全科医疗机构中的不同简单戒烟干预措施的戒烟效果预测因素和调节因素
2010/02/03
目的：在采用两项不同的简单戒烟干预措施的吸烟者中研究人口统计学、健康及吸烟相关性戒烟效果的预测因素及调节因素。
方法：数据来自于半随机对照试验，该试验旨在评估电脑定制信件和医生建议的戒烟效果。从34个全科医疗机构中选取1499名每日吸烟的吸烟者。在第12、18及24个月时对吸烟者的戒烟情况进行评价。采用广义估计方程分析持续6个月的戒断与潜在预测因素和调节因素之间的关系。
结果：女性吸烟者(OR=1.49, 95% CI=1.01-2.19)、受教育程度较高(OR=1.82, 95% CI=1.18-2.82)、打算戒烟(OR=1.66, 95% CI=1.16-2.38)及戒烟自我效能感(OR=1.30, 95% CI=1.03-1.64)与戒烟状态呈正相关，而尼古丁依赖(OR=0.84, 95% CI=0.76-0.94)和存在吸烟同伴(OR=0.60, 95% CI=0.42-0.85)与戒烟状态呈负相关。与单纯评价相比，不打算戒烟及下岗的吸烟者，医生建议对戒烟的效果较差。
结论：可以根据吸烟者的人口统计学及吸烟相关变量来采取最佳戒烟措施。
应用价值：结果表明，在全科医疗机构中，电脑定制信件比医生建议更便于运用。
（刘国梁 审校）
Patient Educ Couns. 2010 Jan;78(1):57-64. Epub 2009 Aug 5.
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.
Ernst-Moritz-Arndt-University Greifswald, Institute of Epidemiology and Social Medicine, Greifswald, Germany.
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.
Haug S, et al. Patient Educ Couns. 2010 Jan;78(1):57-64. Epub 2009 Aug 5.
方法：数据来自于半随机对照试验，该试验旨在评估电脑定制信件和医生建议的戒烟效果。从34个全科医疗机构中选取1499名每日吸烟的吸烟者。在第12、18及24个月时对吸烟者的戒烟情况进行评价。采用广义估计方程分析持续6个月的戒断与潜在预测因素和调节因素之间的关系。
结果：女性吸烟者(OR=1.49, 95% CI=1.01-2.19)、受教育程度较高(OR=1.82, 95% CI=1.18-2.82)、打算戒烟(OR=1.66, 95% CI=1.16-2.38)及戒烟自我效能感(OR=1.30, 95% CI=1.03-1.64)与戒烟状态呈正相关，而尼古丁依赖(OR=0.84, 95% CI=0.76-0.94)和存在吸烟同伴(OR=0.60, 95% CI=0.42-0.85)与戒烟状态呈负相关。与单纯评价相比，不打算戒烟及下岗的吸烟者，医生建议对戒烟的效果较差。
结论：可以根据吸烟者的人口统计学及吸烟相关变量来采取最佳戒烟措施。
应用价值：结果表明，在全科医疗机构中，电脑定制信件比医生建议更便于运用。
（刘国梁 审校）
Patient Educ Couns. 2010 Jan;78(1):57-64. Epub 2009 Aug 5.
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.
Ernst-Moritz-Arndt-University Greifswald, Institute of Epidemiology and Social Medicine, Greifswald, Germany.
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.
Haug S, et al. Patient Educ Couns. 2010 Jan;78(1):57-64. Epub 2009 Aug 5.
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影响戒烟的流行病学因素：罗马全国卫生系统治疗服务的一项回顾性研究
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法国职员和体力劳动者的工作条件、工作不满意和吸烟行为
