Rohsenow Damaris J, Colby Suzanne M, Martin Rosemarie A, Monti Peter M
Providence VA Medical Center/Brown University Medical School, RI, United States.
Addict Behav. 2005 May;30(4):629-41. doi: 10.1016/j.addbeh.2005.01.001.
Smoking and substance abuse co-occur at high rates and substance abusers are less likely to quit smoking than are smokers in general. Therefore, more information about the beliefs substance abusers have about the role of smoking in substance use and in recovery would be useful when designing interventions to impact smoking among substance abusing patients. The present study developed a Nicotine and Other Substance Interaction Expectancies Questionnaire (NOSIE) to investigate the expectancies held by substance abusers in treatment about the effects of smoking on substance use, the effects of substance use on smoking, smoking to cope with recovery, and receptivity to smoking cessation during substance abuse treatment. The 29 items were Likert-rated by 160 substance dependent patients in an inner-city residential substance abuse treatment program and participating in a larger study of smoking at this site. Four components were derived and reduced to a 20-item measure with good reliability. No differences by gender or age were found. On average, the patients reported that substance use almost always increases their smoking or urges to smoke but that smoking only increased substance use or urges about half of the time, that they use smoking to cope with urges to use substances about half of the time, and that they generally agreed that smoking cessation or treatment should be tried during substance abuse treatment and would not harm recovery efforts. Three of the scales correlated with smoking dependence while one scale correlated with drug use severity and heavy drinking days. The scale of receptivity to smoking cessation correlated significantly with measures of motivation and barriers and predicted 1-month smoking cessation outcomes. However, scale scores on smoking to cope with recovery did not significantly predict 3-month relapse to substance use. Implications for theory and clinical interventions with substance abusers who smoke were discussed.
吸烟与药物滥用同时出现的比例很高，而且药物滥用者比一般吸烟者更难戒烟。因此，在设计干预措施以影响药物滥用患者的吸烟行为时，了解更多药物滥用者对吸烟在药物使用及康复过程中所起作用的看法会很有帮助。本研究编制了一份尼古丁与其他物质相互作用预期问卷（NOSIE），以调查接受治疗的药物滥用者对吸烟对药物使用的影响、药物使用对吸烟的影响、通过吸烟来应对康复过程以及在药物滥用治疗期间对戒烟的接受程度的预期。29个项目由160名药物依赖患者进行李克特量表评分，这些患者来自市中心的一个住院药物滥用治疗项目，并参与了该场所一项关于吸烟的更大规模研究。问卷得出了四个分量表，并缩减为一个包含20个项目、具有良好信度的量表。未发现性别或年龄方面的差异。平均而言，患者报告称，药物使用几乎总是会增加他们的吸烟量或吸烟冲动，但吸烟仅在大约一半的时间里会增加药物使用或冲动，他们大约一半的时间会通过吸烟来应对使用药物的冲动，并且他们普遍认为在药物滥用治疗期间应尝试戒烟或接受治疗，这不会损害康复效果。其中三个分量表与吸烟依赖性相关，而一个分量表与药物使用严重程度和重度饮酒天数相关。对戒烟的接受程度分量表与动机和障碍的测量指标显著相关，并预测了1个月的戒烟结果。然而，通过吸烟来应对康复的分量表得分并未显著预测3个月后药物使用的复发情况。文中讨论了该研究结果对吸烟的药物滥用者的理论和临床干预的意义。
