常规医疗实践中不同简短戒烟干预措施的效果：预测和决定因素
2009/10/15
目的：在同时参与两项不同简短戒烟干预的吸烟者中，探讨与人口统计学、健康及吸烟相关的预测和决定因素。数据来源于一项检测单纯评价计算机自动生成的简短邮件和医生给予的简短忠告对戒烟效果影响的半随机对照试验。从34个全科诊所中纳入1499例每日吸烟的人群。采用广义估计方程研究6个月以上戒烟（分别在12、18、24个月的随访中评价）与潜在预测和决定因素之间的关系。
结果：女性（OR=1.49, 95% CI=1.01-2.19）、较高教育水平（OR=1.82, 95% CI=1.18-2.82）、戒烟意向（OR=1.66, 95% CI=1.16-2.38）及戒烟自信心（OR=1.30, 95% CI=1.03-1.64）与戒烟率呈正相关，而尼古丁依赖（OR=0.84, 95% CI=0.76-0.94）和同伴吸烟（OR=0.60, 95% CI=0.42-0.85）则与戒烟率呈负相关。与单纯评估相比，对于无意向戒烟或失业的吸烟者，医生忠告的作用甚微。
结论：戒烟干预可能受某些人口统计学及吸烟相关的因素影响，本研究对其进行了分析，将其列为戒烟的预测因素。结果表明，与医生忠告相比，在常规医疗实践中，特定的信件是更易实施的简单干预措施。
（刘国梁 审校）
Haug S, et al. Patient Educ Couns. 2009 Aug 4.
Predictors and moderators of outcome in different brief interventions for smoking cessation in general medical practice.
Haug S, Meyer C, Ulbricht S, Schorr G, Rüge J, Rumpf HJ, John U.
OBJECTIVE: To explore demographic-, health-, and smoking-related predictors and moderators of outcome in smokers who participated in two different brief smoking cessation interventions.
METHODS: Data were acquired using a quasi-randomized controlled trial that tested the efficacy of computer-generated tailored letters and physician-delivered brief advice against assessment only. Daily smokers (n=1499) were recruited from 34 general medical practices. We used Generalized Estimating Equation analyses to investigate the relationship between 6-month prolonged smoking abstinence assessed at 12-, 18-, and 24-month follow-ups and potential predictors and moderators.
RESULTS: Female gender (OR=1.49, 95% CI=1.01-2.19), higher level of education (OR=1.82, 95% CI=1.18-2.82), intention to quit smoking (OR=1.66, 95% CI=1.16-2.38), and smoking cessation self-efficacy (OR=1.30, 95% CI=1.03-1.64) were positively, nicotine dependence (OR=0.84, 95% CI=0.76-0.94) and the presence of a smoking partner (OR=0.60, 95% CI=0.42-0.85) were negatively associated with smoking abstinence. Compared to assessment only, physician advice was less effective for people without an intention to quit smoking and for unemployed.
CONCLUSION: Smoking cessation interventions might be improved by tailoring them to demographic- and smoking-related variables which were identified as predictors in this study. PRACTICE IMPLICATIONS: The results suggest that tailored letters are a more universally applicable brief intervention in general medical practice than physician advice.
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采用体力活动辅助戒烟：在戒烟门诊的戒烟者中跨理论模型的多种行为变化的应用
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将E-mail咨询纳入戒烟计划的可行性
