Chou Kuan-Ju, Chen Hsing-Kang, Hung Chih-Hung, Chen Tzu-Ting, Chen Chun-Ming, Wu Bo-Jian
Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, No. 448 Chung-Hua Road, Yuli Township, 981, Hualien County, Taiwan.
Eur Arch Psychiatry Clin Neurosci. 2015 Apr;265(3):249-57. doi: 10.1007/s00406-014-0515-7. Epub 2014 Jul 9.
Readiness to quit has been found to predict smoking-cessation outcomes in a general population. However, little is known about the relationship between the readiness to quit and smoking-reduction outcomes in patients with schizophrenia treated with pharmacological adjuvants. The aim of this study was to examine the association between readiness to quit and smoking-reduction outcomes in patients with schizophrenia. A total of 308 subjects using nicotine replacement therapy (NRT) (N = 242) or bupropion (N = 66) participated in an 8-week smoking-reduction programme. Participants were categorised into precontemplators (N = 127), contemplators (N = 76) and preparators (N = 105) to quit smoking based on the transtheoretical model. There was a significant difference in change in number of cigarettes (NOC) (p = 0.007) and Fagerstrom test for nicotine dependence (FTND) score (nicotine dependence level) (p = 0.029) across the stages of change. A linear regression model revealed trend of increasing reduction in NOC and FTND scores in different stages of change (NOC: B = -1.22, t = -2.81, p = 0.005; FTND: B = -0.43, t = -2.57, p = 0.011). However, the 7-day point prevalence of abstinence was 5.5% (18/308), but there was no significant association between stage of change and smoking cessation (p = 0.26), possibly due to a very small sample size of successful quitters. In summary, among a cohort of institutionalised chronic schizophrenia patients receiving 8-week NRT or bupropion, stage of change can predict smoking reduction and may serve as a useful indicator for patients' preparedness before a trial of smoking reduction.
研究发现，在普通人群中，戒烟意愿可预测戒烟结果。然而，对于接受药物辅助治疗的精神分裂症患者，戒烟意愿与减少吸烟量结果之间的关系却知之甚少。本研究旨在探讨精神分裂症患者的戒烟意愿与减少吸烟量结果之间的关联。共有308名使用尼古丁替代疗法（NRT）（n = 242）或安非他酮（n = 66）的受试者参加了为期8周的减少吸烟量计划。根据跨理论模型，参与者被分为未打算戒烟者（n = 127）、打算戒烟者（n = 76）和准备戒烟者（n = 105）。在不同的改变阶段，每日吸烟量（NOC）的变化（p = 0.007）和尼古丁依赖Fagerstrom测试（FTND）评分（尼古丁依赖水平）（p = 0.029）存在显著差异。线性回归模型显示，在不同的改变阶段，NOC和FTND评分的降低趋势呈上升趋势（NOC：B = -1.22，t = -2.81，p = 0.005；FTND：B = -0.43，t = -2.57，p = 0.011）。然而，7天的戒烟点患病率为5.5%（18/308），但改变阶段与戒烟之间没有显著关联（p = 0.26），这可能是由于成功戒烟者的样本量非常小。总之，在一组接受8周NRT或安非他酮治疗的住院慢性精神分裂症患者中，改变阶段可以预测吸烟量的减少，并可能作为患者在尝试减少吸烟之前准备情况的有用指标。
