Häuser Winfried, Schaal Nicole, Schiedermaier Peter, Görge Günter
Medizinische Klinik I (Gastroenterologie, Hepatologie, Stoffwechsel- und Infektionskrankheiten, Psychosomatik), Klinikum Saarbrücken gGmbH.
Psychother Psychosom Med Psychol. 2002 Jul;52(7):302-5. doi: 10.1055/s-2002-32861.
Tobacco cessation interventions are cost effective therapies in the secondary prevention of coronary heart and chronic obstructive pulmonary diseases which however are rarely used in Germany. Therefore the frequency and the degree of tobacco addiction, the previous treatment of tobacco abuse and the present motivation for smoking cessation of all patients treated within one month in a department of cardiology/pneumology were assessed. 255 of 264 admitted patients (39 % women, 61 % men, mean age 65 +/- 13 years) were evaluated. 33/255 patients (13 %) were smokers, 110/255 (43 %) were former smokers and 112/255 (44 %) patients never smoked. 25/33 (76 %) of the smoking patients met the criteria of nicotine dependence and 8/33 (24 %) the criteria of nicotine abuse of the DSM-IV. According to the Fagerström-Nicotine-Dependence-Test (FTND) 6/33 (18 %) smokers were low nicotine dependent (FTND 0 - 3 points), 24/33 (73 %) smokers were moderate nicotine dependent (FTND 4 - 7 points) and 3/33 (9 %) smokers were high nicotine dependent (FTND 8 - 10 points). 8/33 patients (24 %) agreed in, 8/33 patients (24 %) were undecisive with regard to and 17/33 (52 %) smokers refused smoking cessation treatment during their hospital stay. There was no difference in the FTND between patients willing to stop smoking and patients which were undecisive or unwilling to stop smoking. 27/33 (82 %) patients were pointed to the existence of a tobacco induced disease by physicians, 14/33 (42 %) had received informations about smoking cessation, 7/33 (21 %) had received nicotine substitution and 3/33 (9 %) other treatments (smoking cessation training, acupuncture) in the past. Motivation for and realization of smoking cessation interventions should be considered as important tasks of the psychosomatic or addiction primary care in private practices and hospitals.
戒烟干预措施在冠心病和慢性阻塞性肺疾病的二级预防中是具有成本效益的治疗方法，但在德国却很少使用。因此，我们评估了某心内科/呼吸内科在一个月内治疗的所有患者的烟草成瘾频率和程度、既往烟草滥用治疗情况以及目前的戒烟动机。对264名入院患者中的255名（39%为女性，61%为男性，平均年龄65±13岁）进行了评估。255名患者中，33名（13%）为吸烟者，110名（43%）为既往吸烟者，112名（44%）患者从不吸烟。33名吸烟患者中，25名（76%）符合尼古丁依赖标准，8名（24%）符合DSM-IV的尼古丁滥用标准。根据法格斯特罗姆尼古丁依赖测试（FTND），33名吸烟者中，6名（18%）为低尼古丁依赖（FTND 0 - 3分），24名（73%）为中度尼古丁依赖（FTND 4 - 7分），3名（9%）为高尼古丁依赖（FTND 8 - 10分）。33名患者中，8名（24%）同意戒烟，8名（24%）在住院期间对戒烟犹豫不决，17名（52%）吸烟者拒绝戒烟治疗。愿意戒烟的患者与犹豫不决或不愿意戒烟的患者在FTND上没有差异。33名患者中，27名（82%）被医生指出存在烟草诱发疾病，14名（42%）曾收到过戒烟信息，7名（21%）曾接受过尼古丁替代治疗，3名（9%）曾接受过其他治疗（戒烟培训、针灸）。戒烟干预措施的动机和实施应被视为私人诊所和医院心身或成瘾初级保健的重要任务。
