettes per day. Having health problems in the past, smoking for shorter duration, and smoking fewer cigarettes per day were predictors of intention to quit smoking. CONCLUSION: The study identified several predictors of successful quitting that could help improve the provision of current smoking cessation services. Population-based smoking cessation programs, especially those targeted to elderly, should take these predictors into consideration in the design of interventions.     

A randomized trial assessing the Five-Day Plan for smoking cessation

AIM: To evaluate the effectiveness of the Five-Day Plan (FDP) in helping smokers to stop smoking. DESIGN: Randomized controlled trial comparing intervention and control groups. The primary outcome measure was 12 months continuous abstinence verified by expired air carbon monoxide concentration. Secondary outcome measures were self-reported abstinence at end of treatment, at 3 and 6 months. SETTING: Six towns in France. PARTICIPANTS: 228 smokers, recruited by newspaper and radio advertisement, aged 18 years or over and willing to make an attempt to quit smoking. INTERVENTION: The Intervention group (119 participants) received the FDP, which is a behavioural group-based treatment programme that has been in operation in France since 1965. It involves five consecutive evening behavioural therapy sessions. The Control group (109 participants) received a single session discussing the health effects of smoking. FINDINGS: In the Intervention group, 67 participants (56%) quit smoking at the end of the FDP. After three months this number had been reduced to 30 (25%) and to 19 (16%) by the end of one year. In the Control group these numbers were 14 (13%) and 12 (11%), respectively, after three and 12 months. When considering the rate of cessation without lapse after one year a significant difference was observed with a 13% rate in the Intervention group and 3% in the Control group (P = 0.004). CONCLUSIONS: The FDP may be considered as an aid for smokers who want to quit.     

A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV

Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.     

A randomized controlled trial of a smoking reduction plus nicotine replacement therapy intervention for smokers not willing to quit smoking

Aims To examine the effectiveness of smoking reduction counselling plus free nicotine replacement therapy (NRT) for smokers not willing to quit. Design, setting and participants A total of 1154 Chinese adult smokers not willing to quit but who were interested in reducing smoking were allocated randomly to three arms. Intervention group A1 (n = 479) received face‐to‐face counselling on smoking reduction and adherence to NRT at baseline, 1 week and 4 weeks with 4 weeks of free NRT. Group A2 (n = 449) received the same intervention, but without the adherence intervention. Control group B (n = 226) received simple cessation advice at baseline. Measurements Self‐reported 7‐day point prevalence of tobacco abstinence and reduction of cigarette consumption (≥50%) at 6 months and continuous use of NRT for 4 weeks at 3 months. Findings Using intention‐to‐treat analysis, compared to control group B, the intervention groups (A1 + A2) had achieved higher 6‐month tobacco abstinence (17.0% versus 10.2%, P = 0.01) and reduction rates (50.9% versus 25.7%, P < 0.001). There was no significant difference in the 4‐week NRT adherence rate at 3 months, but group A1 achieved a higher abstinence rate than group A2 at 6 months (20.9% versus 12.9%; P = 0.001). Conclusions In smokers with no immediate plans to quit, smoking reduction programmes with behavioural support and nicotine replacement therapy are more effective than brief advice to quit. Current guidelines recommend advice to quit on medical grounds as the best clinical intervention in this group of smokers, but smoking reduction programmes offer an alternative and effective option.     

The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: a cluster-randomized trial

