Kawai Haruyuki, Shibayama Takuo, Tada Atsuhiko, Kawahara Shin, Soda Ryo, Takahashi Kiyoshi
Department of Internal Medicine, Okayama Saiseikai General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2005 Mar;43(3):144-9.
We identified the initial diagnostic factors that influenced the success or failure of patients trying to quit smoking using nicotine patches. In a smoking cessation treatment program at a smoking clinic, each patient received about 30 minutes of counseling in the initial diagnosis, then undertook a 2-month smoking cessation program using the nicotine patch. Between March 2000 and June 2002, 45 patients consulted the clinic. We attempted to monitor 30 patients whose smoking status we were able to observe. The patient group consisted of 5 women and 25 men who ranged in age from 22 to 75 years (mean age, 49 years). A follow-up survey by telephone was carried out (median follow-up time: 184.5 days). Actuarial smoking cessation curves were calculated according to the Kaplan-Meier method, and comparisons were made with the generalized Wilcoxon test. The Cox proportional hazards model was used for multivariate analysis. At the end of the two-month period, 86.3% of the patients had not resumed smoking; at one year after the program began, 56.7% had not resumed smoking. In the univariate analysis, the significant factors in the failure to maintain cessation were: a smoking start age of under 18 years, no affective disease, and smoking the day's first cigarette within 5 minutes after waking up (p < 0.05). In the multivariate analysis, the independent predictive factors in failure were: a starting smoking age of under 18 years and no affective disease (p < 0.05). Thus, patients who started smoking at a young age or who were free of affective disease were more likely to fail in their attempt to quit smoking. Attention to these factors is necessary as part of the guidance provided for smoking cessation.
我们确定了影响使用尼古丁贴片戒烟的患者成败的初始诊断因素。在一家戒烟诊所的戒烟治疗项目中，每位患者在初始诊断时接受约30分钟的咨询，然后使用尼古丁贴片进行为期2个月的戒烟项目。在2000年3月至2002年6月期间，45名患者到该诊所咨询。我们试图对30名吸烟状况可观察的患者进行监测。患者组包括5名女性和25名男性，年龄在22岁至75岁之间（平均年龄49岁）。通过电话进行了随访调查（中位随访时间：184.5天）。根据Kaplan-Meier方法计算精算戒烟曲线，并使用广义Wilcoxon检验进行比较。使用Cox比例风险模型进行多变量分析。在两个月结束时，86.3%的患者没有恢复吸烟；在项目开始一年后，56.7%的患者没有恢复吸烟。在单变量分析中，未能维持戒烟的显著因素是：开始吸烟年龄在18岁以下、没有情感疾病以及醒来后5分钟内吸当天的第一支烟（p<0.05）。在多变量分析中，失败的独立预测因素是：开始吸烟年龄在18岁以下和没有情感疾病（p<0.05）。因此，年轻时开始吸烟或没有情感疾病的患者戒烟尝试更有可能失败。作为戒烟指导的一部分，有必要关注这些因素。
