Matuszewski Paul E, Boulton Christina L, O'Toole Robert V
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Injury. 2016 Jun;47(6):1206-11. doi: 10.1016/j.injury.2016.03.018. Epub 2016 Apr 8.
Smoking is associated with increased complications in fracture care. Smoking cessation has a positive impact on outcomes. It is unknown whether orthopaedic trauma patients understand the ill effects of smoking on fracture care and whether knowledge can improve cessation interest. We hypothesized that (1) smokers less fully understand the negative effects of smoking than do nonsmokers, (2) an increased proportion of orthopaedic trauma patients are further in the process of change to quit smoking, (3) increased knowledge predicts increased readiness to quit, and (4) minimal education through a survey can improve interest in smoking cessation.
Single-centre cross-sectional cohort survey study. Patients were approached consecutively for participation. Patients 18 years or older with a new fracture in our clinic for follow-up were eligible. Smokers and nonsmokers were included and surveyed regarding demographics. Smokers were asked questions about fractures and general knowledge questions regarding the effects of smoking on health. Smokers' interest in smoking cessation was assessed with direct questions, and transtheoretical model stage of change was queried before and after survey administration.
One hundred twelve patients participated (44 smokers, 68 nonsmokers; 75 male patients, 37 female patients). Forty-eight percent of smokers stated that the fracture made them more likely to quit. Smokers answered more questions incorrectly than did nonsmokers (p=0.003). An increased percentage of smokers were in favourable stages of change compared with a population-based tobacco survey (68% versus 54%, p=0.008). Survey administration increased interest in quitting in 48%, and 11% modified their stage of change towards quitting. Smokers scoring higher on knowledge questions had more than 2-fold increased odds of being in a favourable stage of change (p=0.013; odds ratio, 2.13; 95% confidence interval, 1.744-3.855).
Compared with nonsmokers, smokers less fully understand the negative effects of smoking on fracture care and general health. A large proportion of orthopaedic trauma patients who smoke are interested in smoking cessation and are possibly further along the pathway to change than expected. Brief education through a survey can increase interest in quitting. Formal education intervention may improve cessation rates and fracture outcomes.
吸烟与骨折治疗中并发症的增加有关。戒烟对治疗结果有积极影响。目前尚不清楚骨科创伤患者是否了解吸烟对骨折治疗的不良影响，以及相关知识是否能提高戒烟意愿。我们假设：（1）吸烟者比不吸烟者对吸烟的负面影响了解得更少；（2）与基于人群的烟草调查相比，更多比例的骨科创伤患者处于戒烟行为改变的进程中；（3）知识的增加预示着戒烟意愿的增强；（4）通过一项调查进行的最低限度教育可以提高对戒烟的兴趣。
单中心横断面队列调查研究。连续邀请患者参与。年龄在18岁及以上、在我们诊所因新发骨折前来随访的患者符合条件。纳入吸烟者和不吸烟者，并对其进行人口统计学调查。向吸烟者询问有关骨折的问题以及关于吸烟对健康影响的常识性问题。通过直接提问评估吸烟者的戒烟兴趣，并在调查前后询问其行为改变的跨理论模型阶段（情况）。
112名患者参与研究（44名吸烟者，68名不吸烟者；75名男性患者，37名女性患者）。48%的吸烟者表示骨折使他们更有可能戒烟。吸烟者回答错误问题的比例高于不吸烟者（p = 0.003）。与基于人群的烟草调查相比，处于有利行为改变阶段的吸烟者比例有所增加（68%对54%，p = 0.008）。调查实施后，48%的吸烟者对戒烟的兴趣增加，11%的吸烟者改变了其戒烟行为改变阶段。在知识问题上得分较高的吸烟者处于有利行为改变阶段的几率增加了两倍多（p = 0.013；优势比，2.13；95%置信区间，1.744 - 3.855）。
与不吸烟者相比，吸烟者对吸烟对骨折治疗和总体健康的负面影响了解得更少。很大一部分吸烟的骨科创伤患者对戒烟感兴趣，并且可能比预期更深入地处于行为改变的进程中。通过一项调查进行的简短教育可以增加戒烟兴趣。正规的教育干预可能会提高戒烟率和改善骨折治疗结果。
