Michalsen A, Richarz B, Reichardt H, Spahn G, Konietzko N, Dobos G J
Abt. für Innere Medizin V und Integrative Medizin, Kliniken Essen-Mitte, Germany.
Dtsch Med Wochenschr. 2002 Aug 23;127(34-35):1742-7. doi: 10.1055/s-2002-33544.
Smoking prevalence in Germany remains high instead of public information and education. Smoke free hospitals are propagated, but frequently the smoking prevalence in hospital staff is even higher than in the general population. The objectives of the study were to determine the prevalence of smoking amongst hospital employees in a German teaching hospital and subsequently to promote and optimise smoking cessation within controlled trial with additional evaluation of mindfulness based stress reduction, supported by a common workplace action.
A hospital survey was carried out by anonymous questionnaires. Participation in a physician-supervised smoking cessation program with nicotine replacement, brief intervention and, additionally, in a 20-hour stress reduction program over 8 weeks (group B) was offered to all smokers. Primary outcomes were abstinence rates at 3 months, secondary endpoints included abstinence rates at 6 months, cigarette consumption in smokers and expiratory CO-concentration.
Out of 345 employees 296 (86 %) revealed their smoking status, 140 were smokers (47,3 %). 116 of 140 smokers agreed with participation in a smoking cessation program. 53 subjects participated additionally in the stress reduction groups (Group B), 63 subjects wished no additional stress reduction (Group A). Abstinence rates at 3 and 6 months were 38,2 % and 29,7 % for all subjects. Participants with stress reduction showed non-significant higher abstinence rates (3 months: A: 35 % vs. B: 42 % and 6 months: A: 20 % vs. B: 41,2 %), a significant lower CO-concentration and a lower smoking intensity in recurrent smokers.
With a common work place action a substantial part of employees quits smoking. Thus, the study provides support for the active promotion of physician-supervised smoking cessation programs among hospital employees. Supportive mindfulness-based stress reduction may enhance smoking cessation, yet has to be further tested in larger randomised controlled trials.
尽管开展了公共宣传和教育活动,但德国的吸烟率仍然居高不下。无烟医院得到了推广,但医院工作人员的吸烟率往往甚至高于普通人群。本研究的目的是确定一家德国教学医院中医院员工的吸烟率,随后在一项对照试验中促进并优化戒烟,并对基于正念减压法进行额外评估,同时辅以一项常规的工作场所行动。
通过匿名问卷调查进行医院调查。向所有吸烟者提供参与由医生监督的戒烟计划的机会,该计划包括尼古丁替代疗法、简短干预,此外,还提供为期8周、共20小时的减压计划(B组)。主要结局指标是3个月时的戒烟率,次要终点包括6个月时的戒烟率、吸烟者的香烟消费量和呼气一氧化碳浓度。
在345名员工中,296名(86%)透露了他们的吸烟状况,其中140名是吸烟者(47.3%)。140名吸烟者中有116名同意参与戒烟计划。53名受试者额外参加了减压组(B组),63名受试者不希望进行额外的减压(A组)。所有受试者在3个月和6个月时的戒烟率分别为38.2%和29.7%。参加减压计划的参与者戒烟率略高但无显著差异(3个月时:A组为35%,B组为42%;6个月时:A组为20%,B组为41.2%),复吸者的一氧化碳浓度显著降低,吸烟强度也较低。
通过一项常规的工作场所行动,很大一部分员工成功戒烟。因此,本研究为在医院员工中积极推广由医生监督的戒烟计划提供了支持。基于正念的支持性减压可能会增强戒烟效果,但仍需在更大规模的随机对照试验中进一步验证。