Mongan Institute for Health Policy and Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Boston, MA 02114, USA.
Am J Prev Med. 2011 Mar;40(3):286-94. doi: 10.1016/j.amepre.2010.11.016.
Contextual variables often predict long-term abstinence, but little is known about how these variables exert their effects. These variables could influence abstinence by affecting the ability to quit at all, or by altering risk of lapsing, or progressing from a lapse to relapse.
To examine the effect of common predictors of smoking-cessation failure on smoking-cessation processes.
The current study (N=1504, 58% female, 84% Caucasian; recruited from January 2005 to June 2007; data analyzed in 2009) uses the approach advocated by Shiffman et al. (2006), which measures cessation outcomes on three different cessation milestones (achieving initial abstinence, lapse risk, and the lapse-relapse transition) to examine relationships of smoker characteristics (dependence, contextual and demographic factors) with smoking-cessation process.
High nicotine dependence strongly predicted all milestones: not achieving initial abstinence, and a higher risk of both lapse and transitioning from lapse to complete relapse. Numerous contextual and demographic variables were associated with higher initial cessation rates and/or decreased lapse risk at 6 months post-quit (e.g., ethnicity, gender, marital status, education, smoking in the workplace, number of smokers in the social network, and number of supportive others). However, aside from nicotine dependence, only gender significantly predicted the risk of transition from lapse to relapse.
These findings demonstrate that (1) higher nicotine dependence predicted worse outcomes across every cessation milestone; (2) demographic and contextual variables are generally associated with initial abstinence rates and lapse risk and not the lapse-relapse transition. These results identify groups who are at risk for failure at specific stages of the smoking-cessation process, and this may have implications for treatment.
语境变量通常可以预测长期戒烟的成功率，但人们对这些变量如何发挥作用知之甚少。这些变量可能通过影响戒烟的能力，或者通过改变复发的风险，或者从复发转变为复发来影响戒烟的成功率。
研究常见的戒烟失败预测因素对戒烟过程的影响。
本研究（N=1504，58%为女性，84%为白种人；于 2005 年 1 月至 2007 年 6 月招募；2009 年进行数据分析）采用 Shiffman 等人（2006）提出的方法，通过测量三个不同的戒烟里程碑（达到初始戒烟、复发风险和复发转变）上的戒烟结果，来研究吸烟者特征（依赖性、背景和人口统计学因素）与戒烟过程的关系。
高尼古丁依赖强烈预测了所有的里程碑：无法达到初始戒烟，复发风险更高，并且从复发转变为完全复发的风险更高。许多背景和人口统计学变量与更高的初始戒烟率和/或 6 个月后复发风险降低有关（例如，种族、性别、婚姻状况、教育程度、工作场所吸烟、社交网络中吸烟者数量和支持他人的数量）。然而，除了尼古丁依赖之外，只有性别显著预测了从复发转变为复发的风险。
这些发现表明：（1）较高的尼古丁依赖程度预测了每个戒烟里程碑的结果都较差；（2）人口统计学和背景变量通常与初始戒烟率和复发风险有关，而与复发转变无关。这些结果确定了在戒烟过程的特定阶段失败风险较高的人群，这可能对治疗有影响。
