Baha Monique, Le Faou Anne-Laurence
Univ Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, F-75006 Paris, France.
Univ Paris Diderot, Sorbonne Paris Cité, EA 4069, Hôtel-Dieu 1, place du Parvis Notre-Dame, F-75004 Paris, France; AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, F-75015 Paris, France.
Prev Med. 2014 Jun;63:96-102. doi: 10.1016/j.ypmed.2014.03.014. Epub 2014 Mar 20.
This study examined the prevalence and predictors of gradual quitting among treatment-seeking smokers.
This study examined quit attempts among 28,156 adult smokers who attended French smoking cessation services nationwide between 2007 and 2010. Predictors of gradual quitting were determined using multivariate regression models.
Only 4.4% quit gradually whereas 48.7% quit abruptly and 46.9% continued smoking. 34.1% of abrupt quitters and 31.9% of gradual quitters were abstinent at 1month post-quit (p=0.108). Gradual quitting was associated with: older age, heavy smoking at baseline, no previous quit attempts, low self-efficacy, baseline intake of anxiolytics, symptoms of depression and history of depressive episodes. Gradual quitters had a similar anxio-depressive profile than continued smokers but were more educated and more likely to have reported previous quit attempts. Prescription of oral nicotine replacement therapy (NRT) only as opposed to combination NRT doubled the odds of gradual quitting. Likelihood of gradual quitting compared with continued smoking improved with the number of follow-up visits.
Our findings suggest that hard-to-treat smokers may be more likely to quit gradually than abruptly. However, intense follow-up with adapted treatment appears to be crucial to achieve cessation gradually in French smoking cessation services.
本研究调查了寻求治疗的吸烟者逐渐戒烟的患病率及预测因素。
本研究调查了2007年至2010年间在法国全国戒烟服务机构就诊的28156名成年吸烟者的戒烟尝试情况。使用多变量回归模型确定逐渐戒烟的预测因素。
只有4.4%的人逐渐戒烟，而48.7%的人突然戒烟，46.9%的人继续吸烟。在戒烟后1个月，4.1%的突然戒烟者和31.9%的逐渐戒烟者保持戒烟状态（p=0.108）。逐渐戒烟与以下因素相关：年龄较大、基线时重度吸烟、既往无戒烟尝试、自我效能感低、基线时服用抗焦虑药、抑郁症状及抑郁发作史。逐渐戒烟者的焦虑抑郁状况与继续吸烟者相似，但受教育程度更高，且更有可能报告既往有戒烟尝试。仅开具口服尼古丁替代疗法（NRT）而非联合使用NRT会使逐渐戒烟的几率增加一倍。与继续吸烟相比，逐渐戒烟的可能性随着随访次数的增加而提高。
我们的研究结果表明，难以治疗的吸烟者可能更倾向于逐渐戒烟而非突然戒烟。然而，在法国的戒烟服务中，采用适当治疗进行密集随访对于逐渐实现戒烟似乎至关重要。
