Cropsey Karen L, Kristeller Jean L
Department of Psychology, Indiana State University, Terre Haute, IN, USA.
Addict Behav. 2003 Aug;28(6):1081-93. doi: 10.1016/s0306-4603(02)00230-7.
Motivational factors and initial stages of change (precontemplation vs. contemplation) were investigated among incarcerated male smokers forced to quit smoking due to a statewide smoking ban. All smokers completed a baseline questionnaire, which assessed smoking history, nicotine dependence [Fagerstrom Test for Nicotine Dependence (FTND)], nicotine withdrawal [Hughes-Hatsukami Withdrawal Scale (HHWS)], and depression [Center for Epidemiological Studies on Depression (CES-D)]. These measures were given again 4 days (Time 2) and 1 month (Time 3) following the smoking ban. At baseline (n=314), 31.2% of smokers were contemplating quitting within 6 months (contemplators), while the majority of smokers (68.8%) indicated they had not considered quitting (precontemplators). Contemplators at Time 2 reported more success with quitting smoking than precontemplators, although this was no longer significant by Time 3. Logistic regression was used to determine the probability of determining initial stages of change based on demographic and smoking history variables. Smokers in precontemplation scored higher on the FTND, reported less agreement with the smoking policy at baseline, reported more difficulty with their previous quit attempts, and reported increased smoking in anticipation of the smoking ban. The risk of being a precontemplator was over twice as high for smokers who reported increasing the amount they smoked prior to the smoking ban (odds ratio=2.42). Overall, this model correctly classified 70.7% of the smokers. This suggests that initial stages of change plays an important role in eventual quitting even in environments in which smoking has been recently prohibited.
在因全州范围内禁烟而被迫戒烟的被监禁男性吸烟者中，研究了动机因素和改变的初始阶段（未考虑戒烟阶段与考虑戒烟阶段）。所有吸烟者都完成了一份基线调查问卷，该问卷评估了吸烟史、尼古丁依赖程度[尼古丁依赖Fagerstrom测试（FTND）]、尼古丁戒断反应[休斯-哈茨卡米戒断量表（HHWS）]以及抑郁程度[流行病学研究中心抑郁量表（CES-D）]。在禁烟令颁布后的4天（时间2）和1个月（时间3）再次进行这些测量。在基线时（n = 314），31.2%的吸烟者打算在6个月内戒烟（考虑戒烟者），而大多数吸烟者（68.8%）表示他们尚未考虑戒烟（未考虑戒烟者）。时间2时，考虑戒烟者报告的戒烟成功率高于未考虑戒烟者，尽管到时间3时这种差异不再显著。使用逻辑回归来确定基于人口统计学和吸烟史变量判断改变初始阶段的概率。未考虑戒烟的吸烟者在FTND上得分更高，在基线时对吸烟政策的认同度更低，报告其之前的戒烟尝试更困难，并且表示由于预期禁烟令而增加了吸烟量。对于那些报告在禁烟令颁布前增加吸烟量的吸烟者，处于未考虑戒烟阶段的风险高出两倍多（优势比 = 2.42）。总体而言，该模型正确分类了70.7%的吸烟者。这表明，即使在最近禁止吸烟的环境中，改变的初始阶段对最终戒烟也起着重要作用。
