Charité - Universitaetsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charitéplatz 1, Berlin, Germany.
Tob Control. 2009 Aug;18(4):283-93. doi: 10.1136/tc.2008.028753. Epub 2009 Jun 14.
Emergency department (ED) patients show high smoking rates. The effects of ED-initiated tobacco control (ETC) on 7-day abstinence at 12 months were investigated.
A randomised controlled intention-to-treat trial (trials registry no.: ISRCTN41527831) was conducted with 1044 patients in an urban ED. ETC consisted of on-site counselling plus up to four telephone booster sessions. Controls received usual care. Analysis was by logistic regression.
In all, 630 (60.7%) participants were males, the median age was 30 years (range 18-81) and the median smoking intensity was 15 (range 1-60) cigarettes per day. Overall, 580 study participants (55.6%) were unmotivated, 331 (31.7%) were ambivalent and 133 (12.7%) were motivated smokers. ETC (median time 30 (range 1-99) min) was administered to 472 (91.7% out of 515) randomised study participants. At follow-up, 685 study participants (65.6% of 1044) could be contacted. In the ETC group, 73 out of 515 (14.2%) in the ETC group were abstinent, whereas 60 out of 529 (11.3%) controls were abstinent (OR adjusted for age and gender = 1.31 (95% CI 0.91 to 1.89, p = 0.15). Stratified for motivation to change behaviour, the adjusted ORs for ETC versus usual care were OR = 1.00 (95% CI 0.57 to 1.76) in unmotivated smokers, respectively OR = 1.37 (95% CI 0.73 to 2.58) in ambivalent smokers and OR = 2.19 (95% CI 0.98 to 4.89) in motivated smokers, p for trend = 0.29.
ETC, in the form of on-site counselling with up to four telephone booster sessions, showed no overall effect on tobacco abstinence after 12 months. A non-significant trend for a better performance of ETC in more motivated smokers was observed.
急诊科（ED）患者的吸烟率较高。本研究旨在探讨 ED 启动的烟草控制（ETC）对 12 个月时 7 天戒烟的影响。
采用一项随机对照意向治疗试验（试验注册编号：ISRCTN41527831），纳入 1044 例城市 ED 患者。ETC 包括现场咨询以及最多 4 次电话随访。对照组接受常规护理。采用逻辑回归进行分析。
所有患者中，630 例（60.7%）为男性，中位年龄 30 岁（范围 18-81），中位吸烟强度为 15（范围 1-60）支/天。总体而言，580 例研究参与者（55.6%）无戒烟意愿，331 例（31.7%）有戒烟意愿但犹豫不决，133 例（12.7%）有戒烟意愿。ETC（中位时间 30 分钟（范围 1-99））共对 515 例随机研究参与者中的 472 例（91.7%）进行了治疗。随访时，1044 例患者中有 685 例（65.6%）可联系。ETC 组中，515 例患者中有 73 例（14.2%）戒烟，529 例对照组中有 60 例（11.3%）戒烟（年龄和性别校正后的 OR = 1.31（95%CI 0.91-1.89，p = 0.15））。按行为改变意愿分层，无戒烟意愿者的 ETC 与常规护理相比，校正后的 OR 值为 1.00（95%CI 0.57-1.76），有戒烟意愿但犹豫不决者为 1.37（95%CI 0.73-2.58），有戒烟意愿者为 2.19（95%CI 0.98-4.89），p 值趋势检验=0.29。
现场咨询加最多 4 次电话随访的 ETC 形式在 12 个月后对戒烟没有总体效果。观察到 ETC 在更有戒烟意愿的吸烟者中表现出非显著的更好趋势。
