Rohrbaugh M J, Shoham V, Trost S, Muramoto M, Cate R M, Leischow S
Family Research Laboratory, Department of Psychology, University of Arizona, Tucson, AZ 85721-0068, USA.
Fam Process. 2001 Spring;40(1):15-31. doi: 10.1111/j.1545-5300.2001.4010100015.x.
Smoking is North America's leading cause of preventable morbidity and mortality. Although effective cessation treatments exist, their overall effect is modest, and they rarely reach the high-risk, health-compromised smokers who need them most. Surprisingly, despite evidence that marital relationship variables predict the success of cessation efforts, family systems ideas have had little impact on current intervention research. We review and critique the cessation literature from a systemic viewpoint, illustrate two couple-interaction patterns relevant to the maintenance of high-risk smoking, and outline a family-consultation (FAMCON) intervention for couples in which at least one partner continues to smoke despite having heart or lung disease. Taking into account ironic processes and symptom-system fit, FAMCON focuses on the immediate social context of smoking, aiming to interrupt well-intentioned "solutions" that ironically feed back to keep smoking going, and to help clients realign important relationships in ways not organized around tobacco usage. Currently in its pilot-testing phase, FAMCON is an adjunctive, complementary approach designed to include collaboration with primary-care physicians and to make smokers more amenable to other, evidence-based cessation strategies.
吸烟是北美可预防发病和死亡的首要原因。尽管存在有效的戒烟治疗方法，但其总体效果并不显著，而且很少能惠及最需要这些治疗的高风险、健康受损的吸烟者。令人惊讶的是，尽管有证据表明婚姻关系变量能预测戒烟努力的成功与否，但家庭系统观念对当前的干预研究影响甚微。我们从系统的角度审视和批判了戒烟文献，阐述了与维持高风险吸烟行为相关的两种夫妻互动模式，并概述了一种针对夫妻的家庭咨询（FAMCON）干预措施，其中至少有一方伴侣尽管患有心脏病或肺病仍继续吸烟。考虑到反讽过程和症状 - 系统适配性，FAMCON关注吸烟的直接社会背景，旨在打断那些好心却反而促使吸烟行为持续的“解决方案”，并帮助客户以不围绕烟草使用来组织的方式重新调整重要关系。目前FAMCON正处于试点测试阶段，它是一种辅助性、补充性的方法，旨在与初级保健医生合作，并使吸烟者更易于接受其他基于证据的戒烟策略。
