Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles, 911 Broxton Avenue, First Floor, Los Angeles, CA 90024, USA.
Nicotine Tob Res. 2011 Dec;13(12):1193-201. doi: 10.1093/ntr/ntr167. Epub 2011 Aug 22.
Individuals with alcohol, drug, or mental (ADM) disorders combined make up over 40% of all smokers in the U.S. Primary care providers (PCPs) play an important role in smoking cessation counseling, but their effectiveness with this population is unclear. This study evaluated the effectiveness of PCP smoking cessation counseling for smokers with ADM disorders.
Probit regressions conducted in 2009-2010 examined the relationship between past year PCP smoking cessation counseling and successful quitting among 1,356 adults who reported smoking in the 1998-1999 Community Tracking Study survey and who reported seeing a PCP in the past year in the follow-up 2000-2001 Healthcare for Communities Survey. Past year PCP exercise counseling was used as an instrumental variable for past year PCP smoking cessation counseling to account for potential hidden bias between smoking status and receipt of smoking cessation counseling.
Smokers with and without ADM disorders were equally likely to receive smoking cessation counseling (72.9% vs. 69.9%). Using the instrumental variable approach, smoking cessation counseling by PCPs was significantly associated (p < .01) with quitting among both groups. Predicted probabilities of quitting without smoking cessation counseling were 6.0% for smokers with ADM disorders and 10.5% for smokers without ADM disorders. Predicted probabilities of quitting with smoking cessation counseling were 31.3% for smokers with ADM disorders and 34.9% for smokers without ADM disorders.
This study shows that PCPs can help smokers with ADM disorders successfully quit. These smokers should be targeted for smoking cessation counseling to reduce the health burden of tobacco.
在美国，患有酒精、药物或精神（ADM）障碍的个体加起来占所有吸烟者的 40%以上。初级保健提供者（PCP）在戒烟咨询方面发挥着重要作用，但他们在这一人群中的效果尚不清楚。本研究评估了 PCP 对患有 ADM 障碍的吸烟者进行戒烟咨询的效果。
2009-2010 年进行的概率回归分析考察了过去一年 PCP 戒烟咨询与 1356 名成年人成功戒烟之间的关系，这些成年人在 1998-1999 年社区追踪研究调查中报告吸烟，在 2000-2001 年医疗保健社区研究的随访中报告过去一年看过 PCP。过去一年 PCP 运动咨询被用作过去一年 PCP 戒烟咨询的工具变量，以解释吸烟状况和接受戒烟咨询之间潜在的隐藏偏差。
有和没有 ADM 障碍的吸烟者接受戒烟咨询的可能性相同（72.9%与 69.9%）。使用工具变量方法，PCP 提供的戒烟咨询与两组人群的戒烟均显著相关（p<.01）。没有戒烟咨询的情况下，有 ADM 障碍的吸烟者戒烟的预测概率为 6.0%，没有 ADM 障碍的吸烟者戒烟的预测概率为 10.5%。有戒烟咨询的情况下，有 ADM 障碍的吸烟者戒烟的预测概率为 31.3%，没有 ADM 障碍的吸烟者戒烟的预测概率为 34.9%。
本研究表明，PCP 可以帮助患有 ADM 障碍的吸烟者成功戒烟。这些吸烟者应作为戒烟咨询的目标，以减轻烟草带来的健康负担。
