Deschenau A, Le Faou A-L, Touzeau D
Pôle addiction, groupe hospitalier Paul-Guiraud, 54, avenue de la République, 94800 Villejuif, France.
Hôpital européen Georges-Pompidou, Assitance publique-Hôpitaux de Paris, centre ambulatoire d'addictologie, université Paris Diderot, Sorbonne Paris Cité, UMRS 1123, 75010 Paris, France.
Rev Mal Respir. 2017 Jan;34(1):44-52. doi: 10.1016/j.rmr.2016.03.010. Epub 2016 Jun 6.
Underprivileged people smoke more frequently, present with a more severe smoking profile and stop less often than wealthier smokers. They can have difficulties to afford smoking cessation treatments as the French medical insurance coverage system requires smokers to pay it in advance with a later reimbursement. The objective of this study was to compare the characteristics, treatment plans and cessation rates of smokers from disadvantaged population in comparison with smokers in wealthier condition.
Study population concerned smokers received for a first visit in the smoking cessation service at Georges-Pompidou European Hospital (Paris, France) in 2013. The EPICES score was used to define precariousness. The national file of smoking cessation consultation (CDT) was completed and the nicotine replacement therapy (NRT) prescriptions were detailed, as treatment could be given for free to precarious smokers on a weekly basis. Data were registered in CDTnet, the French national database of smoking cessation services.
Precarious smokers (36.8%) presented with a more severe smoking profile and suffered more often from psychiatric disorders than wealthier smokers. They benefited most often from a combination NRT with patch and oral forms. The followed-up precarious smokers attended a greater number of consultations (4.7 against 3.4) and, if they were less often abstainers (22.2% against 41.3%), they were able to significantly reduce their consumption.
Precarious smokers adhere to structured care with aid for access to TSN with a positive consequent impact on consumption.
弱势群体比富裕吸烟者吸烟更频繁,吸烟情况更严重,戒烟的频率更低。由于法国医疗保险覆盖系统要求吸烟者预先支付戒烟治疗费用,之后再报销,他们可能难以负担戒烟治疗费用。本研究的目的是比较弱势群体吸烟者与富裕吸烟者的特征、治疗方案和戒烟率。
研究人群为2013年在法国巴黎乔治·蓬皮杜欧洲医院戒烟服务中心首次就诊的吸烟者。采用EPICES评分来定义不稳定状况。完成了国家戒烟咨询档案(CDT),并详细记录了尼古丁替代疗法(NRT)的处方,因为不稳定吸烟者每周可免费获得该治疗。数据记录在法国国家戒烟服务数据库CDTnet中。
不稳定吸烟者(36.8%)的吸烟情况比富裕吸烟者更严重,患精神疾病的频率也更高。他们最常受益于贴片和口服形式相结合的NRT。接受随访的不稳定吸烟者就诊次数更多(4.7次对3.4次),并且,如果他们较少成为戒烟者(22.2%对41.3%),他们能够显著减少吸烟量。
不稳定吸烟者坚持接受结构化护理,并获得了获取戒烟治疗的帮助,这对吸烟量产生了积极的后续影响。