Clyde M, Tulloch H, Reid R, Els C, Pipe A
University of Ottawa Heart Institute, Canada; University of Ottawa, Department of Psychology, Canada.
University of Ottawa Heart Institute, Canada; University of Ottawa, Department of Psychology, Canada; University of Ottawa, Faculty of Medicine, Canada.
Addict Behav. 2015 Jul;46:65-9. doi: 10.1016/j.addbeh.2015.03.002. Epub 2015 Mar 11.
Individuals with a lifetime diagnosis of mental illness smoke at rates greater than the general population, and have more difficulty quitting. Cessation self-efficacy has been linked with positive cessation outcomes and can be assessed as either task (confidence to quit) or barrier self-efficacy (confidence to quit in the face of obstacles). We investigated differences in self-efficacy among smokers with a current, past or no lifetime diagnosis of psychiatric illness.
737 treatment-seeking smokers provided demographic info and smoking history, and were assessed for nicotine dependence, motivation to quit, and task and barrier self-efficacy (Smoking Self-Efficacy Questionnaire; SEQ-12) for smoking cessation. Current and past psychiatric diagnoses were assessed with the Mini International Psychiatric Interview (M.I.N.I. 6.0). ANOVA, chi-square and correlations were calculated for the smoking-related variables across the psychiatric categories.
Those with a current diagnosis smoked more cigarettes and were highly nicotine dependent. These individuals had lower barrier self-efficacy compared to those with past or no diagnosis; no differences between groups were observed on task self-efficacy. Motivation to quit was significantly correlated with task self-efficacy in all 3 groups, but with barrier-self efficacy only among those with no lifetime diagnosis of psychiatric illness.
Our results highlight the differences in task and barrier cessation self-efficacy in treatment-seeking smokers. Those with a current psychiatric diagnosis have less confidence in their ability to quit when confronting barriers, especially those reflecting internal states. These results highlight the need for targeted interventions to improve cessation self-efficacy, an important determinant of health behavior change.
终生被诊断患有精神疾病的个体吸烟率高于普通人群，且戒烟难度更大。戒烟自我效能与积极的戒烟结果相关，可被评估为任务自我效能（戒烟信心）或障碍自我效能（面对障碍时戒烟的信心）。我们调查了目前、过去或从未有过终生精神疾病诊断的吸烟者在自我效能方面的差异。
737名寻求治疗的吸烟者提供了人口统计学信息和吸烟史，并接受了尼古丁依赖、戒烟动机以及戒烟任务自我效能和障碍自我效能（吸烟自我效能量表；SEQ - 12）的评估。使用迷你国际神经精神访谈（M.I.N.I. 6.0）评估当前和过去的精神疾病诊断。对各精神疾病类别中与吸烟相关的变量进行方差分析、卡方检验和相关性计算。
目前被诊断患有精神疾病的吸烟者吸烟量更多，且尼古丁依赖程度高。与过去或未被诊断的吸烟者相比，这些个体的障碍自我效能较低；各群体在任务自我效能方面未观察到差异。在所有三组中，戒烟动机与任务自我效能显著相关，但仅在从未有过终生精神疾病诊断的吸烟者中与障碍自我效能相关。
我们的结果突出了寻求治疗的吸烟者在任务和障碍戒烟自我效能方面的差异。目前患有精神疾病的吸烟者在面对障碍时，尤其是那些反映内部状态的障碍时，对自己戒烟能力的信心较低。这些结果凸显了需要有针对性的干预措施来提高戒烟自我效能，这是健康行为改变的一个重要决定因素。
