Louwagie Goedele M C, Ayo-Yusuf Olalekan A
Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Private Bag X 323, Pretoria, 0001, Republic of South Africa,
J Behav Med. 2015 Jun;38(3):472-82. doi: 10.1007/s10865-015-9620-y. Epub 2015 Feb 6.
This study examines predictors of smoking cessation in tuberculosis patients with high HIV co-infection rates in a South African primary care setting. Current smokers were randomly allocated to brief motivational interviewing (n = 205) or receipt of a brief message (n = 204). Multi-level logistic regression was performed to identify predictors of sustained 3- and 6-month abstinence and 7-day point prevalence abstinence (PPA) at 1 month, with the facility as a random effect. The intervention was ineffective among smokers with high nicotine-dependence at 1 month, but was effective for all smokers over longer periods. Higher baseline self-efficacy predicted the 1-month 7-day PPA, but not sustained abstinence. HIV-positive participants' odds of sustained abstinence were about three times higher than those of their HIV-negative counterparts. Results support a more intensive motivational intervention and/or coping skills' training to increase self-efficacy and abstinence rates. Tobacco cessation services can be introduced in tuberculosis services where high HIV co-infection rates occur.
本研究在南非初级保健机构中,对合并感染艾滋病毒率高的结核病患者戒烟的预测因素进行了调查。当前吸烟者被随机分配接受简短动机访谈(n = 205)或接收简短信息(n = 204)。采用多水平逻辑回归分析,以机构为随机效应,确定持续3个月和6个月戒烟以及1个月时7天点流行率戒烟(PPA)的预测因素。该干预措施在1个月时对尼古丁依赖程度高的吸烟者无效,但在较长时期内对所有吸烟者均有效。较高的基线自我效能可预测1个月时的7天PPA,但不能预测持续戒烟情况。艾滋病毒阳性参与者持续戒烟的几率比艾滋病毒阴性参与者高出约三倍。研究结果支持开展更强化的动机干预和/或应对技能培训,以提高自我效能和戒烟率。在合并感染艾滋病毒率高的结核病服务中可引入戒烟服务。