Coleman Tim, Wynn Alison, Barrett Stephen, Wilson Andrew
Department of General Practice and Primary Health Care, Leicester Warwick Medical School, Leicester General Hospital Leicester, England.
Nicotine Tob Res. 2003 Apr;5(2):163-8. doi: 10.1080/1462220031000073261.
Nicotine replacement therapy (NRT) is an effective smoking cessation treatment, but little information is available about how primary care physicians use the therapy. We investigated the quality of UK general practitioners' (GPs') advice against smoking, including how frequently they recommend NRT to smokers. We compared the characteristics of smokers whom GPs recommended use NRT with smokers who did not receive GP recommendations. We conducted a cross-sectional survey of 3,525 adult patients attending 35 UK GPs over a 16-month period. Of those surveyed, 2,955 eligible patients (83.8%) completed preconsultation questionnaires, and 1,026 (34.7%) were regular smokers, with 927 (90.4%) of the regular smokers completing postconsultation questionnaires. Of those completing the questionnaires, 20.2% (95% CI, 17.7% to 22.9%) or 187 recalled discussion of smoking with their GPs and of these, 66.3% (95% CI, 60.1% to 74.1%) or 124 perceived that they had been given an unequivocal message to stop smoking. Although 60.4% of smokers (606 of 1,004) (95% CI, 57.3% to 63.3%) or smoked more than 10 cigarettes daily, only 17.6% (95% CI, 12.9% to 23.7%) or 33 of those recalling antismoking advice reported discussion of NRT. Accordingly, GPs discussed NRT with only a minority of smokers who might benefit from the therapy. Intending to give up smoking in the next 4 weeks was the only variable independently associated with smokers' recall of discussing NRT (OR=2.58 [95% CI 1.20% to 5.57%]). The study findings thus provide only limited information to support the notion that UK GPs recommend NRT in an evidence-based manner. Now that NRT is available by prescription from UK GPs, further research is needed to monitor whether this effective antismoking therapy is being prescribed appropriately.
尼古丁替代疗法（NRT）是一种有效的戒烟治疗方法，但关于基层医疗医生如何使用该疗法的信息却很少。我们调查了英国全科医生（GPs）戒烟建议的质量，包括他们向吸烟者推荐NRT的频率。我们比较了被全科医生推荐使用NRT的吸烟者与未收到全科医生推荐的吸烟者的特征。我们在16个月的时间里，对35位英国全科医生接诊的3525名成年患者进行了横断面调查。在接受调查的患者中，2955名符合条件的患者（83.8%）完成了咨询前问卷，1026名（34.7%）为经常吸烟者，其中927名（90.4%）经常吸烟者完成了咨询后问卷。在完成问卷的患者中，20.2%（95%CI，17.7%至22.9%）即187人回忆起与他们的全科医生讨论过吸烟问题，其中66.3%（95%CI，60.1%至74.1%）即124人认为他们收到了明确的戒烟信息。尽管60.4%的吸烟者（1004人中的606人）（95%CI，57.3%至63.3%）每天吸烟超过10支，但在回忆起反吸烟建议的人中，只有17.6%（95%CI，12.9%至23.7%）即33人报告讨论过NRT。因此，全科医生仅与少数可能从该疗法中受益的吸烟者讨论了NRT。打算在接下来4周内戒烟是与吸烟者回忆起讨论NRT唯一独立相关的变量（OR = 2.58 [95%CI 1.20%至5.57%]）。因此，该研究结果仅提供了有限的信息来支持英国全科医生以循证方式推荐NRT这一观点。鉴于在英国全科医生处可凭处方获得NRT，需要进一步研究以监测这种有效的反吸烟疗法是否得到了恰当的处方。
