戒烟干预对吸烟者知识、态度和行为的影响

目的 评价戒烟干预对戒烟门诊求助者烟草相关知识、态度和行为(知、信、行)的影响。方法 以2008年10 月至2013 年8月解放军总医院戒烟门诊就医的未使用戒烟药物的吸烟者为研究对象,戒烟门诊医师首诊时为吸烟者进行≥30 min的面对面咨询和心理干预,之后1周、1个月、3个月和6个月时共进行4次随访电话干预(每次15～20 min).对照组为2012 年8月至2013 年8月解放军总医院健康医学中心某病区常规查体的吸烟者,基线和随访时均不进行干预。比较基线和1年随访时干预组和对照组烟草相关知、信、行的变化情况。结果 干预组和对照组分别纳入414例和213例研究对象。意向性分析显示,干预组1年随访烟草相关知、信方面共有5个变量的知晓/同意率高于基线。两组的1年随访时点戒烟率分别为4.7%和27.3%.logistic 多元回归分析显示,1年随访时戒烟率与暴露于戒烟干预、女性、尼古丁依赖评分低和烟草相关知识及态度正向变化(吸烟导致心脏病、应该禁止各种形式的烟草产品推广、吸烟浪费金钱和酒楼、饭店应该全面禁烟)共7个变量呈正相关,其OR值(95%CI)分别为2.85(2.00～4.07)、3.34(1.23～9.07)、2.78(1.64～4.72)、2.30(1.03～5.15)、5.33(1.47～19.32)、6.32(1.56～25.62)和10.47(2.25～48.84).结论 戒烟门诊求助者的烟草危害认知水平普遍较高,通过系统化戒烟干预,部分吸烟者知识及态度有了一定提高。烟草相关知识及态度的有益转变,有利于提高戒烟率。

Impact of intervention on tobacco related knowledge,attitudes and practice of smokers

Objective To evaluate the impact of intervention on tobacco related knowledge,attitudes and practice of smokers. Methods An observational study was conducted among the smokers seeking counsel at smoking cessation clinic in our hospital from October 2008 to August 2013. First,a face to face counsel and mental intervention for more than 30 minutes was given to smoker, then 4 interventions through telephone call for 15-20 minutes for each time were conducted 1 week later,1 month later,3 months later and 6 months later,respectively. The controls were smokers receiving health examination in our hospital. No interventions were conducted among them. The tobacco related knowledge,attitudes and practice at baseline survey and follow up 1 year later were compared between intervention group and control group. Results The intervention group included 414 smokers and the control group included 213 smokers. Intentional analysis indicated that the awareness/acceptance rates of 5 items about tobacco related knowledge and attitudes at follow up 1 year later was higher than those at baseline survey in intervention group. The smoking cessation rate was 27.3% in intervention group and 4.7% in control group. Multivariate logistic regression analysis indicated that the smoking cessation rate was positively correlated with intervention,female,highly nicotine dependence and positive change of tobacco related knowledge and attitudes (smoking can cause heart disease,all kinds of tobacco advertisements should be prohibited,smoking waste money and restaurant should be smoking free) with OR(95%CI):2.85(2.00-4.07),3.34(1.23-9.07),2.78 (1.64-4.72),2.30(1.03-5.15),5.33(1.47-19.32),6.32(1.56-25.62) and 10.47(2.25-48.84),respectively. Conclusion The awareness rate of tobacco related harm was high among the smokers seeking counsel at smoking cessation clinic. Systematic smoking cessation intervention can improve smokers'' tobacco related knowledge and attitudes and increase smoking cessation rate.