Lucksted A, Dixon L B, Sembly J B
Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA.
Psychiatr Serv. 2000 Dec;51(12):1544-8. doi: 10.1176/appi.ps.51.12.1544.
The study explored the perceived advantages and disadvantages of tobacco smoking and quitting among clients in psychosocial rehabilitation programs. Deeper understanding of such perceptions may be useful in creating maximally effective cessation and prevention interventions for this population.
Five focus groups of six to ten persons were formed with a total of 40 clients from two programs. Participants included smokers and nonsmokers-including former smokers and smokers who explicitly were not interested in quitting smoking. The semistructured, researcher-facilitated discussions covered pros and cons of smoking and not smoking, barriers to and facilitators of abstinence, and other issues. Audiotapes of the group discussions were transcribed and analyzed qualitatively.
Participants emphasized their reasons for smoking, reasons for quitting or wanting to quit, views on smoking-related health concerns, perceived social costs and benefits of smoking, and strategies for quitting and maintaining abstinence. Many similarities between the focus groups' views and those of the general population were noted, along with some issues that are specific to having a mental illness or attending a psychosocial rehabilitation program, such as coping with psychiatric symptoms and limited access to information, support, and other coping methods. All of these views influenced participants' motivations and perceived readiness to smoke or to abstain, or to struggle between the two alternatives.
Issues and needs that are specific to smokers who use mental health services must be addressed in the development of smoking prevention and cessation interventions in psychosocial rehabilitation and other mental health programs. The importance of messages about smoking that clients receive from program rules, program staff, and other sources is highlighted, as is the possibility that the regulation of affect and stress provided by tobacco use is especially important for people experiencing psychiatric symptoms.
本研究探讨了心理社会康复项目中的服务对象对吸烟及戒烟的利弊看法。深入了解这些看法可能有助于为该人群制定最有效的戒烟和预防干预措施。
来自两个项目的40名服务对象组成了5个焦点小组，每组6至10人。参与者包括吸烟者和非吸烟者，其中非吸烟者包括曾经吸烟者以及明确表示对戒烟不感兴趣的吸烟者。由研究人员引导的半结构化讨论涵盖了吸烟与不吸烟的利弊、戒烟的障碍与促进因素以及其他问题。小组讨论的录音被转录并进行定性分析。
参与者强调了他们吸烟的原因、戒烟或想要戒烟的原因、对吸烟相关健康问题的看法、对吸烟的社会成本和益处的认知，以及戒烟和保持戒烟状态的策略。研究发现焦点小组的观点与普通人群的观点有许多相似之处，同时也存在一些与患有精神疾病或参加心理社会康复项目相关的特定问题，例如应对精神症状以及获取信息、支持和其他应对方法的机会有限。所有这些观点都影响了参与者吸烟或戒烟的动机以及他们对吸烟或戒烟的意愿，或者在这两种选择之间挣扎的意愿。
在心理社会康复及其他心理健康项目中制定吸烟预防和戒烟干预措施时，必须解决使用心理健康服务的吸烟者所特有的问题和需求。强调了服务对象从项目规则、项目工作人员和其他来源收到的关于吸烟的信息的重要性，以及烟草使用所提供的情绪调节和压力缓解对经历精神症状的人可能尤为重要的可能性。
