Serious Mental Illness Treatment Resource and Evaluation Center, US Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, 2215 Fuller Rd., Ann Arbor, MI 48105, USA.
Psychiatr Serv. 2012 Apr;63(4):325-32. doi: 10.1176/appi.ps.201100097.
The purpose of this study was to determine rates of smoking and receipt of provider recommendations to quit smoking among patients with mental disorders treated in U.S. Department of Veterans Affairs (VA) treatment settings.
The authors conducted a secondary analysis of the yearly, cross-sectional 2007 Veterans Health Administration Outpatient Survey of Healthcare Experiences of Patients (N=224,193). Logistic regression was used to determine the independent association of mental health diagnosis and the dependent variables of smoking and receipt of provider recommendations to quit smoking.
Patients with mental disorders had greater odds of smoking, compared with those without mental disorders (p<.05). Those with various mental disorders reported similar rates of receiving services (more than 60% to 80% reported receiving selected services), compared with those without these disorders, except that those with schizophrenia had more than 30% lower odds of receiving advice to quit smoking from their physicians (p<.05). Moreover, those who had co-occurring posttraumatic stress disorder or substance use disorders had significantly greater odds of reporting that they received advice to quit, recommendations for medications, and physician discussions of quitting methods, compared with those without these disorders (p<.05). Older patients, male patients, members of ethnic minority groups, those who were unmarried, those who were disabled or unemployed, and those living in rural areas had lower odds of receiving selected services (p<.05).
The majority of patients with mental disorders served by the VA reported receiving cessation services, yet their smoking rates remained high, and selected groups were at risk for receiving fewer cessation services, suggesting the continued need to disseminate cessation services.
本研究旨在确定在美国退伍军人事务部（VA）治疗环境中接受治疗的精神障碍患者的吸烟率和获得戒烟建议的情况。
作者对 2007 年退伍军人健康管理局门诊患者医疗体验年度横断面调查（共 224193 名患者）进行了二次分析。采用逻辑回归分析确定精神健康诊断与吸烟和获得戒烟建议这两个因变量之间的独立关联。
与无精神障碍的患者相比，患有精神障碍的患者吸烟的可能性更大（p<.05）。与无这些障碍的患者相比，患有各种精神障碍的患者报告接受服务的比例相似（超过 60%至 80%的患者报告接受了某些服务），但精神分裂症患者接受医生戒烟建议的可能性低 30%以上（p<.05）。此外，同时患有创伤后应激障碍或物质使用障碍的患者报告他们接受戒烟建议、戒烟药物推荐以及医生讨论戒烟方法的可能性显著更高，与无这些障碍的患者相比（p<.05）。年龄较大的患者、男性患者、少数民族群体成员、未婚患者、残疾或失业患者以及居住在农村地区的患者接受某些服务的可能性较低（p<.05）。
在 VA 接受治疗的大多数精神障碍患者都报告接受了戒烟服务，但他们的吸烟率仍然很高，而且某些群体接受戒烟服务的机会较少，这表明继续需要传播戒烟服务。