AIMS: To establish whether proactively identifying all smokers in primary care populations and offering smoking cessation support is effective in increasing long-term abstinence from smoking. DESIGN: Cluster randomized controlled trial. SETTING: Twenty-four general practices in Nottinghamshire, randomized by practice to active or control intervention. PARTICIPANTS: All adult patients registered with the practices who returned a questionnaire confirming that they were current smokers (n = 6856). INTERVENTION: Participants were offered smoking cessation support by letter and those interested in receiving it were contacted and referred into National Health Service (NHS) stop smoking services if required. MEASUREMENTS: Validated abstinence from smoking, use of smoking cessation services and number of quit attempts in continuing smokers at 6 months. FINDINGS: Smokers in the intervention group were more likely than controls to report that they had used local cessation services during the study period [16.6% and 8.9%, respectively, adjusted odds ratio (OR) 2.09, 95% confidence interval (CI) 1.57-2.78], and continuing smokers (in the intervention group) were more likely to have made a quit attempt in the last 6 months (37.4% and 33.3%, respectively, adjusted OR 1.23, 95% CI 1.01-1.51). Validated point prevalence abstinence from smoking at 6 months was higher in the intervention than the control groups (3.5% and 2.5%, respectively) but the difference was not statistically significant (adjusted OR controlling for covariates: 1.64, 95% CI 0.92-2.89). CONCLUSIONS: Proactively identifying smokers who want to quit in primary care populations, and referring them to a cessation service, increased contacts with cessation services and the number of quit attempts. We were unable to detect a significant effect on long-term cessation rates, but the study was not powered to detect the kind of difference that might be expected.     

Effectiveness of hospital-based smoking cessation

STUDY OBJECTIVES: Smoking cessation for current smokers is a health-care imperative. It is not clear which approaches to smoking cessation are the most effective in the hospital setting and which factors predict long-term abstinence. We hypothesized that a hospital-based smoking cessation program involving behavioral modification and support would provide an effective intervention for smoking cessation. DESIGN: Prospective cohort study. SETTING: Smoking cessation clinics in a tertiary referral, cardiothoracic hospital. PATIENTS OR PARTICIPANTS: Two hundred forty-three smokers and 187 never-smoker control subjects. INTERVENTIONS: Smokers underwent specific sessions of individual counseling on behavioral modification, including written information, advice about quit aids, and support during the quit attempt. Abstinence was confirmed by exhaled carbon monoxide measurements. MEASUREMENTS AND RESULTS: Compared to never-smoker control subjects, smokers were more likely to have grown up with a smoking father or siblings, and to currently live or socialize with other smokers. Two hundred sixteen smokers attended at least two sessions of the smoking cessation program. Of these, 25% were unavailable for follow-up at 12 months and were assumed to be smoking. The point prevalence abstinence rate at 12 months was 32%. Independent factors associated with abstinence at 12 months were self-belief in quitting ability, having a heart condition, growing up without siblings who smoked, and increasing number of pack-years. CONCLUSIONS: This prospective study has demonstrated that this hospital-based smoking cessation program was as effective as programs in other settings. Social and psychological factors were associated with a greater chance of abstinence.     

The timing of smoking onset, prolonged abstinence and relapse in men: a prospective study from ages 18 to 32 years

Aim To describe the rate and timing of smoking onset, prolonged abstinence (≥1 year) and relapses from ages 18 to 32 years in initially smoking and non‐smoking men. Design A 23‐year longitudinal study. Setting Untreated community sample. Participants A total of 154 American boys were recruited at age 10 years to a larger study (n = 206) of delinquency risk; 71 participants who smoked cigarettes and did not use smokeless tobacco and 83 participants who initially did not use tobacco were followed from age 18 to 32 years. Measurements Frequency of tobacco use and weekly cigarettes smoked in the past year were assessed annually. Onset (>6 cigarettes/week), abstinence (0 tobacco uses in the past year) and relapse (>0 cigarettes/week) were tracked annually. Findings Of smokers, 36% achieved 1 or more years of abstinence by age 32 years; 52% who reached abstinence relapsed at least once. One‐half of men who showed onset after age 18 years were smoking at the end of the study, compared to nearly three‐quarters of men who were smokers at age 18 years. Risk for relapse following prolonged abstinence was strongest initially and diminished thereafter. Transition probabilities were stronger for the second period of abstinence than for the first. Models were limited by sample size and statistical power. Conclusions Relapses continue to erode men's quit success even after long periods of abstinence from smoking. Long‐term abstinence, despite intervening relapse, bodes well for eventual abstinence. Adolescent onset appears relevant to the likelihood of adult abstinence and relapse patterns.