Wiggers Louise C W, Oort Frans J, Peters Ron J G, Legemate Dink A, de Haes Hanneke C J M, Smets Ellen M A
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands.
Nicotine Tob Res. 2006 Aug;8(4):581-9. doi: 10.1080/14622200600790005.
The benefits of smoking cessation on patients' medical conditions are well documented. Cardiovascular patients who quit smoking significantly reduce their risk of a new event compared with those who continue smoking. Several studies have found that smoking is related to poor quality of life (QoL). In cardiovascular patients, however, less attention has been given to the effect of smoking cessation on patients' QoL. The present study examined the extent to which smoking cessation leads to changes in QoL in these patients within the first year of follow-up. Data were collected in the context of a randomized clinical trial. Smoking outpatients (N = 346) with atherosclerotic disease were included and received medical treatment. They were randomized to receive either nicotine replacement therapy (NRT) or NRT plus a behavioral intervention meant to promote smoking cessation. At baseline, sociodemographic and clinical characteristics were established. Generic and disease-specific QoL as well as smoking status were assessed at baseline and with three follow-up measurements. Multilevel modeling showed that generic and disease-specific QoL in atherosclerotic patients improved significantly within the first year of follow-up. No main differences were found between quitters and smokers in terms of improvement in QoL. In fact, some subgroups reported a poorer QoL after smoking cessation: More highly educated patients reported lower general QoL (p < .05), and patients suffering from coronary artery disease who had a low level of education (p < .01) and patients suffering from peripheral arterial disease who had low nicotine dependency (p < .01) reported lower disease-specific QoL. Atherosclerotic patients' QoL improved significantly but was not enhanced by smoking cessation activities.
戒烟对患者健康状况的益处已有充分记录。与继续吸烟的心血管疾病患者相比，戒烟的心血管疾病患者显著降低了发生新事件的风险。多项研究发现，吸烟与生活质量（QoL）较差有关。然而，在心血管疾病患者中，较少有人关注戒烟对患者生活质量的影响。本研究调查了在随访的第一年中，戒烟在多大程度上导致这些患者的生活质量发生变化。数据是在一项随机临床试验的背景下收集的。纳入了患有动脉粥样硬化疾病的吸烟门诊患者（N = 346）并给予药物治疗。他们被随机分配接受尼古丁替代疗法（NRT）或NRT加一种旨在促进戒烟的行为干预。在基线时，确定了社会人口统计学和临床特征。在基线以及三次随访测量时评估了一般生活质量和疾病特异性生活质量以及吸烟状况。多层次模型显示，动脉粥样硬化患者的一般生活质量和疾病特异性生活质量在随访的第一年内有显著改善。戒烟者和吸烟者在生活质量改善方面没有发现主要差异。事实上，一些亚组报告戒烟后生活质量较差：受教育程度较高者报告一般生活质量较低（p < 0.05），患有冠状动脉疾病且教育程度低的患者（p < 0.01）以及患有外周动脉疾病且尼古丁依赖程度低（p < 0.01）的患者报告疾病特异性生活质量较低。动脉粥样硬化患者的生活质量有显著改善，但戒烟活动并未增强这种改善。
