Duncan C L, Cummings S R, Hudes E S, Zahnd E, Coates T J
Department of Medicine, University of California, San Francisco.
J Gen Intern Med. 1992 Jul-Aug;7(4):398-404. doi: 10.1007/BF02599155.
To describe why medical patients quit smoking and the methods they use.
Cross-sectional and prospective cohort design. Patient smokers were enrolled in a study of physician counseling about smoking. One year later, 2,581 of the patients were asked about quit attempts and methods used. Of those, 245 former smokers whose quitting had been biologically validated were interviewed about why and how they had quit.
Offices of internists and family practitioners in private practice and a health maintenance organization.
Consecutive sample of ambulatory patients who smoked.
Baseline questionnaires included demographic data, smoking history, and symptoms and diagnoses related to smoking. After one year, subjects were interviewed about smoking status and methods used in attempting to quit. Cessation was confirmed by biochemical testing. Those who had quit were asked about reasons for quitting. Seventy-seven percent of successful quitters gave health-related reasons for quitting and the quitters ranked "harmful to health" as the most important reason for quitting. In a multivariate analysis, those who had a college education, who had social pressures to quit, and who had greater confidence in being able to quit were more likely to have quit smoking one year later, while those who smoked their first cigarette within 15 minutes of awakening and who had more diagnoses related to smoking were less likely to have quit smoking one year later. Participation in a treatment program and having been counseled by a physician or nurse practitioner were positively related to successful quitting, while use of filters or mouthpieces was negatively related.
Concerns about health are the most common reason patients give for quitting, and addiction is the most important barrier to quitting. Education, social pressure, provider advice, and formal programs, but not over-the-counter devices, appear to increase the chances that smokers will quit.
描述医学患者戒烟的原因及其采用的方法。
横断面和前瞻性队列设计。吸烟患者参与了一项关于医生戒烟咨询的研究。一年后，对2581名患者进行了关于戒烟尝试和所用方法的询问。其中，对245名戒烟已得到生物学验证的 former smokers 就其戒烟原因及方式进行了访谈。
私人执业的内科医生和家庭医生办公室以及一个健康维护组织。
连续抽样的门诊吸烟患者。
基线调查问卷包括人口统计学数据、吸烟史以及与吸烟相关的症状和诊断。一年后，就吸烟状况和戒烟尝试所用方法对研究对象进行了访谈。通过生化检测确认戒烟情况。询问已戒烟者的戒烟原因。77%的成功戒烟者给出了与健康相关的戒烟原因，且这些戒烟者将“对健康有害”列为最重要的戒烟原因。在多变量分析中，接受过大学教育、有社会戒烟压力且对能够戒烟更有信心的人，一年后更有可能戒烟，而醒来后15分钟内就吸第一支烟且有更多与吸烟相关诊断的人，一年后戒烟的可能性较小。参与治疗项目以及接受医生或执业护士的咨询与成功戒烟呈正相关，而使用过滤嘴或烟嘴则呈负相关。
对健康的担忧是患者给出的最常见戒烟原因，而成瘾是戒烟的最重要障碍。教育、社会压力、提供者建议和正规项目，而非非处方设备，似乎会增加吸烟者戒烟的几率。
