Hausherr Yann, Quinto Carlos, Grize Leticia, Schindler Christian, Probst-Hensch Nicole
Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Basel, Switzerland; University of Basel, Faculty of Medicine, Basel, Switzerland.
Swiss Med Wkly. 2017 Sep 13;147:w14500. doi: 10.4414/smw.2017.14500. eCollection 2017.
To capitalise on the opportunities that the smoking ban legislation in Switzerland offers for the prevention of tobacco-related diseases, a smoking cessation programme in a workplace setting was developed and implemented in companies across the language and cultural regions of Switzerland. Our goal was to identify factors associated with relapse into smoking that may be overcome during training sessions or that should be considered for the optimisation of future interventions.
Between 2006 and 2012, 1287 smokers aged 16 to 68 years voluntarily attended smoking cessation training at their workplace. The intervention was based on a cognitive behavioural group therapy combined with individual proactive telephone counselling. The evaluation consisted of three anonymised questionnaires (pre- and postintervention, and 12-month follow-up). In this prospective cohort study, we investigated the association of smoking quit rates with training and participant characteristics, including withdrawal symptoms, by use of multilevel logistic regression analysis with a random intercept for training courses.
The self-reported abstinence rate was 72.4% at the end of the training, and 18.6% 1 year later. The risk of relapse during the training was positively associated with the number of years and daily cigarettes smoked, and negatively with increased appetite, sleeping troubles and satisfaction with learned techniques. Failed abstinence within the first year was associated with younger age, higher numbers of daily smoked cigarettes and unsuccessful recent quit attempts.
Our evaluation suggests that younger and more addicted smokers attending smoking cessation trainings may need additional support to achieve long lasting abstinence rates. Offering smoking cessation training in a workplace setting can achieve reasonable long-term quit rates, but a subset of employees needs additional support at the group or personal level.
Group behaviour therapy could be an effective method to achieve long-term smoking abstinence. The workplace is an important setting to reach and encourage a large number of smokers to participate in a smoking cessation programme, but only few studies investigated its potential. The findings of this study of a modern real-life workplace-based smoking cessation programme endorse the effectiveness and viability of cognitive behavioural group therapy. This group-level intervention at the workplace may be insufficient for young and heavy smokers, as well as women with increased appetite after cessation, who potentially benefit from re-intervention and additional individual level counselling.
为利用瑞士禁烟立法为预防烟草相关疾病带来的机遇，我们在瑞士各语言和文化区域的公司中制定并实施了一项工作场所戒烟计划。我们的目标是确定与复吸相关的因素，这些因素可能在培训课程中得以克服，或者在优化未来干预措施时应予以考虑。
2006年至2012年期间，1287名年龄在16至68岁之间的吸烟者自愿在其工作场所参加戒烟培训。干预措施基于认知行为团体治疗并结合个人主动电话咨询。评估包括三份匿名问卷（干预前、干预后以及12个月随访）。在这项前瞻性队列研究中，我们通过使用带有培训课程随机截距的多水平逻辑回归分析，研究了戒烟率与培训及参与者特征（包括戒断症状）之间的关联。
培训结束时自我报告的戒烟率为72.4%，一年后为18.6%。培训期间复吸的风险与吸烟年限和每日吸烟量呈正相关，与食欲增加、睡眠问题以及对所学技巧的满意度呈负相关。第一年戒烟失败与年龄较小、每日吸烟量较多以及近期戒烟尝试未成功有关。
我们的评估表明，参加戒烟培训的年轻且烟瘾更大的吸烟者可能需要额外支持才能实现长期戒烟率。在工作场所提供戒烟培训可以实现合理的长期戒烟率，但一部分员工在团体或个人层面需要额外支持。
团体行为疗法可能是实现长期戒烟的有效方法。工作场所是接触并鼓励大量吸烟者参与戒烟计划的重要场所，但仅有少数研究调查了其潜力。这项关于现代现实生活中基于工作场所的戒烟计划的研究结果证实了认知行为团体治疗的有效性和可行性。这种在工作场所的团体层面干预对于年轻和重度吸烟者以及戒烟后食欲增加的女性可能并不充分，他们可能会从再次干预和额外的个人层面咨询中受益。
