Abdullah Abu Saleh M, Lam Tai-Hing, Chan Steve K K, Leung Gabriel M, Chi Iris, Ho Winnie W N, Chan Sophia S C
Department of Community Medicine, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, PR China.
BMC Geriatr. 2008 Oct 6;8:25. doi: 10.1186/1471-2318-8-25.
Different smoking cessation programmes have been developed in the last decade but utilization by the elderly is low. We evaluated a pilot mobile smoking cessation service for the Chinese elderly in Hong Kong and identified predictors of quitting.
The Mobile Smoking Cessation Programme (MSCP) targeted elderly smokers (aged 60 or above) and provided service in a place that was convenient to the elderly. Trained counsellors provided individual counselling and 4 week's free supply of nicotine replacement therapy (NRT). Follow up was arranged at 1 month by face-to-face and at 3 and 6 months by telephone plus urinary cotinine validation. A structured record sheet was used for data collection. The service was evaluated in terms of process, outcome and cost.
102 governmental and non-governmental social service units and private residential homes for the elderly participated in the MSCP. We held 90 health talks with 3266 elderly (1140 smokers and 2126 non-smokers) attended. Of the 1140 smokers, 365 (32%) received intensive smoking cessation service. By intention-to-treat, the validated 7 day point prevalence quit rate was 20.3% (95% confidence interval: 16.2%-24.8%). Smoking less than 11 cigarettes per day and being adherent to NRT for 4 weeks or more were significant predictors of quitting. The average cost per contact was US$54 (smokers only); per smoker with counselling: US$168; per self-reported quitter: US$594; and per cotinine validated quitter: US$827.
This mobile smoking cessation programme was acceptable to elderly Chinese smokers, with quit rate comparable to other comprehensive programmes in the West. A mobile clinic is a promising model to reach the elderly and probably other hard to reach smokers.
在过去十年中已开发出不同的戒烟项目，但老年人对其利用率较低。我们评估了一项针对香港中国老年人的试点移动戒烟服务，并确定了戒烟的预测因素。
移动戒烟项目（MSCP）针对老年吸烟者（60岁及以上），并在方便老年人的场所提供服务。经过培训的咨询师提供个体咨询以及为期4周的免费尼古丁替代疗法（NRT）。在1个月时安排面对面随访，在3个月和6个月时通过电话随访并进行尿可替宁验证。使用结构化记录表进行数据收集。从过程、结果和成本方面对该服务进行评估。
102个政府和非政府社会服务单位以及私立老人院舍参与了MSCP。我们举办了90场健康讲座，3266名老年人（1140名吸烟者和2126名非吸烟者）参加。在1140名吸烟者中，365名（32%）接受了强化戒烟服务。按照意向性分析，经验证的7天时点患病率戒烟率为20.3%（95%置信区间：16.2%-24.8%）。每天吸烟少于11支以及坚持使用NRT 4周或更长时间是戒烟的显著预测因素。每次接触的平均成本为54美元（仅针对吸烟者）；每位接受咨询的吸烟者：168美元；每位自我报告的戒烟者：594美元；以及每位经尿可替宁验证的戒烟者：827美元。
这个移动戒烟项目为中国老年吸烟者所接受，戒烟率与西方其他综合项目相当。移动诊所是接触老年人以及可能其他难以接触到的吸烟者的一个有前景的模式。
