Sivarajan Froelicher Erika S, Miller Nancy Houston, Christopherson Dianne J, Martin Kirsten, Parker Kathleen M, Amonetti Marcy, Lin Zhen, Sohn Min, Benowitz Neal, Taylor C B, Bacchetti Peter
University of California at San Francisco, Department of Physiological Nursing, School of Nursing, San Francisco, CA 94143-0610, USA.
Circulation. 2004 Feb 10;109(5):587-93. doi: 10.1161/01.CIR.0000115310.36419.9E.
Although men hospitalized with cardiovascular disease (CVD) show high smoking-cessation rates, similar data for women are lacking. We tested the efficacy of smoking-cessation intervention in women hospitalized for CVD.
In this randomized controlled trial conducted from 1996 to 2001, 277 women diagnosed with CVD (mean age 61+/-10 years) were randomly assigned within 1 of 12 San Francisco Bay Area hospitals to a usual-care group (UG; n=135) or intervention group (IG; n=142). Baseline histories were obtained, and interviews to ascertain self-reported smoking status occurred at 6, 12, 24, and 30 months after hospitalization. The UG received strong physician's advice, a self-help pamphlet, and a list of community resources. The IG received strong physician's advice and a nurse-managed cognitive behavioral relapse-prevention intervention at bedside, with telephone contact at intervals after discharge. The groups were similar demographically and had smoked cigarettes for a median of 38 (IG) or 40 (UG) years. Time to resumption of continuous smoking was assessed by Kaplan-Meier analysis, and risk differences between groups were determined. Time smoke-free was significantly greater for the IG than the UG (P=0.038). Point prevalence for nonsmoking at the interviews was somewhat greater for the IG than the UG (P>0.15 at all times).
Cognitive behavioral intervention resulted in longer average times to resumption of smoking, but in these 2 groups of older women with limited social and financial resources, long-term success rates were similar. Systematic identification of smokers and even the brief intervention afforded the UG yielded a high smoking-cessation rate over time.
虽然因心血管疾病（CVD）住院的男性戒烟率较高，但缺乏女性的类似数据。我们测试了针对因CVD住院女性的戒烟干预效果。
在这项于1996年至2001年进行的随机对照试验中，277名被诊断为CVD的女性（平均年龄61±10岁）在旧金山湾区的12家医院中的1家内被随机分配至常规护理组（UG；n = 135）或干预组（IG；n = 142）。获取了基线病史，并在住院后6、12、24和30个月进行访谈以确定自我报告的吸烟状况。UG接受了医生的强烈建议、一本自助手册以及一份社区资源清单。IG接受了医生的强烈建议，并在床边接受了护士管理的认知行为复发预防干预，出院后定期进行电话联系。两组在人口统计学上相似，吸烟中位数为38年（IG）或40年（UG）。通过Kaplan-Meier分析评估恢复持续吸烟的时间，并确定组间风险差异。IG的无烟时间显著长于UG（P = 0.038）。在访谈时，IG的非吸烟点患病率略高于UG（在所有时间点P>0.15）。
认知行为干预导致恢复吸烟的平均时间更长，但在这两组社会和经济资源有限的老年女性中，长期成功率相似。随着时间的推移，对吸烟者进行系统识别，即使是UG所接受的简短干预也产生了较高的戒烟率。
