Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
J Behav Med. 2010 Jun;33(3):209-18. doi: 10.1007/s10865-010-9254-z. Epub 2010 Mar 4.
Disease diagnosis and poor quality of life has been suggested as a "teachable moment" that facilitates smoking cessation, yet many patients continue to smoke. One reason for this inconsistency may be the potential moderating role of depressed mood. This study prospectively examined the role of depressed mood on the relationship between physical quality of life (PQoL) and smoking cessation among medically ill smokers. We hypothesized that poorer PQoL will be associated with smoking cessation, but only among those with little to no depressed mood. Nurses delivered smoking cessation counseling to medically ill patients (N = 273) who continued to smoke despite past hospitalization. Participants were assessed at baseline and at 2, 6, and 12-months later. The interaction between PQoL and depressed mood significantly predicted 1) 7-day point prevalence abstinence rates at both 2 and 12 months post-treatment [2 months: adjusted OR = 1.005, 95%CI 1.001-1.009, p < .05; 12 months: adjusted OR = 1.007, 95%CI 1.002-1.011, p < .005)] and 2) continuous abstinence rates at both 2 and 12 months post-treatment [2 months: adjusted OR = 1.011, 95%CI 1.004-1.019, p < .005; 12 months: adjusted OR = 1.006, 95%CI 1.001-1.011, p < .05] even after controlling for important covariates. The odds of quitting smoking increased for every one-unit decrease in PQoL, but only among those with little to no depressed mood. Medically ill smokers with poor quality of life may need more intensive smoking cessation interventions that include mood management to help them quit smoking.
疾病诊断和生活质量差被认为是促进戒烟的“教育时刻”，但许多患者仍继续吸烟。造成这种不一致的一个原因可能是抑郁情绪的潜在调节作用。这项前瞻性研究考察了抑郁情绪对患有躯体疾病的吸烟者的生理生活质量（PQoL）与戒烟之间关系的调节作用。我们假设，较差的 PQoL 与戒烟有关，但仅在抑郁情绪较少或没有的患者中。护士向继续吸烟的患有躯体疾病的患者（N=273）提供戒烟咨询。参与者在基线和治疗后 2、6 和 12 个月进行评估。PQoL 和抑郁情绪之间的交互作用显著预测了 1）治疗后 2 个月和 12 个月时 7 天点流行率的戒烟率[2 个月：调整后的优势比（OR）=1.005，95%可信区间（CI）为 1.001-1.009，p<0.05；12 个月：调整后的 OR=1.007，95%CI 为 1.002-1.011，p<0.005]和 2）治疗后 2 个月和 12 个月时的连续戒烟率[2 个月：调整后的 OR=1.011，95%CI 为 1.004-1.019，p<0.005；12 个月：调整后的 OR=1.006，95%CI 为 1.001-1.011，p<0.05]，即使在控制了重要的协变量后也是如此。PQoL 每降低一个单位，戒烟的可能性就会增加，但仅在抑郁情绪较少或没有的患者中。生活质量差的患有躯体疾病的吸烟者可能需要更强化的戒烟干预措施，包括情绪管理，以帮助他们戒烟。
