Twardella Dorothee, Loew Michael, Rothenbacher Dietrich, Stegmaier Christa, Ziegler Hartwig, Brenner Hermann
German Center for Research on Ageing, Bergheimer Str. 20, D-69115 Heidelberg, Germany.
J Clin Epidemiol. 2006 Jan;59(1):82-9. doi: 10.1016/j.jclinepi.2005.05.003. Epub 2005 Oct 13.
We evaluated the impact of demographic factors, smoking patterns, and the occurrence of smoking-related diseases on smoking cessation, with a particular emphasis on the temporal relationship between diagnosis of smoking-related diseases and cessation.
A cohort was assembled of participants of a general health screening examination aged 50-74 years. Lifetime smoking habits and medical history were obtained by a self-administered questionnaire. In a retrospective cohort study approach, predictors of cessation among ever-smokers (n = 4,575) were identified using the extended proportional hazards model.
Male gender, late onset of smoking, and higher educational level were predictive of cessation. However, the by far strongest predictors of cessation were diagnoses of smoking-related diseases: relative cessation rates in the year of disease occurrence were 11.2 for myocardial infarction (95% confidence interval CI = 8.9-14.0), 7.2 for stroke (95% CI = 5.1-11.6), 2.5 for diabetes mellitus (95% CI = 1.6-4.0) and 4.8 for cancer (95% CI = 3.1-7.4) relative to years before diagnosis of the respective diseases.
Our results underline the key role of perceived detrimental effects of smoking for cessation. When smokers personally experience the health consequences of smoking, many permanently quit.
我们评估了人口统计学因素、吸烟模式以及吸烟相关疾病的发生对戒烟的影响，特别强调了吸烟相关疾病诊断与戒烟之间的时间关系。
选取了50 - 74岁参加一般健康筛查检查的参与者组成队列。通过自填问卷获取终生吸烟习惯和病史。采用回顾性队列研究方法，使用扩展比例风险模型确定曾经吸烟者（n = 4575）中戒烟的预测因素。
男性、吸烟开始较晚以及较高的教育水平是戒烟的预测因素。然而，迄今为止最强的戒烟预测因素是吸烟相关疾病的诊断：疾病发生当年相对于各自疾病诊断前几年的相对戒烟率，心肌梗死为11.2（95%置信区间CI = 8.9 - 14.0），中风为7.2（95%CI = 5.1 - 11.6），糖尿病为2.5（95%CI = 1.6 - 4.0），癌症为4.8（95%CI = 3.1 - 7.4）。
我们的结果强调了吸烟的感知有害影响对戒烟的关键作用。当吸烟者亲身经历吸烟对健康的影响时，许多人会永久戒烟。
