Carlston David L, Mattar Ahmed A, Packard Josh
Wichita Falls Family Practice Residency Program, Wichita Falls, TX 76301, USA.
Fam Med. 2012 Nov-Dec;44(10):727-30.
Significant research has evaluated the impacts of smoking, the impacts of exposure to secondhand smoke, the effectiveness of a variety of social and individual interventions for smoking cessation, and the frequency at which physicians discuss smoking cessation with their patients. Little research has addressed barriers to physician-initiated discussion and intervention related to smoking cessation, especially pertaining to resident physicians treating low-income patients. The existing research indicates that physicians have low expectations regarding patients' desires to quit smoking and often wait to discuss smoking cessation with patients until the patient broaches the subject. The purpose of this pilot was to identify trends in smoking, desire for smoking cessation, and desire to participate in smoking cessation classes at the family practice clinic.
Patients completed a survey eliciting demographic information, smoking behavior, presence of chronic illness, desire to quit smoking, and reasons for wanting to quit smoking.
Higher rates of smoking and lower rates of desired cessation were identified. However, among patients contemplating smoking cessation, a relatively high number desired cessation classes. Higher numbers of failed quit attempts were predictive of increases odds of both wanting to quit and desire for cessation classes. Other predictors of cessation desire and class participation are discussed.
Based on the current research, physicians are encouraged to follow practice guidelines, asking all patients about smoking behavior and assisting in their efforts to quit, especially those who have previously been unsuccessful in the past.
大量研究评估了吸烟的影响、接触二手烟的影响、各种戒烟的社会和个人干预措施的有效性,以及医生与患者讨论戒烟的频率。很少有研究探讨医生发起与戒烟相关的讨论和干预的障碍,尤其是在治疗低收入患者的住院医生方面。现有研究表明,医生对患者戒烟意愿的期望较低,通常会等到患者主动提出这个话题才与患者讨论戒烟。这项试点研究的目的是确定家庭医疗诊所中吸烟的趋势、戒烟意愿以及参加戒烟课程的意愿。
患者完成了一项调查,该调查收集了人口统计学信息、吸烟行为、慢性病情况、戒烟意愿以及戒烟原因。
发现吸烟率较高,而期望戒烟的比率较低。然而,在考虑戒烟的患者中,有相当一部分人希望参加戒烟课程。较高的戒烟失败尝试次数预示着想要戒烟和希望参加戒烟课程的几率都会增加。还讨论了其他与戒烟意愿和课程参与相关的预测因素。
基于当前的研究,鼓励医生遵循实践指南,询问所有患者的吸烟行为,并协助他们努力戒烟,尤其是那些过去戒烟未成功的患者。