Takahashi Kosuke, Saso Harumi, Saka Hideo, Saso Harumi, Iwata Masamitsu, Hashimoto Izumi, Naito Mariko, Hamajima Nobuyuki
Department of Medicine, Division of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Asian Pac J Cancer Prev. 2006 Jan-Mar;7(1):131-5.
Asking smokers about their smoking status, followed by advice to quit smoking, assessing the intention to quit, assistance with cessation, and arrange of follow-up (5A) is recommended for induction of smoking cessation. To obtain preliminary data on effects of "5A" , we investigated the smoking cessation rate with two modes in the phase I: 1) self-administered questionnaire and 2) doctor's interview at respiratory disease clinics of three general hospitals in Japan, and another mode in phase II: 3) doctor's interview with an additional pamphlet at one of the three hospitals. The interviews for smokers were conducted by doctors in charge of treatment. Subject smoking habits were followed up by postal surveys three months after the enrollment. In phase I, 359 outpatients were recruited and 189 smokers responded, among whom 27 patients (7.5% of 359 outpatients) had quit smoking at the three months after the enrollment. The cessation rate of the self-administered questionnaire group (8.4% of 238 smokers) did not differ significantly from that of doctors' interview group (5.8% of 121 smokers). Age and intention to quit at enrollment were found to be independent predictors of smoking cessation. Patients aged 50 years or older (odds ratio=5.05, 95% confidence interval 1.89-13.54), and participants with an intention to quit (odds ratio=6.78, 95% confidence interval 2.66-17.30) were more likely to be successful in quitting. In phase II, another 212 smokers of one hospital were interviewed by doctors in charge and provided with an additional pamphlet describing how to practice to dislike smoking. No significant difference in the cessation rate was observed between phase I and phase II (5.8% vs. 8.0%). In conclusion, there were no differences among the three modes of "5A", but 7.7% of the 571 outpatients visiting respiratory divisions quit smoking with this simple "5A". The findings may indicate that this simple practice at clinics is useful for smoking cessation strategy, although randomized trials are now required.
建议询问吸烟者的吸烟状况，随后给予戒烟建议、评估戒烟意愿、提供戒烟帮助并安排随访（5A法）以促使戒烟。为获取关于“5A法”效果的初步数据，我们在第一阶段采用两种方式调查戒烟率：1）自行填写问卷；2）在日本三家综合医院的呼吸科门诊由医生进行访谈；在第二阶段采用另一种方式：3）在三家医院之一由医生进行访谈并额外提供一份宣传册。对吸烟者的访谈由负责治疗的医生进行。通过邮寄调查问卷在入组三个月后对受试者的吸烟习惯进行随访。在第一阶段，招募了359名门诊患者，189名吸烟者作出回应，其中27名患者（占359名门诊患者的7.5%）在入组三个月后戒烟。自行填写问卷组的戒烟率（占238名吸烟者的8.4%）与医生访谈组（占121名吸烟者的5.8%）无显著差异。发现年龄和入组时的戒烟意愿是戒烟的独立预测因素。50岁及以上的患者（比值比=5.05，95%置信区间1.89 - 13.54）以及有戒烟意愿的参与者（比值比=6.78，95%置信区间2.66 - 17.30）更有可能成功戒烟。在第二阶段，另一家医院的212名吸烟者由负责医生进行访谈，并额外提供一份描述如何养成厌恶吸烟习惯的宣传册。第一阶段和第二阶段的戒烟率无显著差异（5.8%对8.0%）。总之，“5A法”的三种方式之间没有差异，但在呼吸科就诊的571名门诊患者中有7.7%通过这种简单的“5A法”戒烟。这些发现可能表明，尽管现在需要进行随机试验，但这种在诊所的简单做法对戒烟策略是有用的。
