Hasuo Seiko, Tanaka Hideo, Oshima Akira
Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases.
Nihon Koshu Eisei Zasshi. 2004 Jun;51(6):403-12.
This randomized controlled trial assessed the efficacy of a smoking relapse prevention program featuring 3 postdischarge telephone contacts with subjects who had quit smoking on hospitalization.
Patients were randomly assigned to public health nurse-mediated behaviorally oriented in-patient counseling focused on relapse prevention (control group, n = 49), or the same inpatient counseling with postdischarge telephone contacts at 7, 21 and 42 days after discharge (intervention group, n = 57). The main outcome measure, smoking cessation rate, was obtained from self-reports at 3, 6 and 12 months after discharge. Smoking cessation at 12 months after discharge was confirmed by urinary nicotine concentration.
At 3, 6 and 12 months smoking cessation rates were 83%, 63% and 56% for the intervention group, and 76%, 65% and 51% for control group. After adjustment for sex, age, having any complication, number of family members, smoking status on admission, strength of nicotine dependence and self confidence to quit smoking, the odds ratio of cessation among the intervention group were 1.46 (95% confidence interval (CI): 0.48-4.47), 0.82 (95% CI: 0.31-2.17) and 0.99 (95% CI: 0.40-2.45) at 3, 6 and 12 months after discharge, respectively.
This program had limited efficacy to maintain postdischarge smoking abstinence. We should re-consider the modality of smoking cessation program for relapse prevention among hospitalized patients.
本随机对照试验评估了一项戒烟预防复发计划的效果,该计划包括对住院期间戒烟的受试者进行3次出院后电话随访。
患者被随机分配至接受由公共卫生护士介导的、以行为为导向的住院患者戒烟预防咨询(对照组,n = 49),或接受相同的住院咨询,并在出院后7天、21天和42天进行出院后电话随访(干预组,n = 57)。主要结局指标为戒烟率,通过出院后3个月、6个月和12个月的自我报告获得。出院后12个月的戒烟情况通过尿中尼古丁浓度进行确认。
干预组在出院后3个月、6个月和12个月的戒烟率分别为83%、63%和56%,对照组分别为76%、65%和51%。在对性别、年龄、是否有并发症、家庭成员数量、入院时吸烟状况、尼古丁依赖强度和戒烟自信心进行调整后,干预组在出院后3个月、6个月和12个月戒烟的优势比分别为1.46(95%置信区间(CI):0.48 - 4.47)、0.82(95% CI:0.31 - 2.17)和0.99(95% CI:0.40 - 2.45)。
该计划在维持出院后戒烟方面效果有限。我们应重新考虑针对住院患者预防复发的戒烟计划模式。