初级保健医务人员劝说戒烟:在有无饮酒、药物或精神疾病患者中的戒烟效果比较

2011/10/11

   摘要
   前言:美国烟民中合并有饮酒、药物或精神疾病者(ADM)占40%。初级保健医务人员(PCP)在戒烟咨询中具有重要作用,但该人群中的戒烟有效性尚不清楚。本研究评价在ADM 吸烟者中PCP进行戒烟咨询的有效性。
   方法:于2009-2010年采用Probit回归对1356名在“1998-1999年社区跟踪研究”中报告吸烟的成人进行分析,检验过去1年PCP戒烟咨询和成功戒断之间的相关性,这些吸烟者在后续的“2000-2001年医疗保健社区调查研究”中在过去1年内进行过PCP咨询。将过去1年PCP锻炼咨询作为过去1年PCP戒烟咨询的辅助变量,解释吸烟状态和接受戒烟咨询之间潜在的隐藏偏差。
   结果:有和无ADM疾病的吸烟者同样可能接受戒烟咨询(72.9% vs. 69.9%)。采用辅助变量法,通过PCP戒烟咨询与两组参与者戒烟显著相关(p < .01)。无戒烟咨询的参与者,预测的戒烟可能性,在无ADM疾病的参与者中为6.0%,在患ADM疾病的参与者中为10.5%。对于进行戒烟咨询的参与者,预测的戒烟可能性,在无ADM疾病的参与者中为34.9%,在患ADM疾病的参与者中为31.3%。
   结论:本研究显示,PCP能帮助有ADM疾病的吸烟者成功戒烟。这些吸烟者应该作为戒烟咨询的目标人群,以降低烟草带来的健康负担。

                                                                 (陈欣 审校)
                          
Nicotine Tob Res. 2011 Aug 22. [Epub ahead of print]
 
 

Primary Care Providers Advising Smokers to Quit: Comparing Effectiveness Between Those With and Without Alcohol, Drug, or Mental Disorders.

Ong MK, Zhou Q, Sung HY.

Source
Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles, 911 Broxton Avenue, First Floor, Los Angeles, CA 90024, USA. michael.ong@ucla.edu.

Abstract

INTRODUCTION: Individuals with alcohol, drug, or mental (ADM) disorders combined make up over 40% of all smokers in the U.S. Primary care providers (PCPs) play an important role in smoking cessation counseling, but their effectiveness with this population is unclear. This study evaluated the effectiveness of PCP smoking cessation counseling for smokers with ADM disorders.
METHODS: Probit regressions conducted in 2009-2010 examined the relationship between past year PCP smoking cessation counseling and successful quitting among 1,356 adults who reported smoking in the 1998-1999 Community Tracking Study survey and who reported seeing a PCP in the past year in the follow-up 2000-2001 Healthcare for Communities Survey. Past year PCP exercise counseling was used as an instrumental variable for past year PCP smoking cessation counseling to account for potential hidden bias between smoking status and receipt of smoking cessation counseling.
RESULTS: Smokers with and without ADM disorders were equally likely to receive smoking cessation counseling (72.9% vs. 69.9%). Using the instrumental variable approach, smoking cessation counseling by PCPs was significantly associated (p < .01) with quitting among both groups. Predicted probabilities of quitting without smoking cessation counseling were 6.0% for smokers with ADM disorders and 10.5% for smokers without ADM disorders. Predicted probabilities of quitting with smoking cessation counseling were 31.3% for smokers with ADM disorders and 34.9% for smokers without ADM disorders.
CONCLUSIONS: This study shows that PCPs can help smokers with ADM disorders successfully quit. These smokers should be targeted for smoking cessation counseling to reduce the health burden of tobacco.

Nicotine Tob Res. 2011 Aug 22. [Epub ahead of print]


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