Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Suite 300, Palo Alto, CA 94304-1334, USA.
Nicotine Tob Res. 2011 Nov;13(11):1092-7. doi: 10.1093/ntr/ntr151. Epub 2011 Aug 10.
The factors that influence the initial phase of quitting smoking have been understudied. Although maintenance of change is the ultimate test of the efficacy of treatment, maintenance is a nonissue for those who fail to manage even brief periods of abstinence. We examined factors associated with smokers' ability to achieve a targeted 24-hr quit during a smoking cessation program. As a comparison, we also examine whether predictors of an initial quit are different from factors that predict smoking abstinence at 52-week follow-up.
Using baseline data from a randomized clinical trial to examine the efficacy of selegiline for cigarette smoking cessation (n = 280), we conducted univariate analyses (analysis of variance or chi-square) to determine statistically significant predictors of a successful quit attempt (SQA) versus unsuccessful quit attempt. Multiple logistic regression was performed with significant predictors from the univariate analyses to determine main effects and interactions in a multivariate model. The same factors and analyses were used to examine predictors of 52-week point prevalence abstinence.
Lower nicotine dependence (modified Fagerström Tolerance Questionnaire [mFTQ]), higher Behavioral Inhibition System score, and lower baseline heart rate were predictive of SQA in both the univariate and the multivariate models. Gender was the only predictor of 52-week smoking abstinence.
Predictors of initial induction of change were not predictors of abstinence at the 1-year follow-up, suggesting that different factors mediate the different subprocesses of behavior change. Knowledge of these pretreatment factors that moderate a SQA could help clinicians target smokers who need more intensive therapy during the initial induction of cessation.
影响戒烟初始阶段的因素尚未得到充分研究。虽然维持戒烟成功是治疗效果的最终检验标准,但对于那些甚至无法维持短暂戒烟期的人来说,维持阶段已经不是问题了。我们研究了与吸烟者在戒烟计划中实现目标性 24 小时戒烟能力相关的因素。作为比较,我们还检查了预测初始戒烟的因素是否与预测 52 周随访时戒烟成功率的因素不同。
我们使用一项随机临床试验的基线数据来检验司来吉兰戒烟的疗效(n = 280),我们进行了单变量分析(方差分析或卡方检验),以确定成功戒烟尝试(SQA)与不成功戒烟尝试的有统计学意义的预测因素。我们对单变量分析中的显著预测因素进行了多变量逻辑回归,以确定多变量模型中的主要影响因素和交互作用。我们使用相同的因素和分析方法来检验预测 52 周点患病率戒烟的因素。
较低的尼古丁依赖(改良 Fagerström 耐受问卷 [mFTQ])、较高的行为抑制系统得分和较低的基线心率在单变量和多变量模型中均预测 SQA。性别是 52 周吸烟戒断的唯一预测因素。
初始戒烟诱导的预测因素不是 1 年随访时的戒烟预测因素,这表明不同的因素中介了行为改变的不同子过程。了解这些治疗前因素,可帮助临床医生针对那些在初始戒烟诱导阶段需要更强化治疗的吸烟者。