参与一项戒烟 RCT 的 homeless 吸烟者戒烟自我效能感和吸烟欲望的趋势。
Trends in self-efficacy to quit and smoking urges among homeless smokers participating in a smoking cessation RCT.
机构信息
Minneapolis VA Health Care System, Center for Chronic Disease Outcomes Research, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota, Department of Medicine, 401 East River Parkway Suite 131, Minneapolis, MN 55455, USA.
University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA.
出版信息
Addict Behav. 2018 Mar;78:43-50. doi: 10.1016/j.addbeh.2017.10.025. Epub 2017 Nov 2.
INTRODUCTION
In the U.S., approximately 73% of homeless adults smoke cigarettes and they experience difficulty quitting. Homeless smokers report low self-efficacy to quit and that smoking urges are a barrier to quitting. Self-efficacy to quit and smoking urges are dynamic and change throughout smoking cessation treatment. This study examines changes in self-efficacy to quit and smoking urges throughout a smoking cessation intervention among the homeless and identifies predictors of change in these characteristics.
METHODS
Homeless smokers (n=430) participating in a smoking cessation randomized controlled trial in the U.S. completed surveys at baseline, and weeks 1, 2, 4, 6, 8, and 26 on demographic and smoking characteristics (i.e., confidence to quit, self-efficacy to refrain from smoking, and smoking urges). A growth curve analysis was conducted by modeling change in the smoking characteristics over time and examining the variability in the change in smoking characteristics by demographic characteristics and treatment group.
RESULTS
Among the full sample, self-efficacy to refrain from smoking increased linearly over time, confidence to quit increased until the midpoint of treatment but subsequently decreased, and smoking urges decreased until the midpoint of treatment but subsequently increased. There were race differences in these trajectories. Racial minorities experienced significantly greater increases in self-efficacy to refrain from smoking than Whites and Blacks had higher confidence to quit than Whites.
CONCLUSIONS
White participants experienced less increase in self-efficacy to refrain from smoking and lower confidence to quit and therefore may be a good target for efforts to increase self-efficacy to quit as part of homeless-targeted smoking cessation interventions. Sustaining high confidence to quit and low smoking urges throughout treatment could be key to promoting higher cessation rates among the homeless.
简介
在美国，大约 73%的无家可归成年人吸烟，他们戒烟困难。无家可归的吸烟者报告说戒烟自我效能感低，吸烟欲望是戒烟的障碍。戒烟自我效能感和吸烟欲望是动态的，在戒烟治疗过程中会发生变化。本研究在美国一项戒烟随机对照试验中，考察了无家可归吸烟者在戒烟干预过程中戒烟自我效能感和吸烟欲望的变化，并确定了这些特征变化的预测因素。
方法
参与美国一项戒烟随机对照试验的无家可归吸烟者（n=430）在基线时以及第 1、2、4、6、8 和 26 周完成了关于人口统计学和吸烟特征的调查（即戒烟信心、戒烟自我效能感和吸烟欲望）。通过对吸烟特征随时间的变化进行建模，以及通过人口统计学特征和治疗组来检查吸烟特征变化的可变性，进行了增长曲线分析。
结果
在全样本中，戒烟自我效能感随时间呈线性增加，戒烟信心在治疗中期前增加，但随后下降，吸烟欲望在治疗中期前下降，但随后增加。这些轨迹存在种族差异。少数族裔经历了更大的戒烟自我效能感的增加，而黑人的戒烟信心比白人高。
结论
白人参与者经历的戒烟自我效能感增加较少，戒烟信心较低，因此可能是增加无家可归者戒烟干预中戒烟自我效能感的目标人群。在整个治疗过程中保持较高的戒烟信心和较低的吸烟欲望可能是促进无家可归者戒烟率提高的关键。
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