戒烟疲劳是否能预测戒烟阶段的里程碑？一项对当前和曾经吸烟者的纵向研究。
Does cessation fatigue predict smoking-cessation milestones? A longitudinal study of current and former smokers.
机构信息
Department of Psychiatry and Behavioral Sciences.
Department of Psychiatry, University of Pittsburgh.
出版信息
J Consult Clin Psychol. 2018 Nov;86(11):903-914. doi: 10.1037/ccp0000338.
OBJECTIVE
Long-term abstinence can be undermined by cessation fatigue-an exhaustion of coping resources attributable to quitting smoking/staying quit. The current study examines the predictive validity of a Cessation Fatigue Scale (CFS; three subscales). Among current smokers, we hypothesized higher fatigue would predict longer latency to both quit initiation and achieving 7-day point prevalence abstinence (7-day PPA). Among recent quitters, we expected higher cessation fatigue would confer greater lapse/relapse risk. Lower rates of abstinence at 2-month follow-up were expected for those with higher fatigue.
METHOD
Current smokers motivated to quit in the next month (n = 301) and recent quitters (n = 242) were assessed biweekly over the course of 2 months. Retention rates were high (>85%). Cox and logistic regression analyses tested hypotheses.
RESULTS
Among smokers, greater emotional exhaustion predicted longer delay to achieving 7-day PPA (HR = .53, 95% CI [.40, -.68], p < .001) and lower likelihood of 7-day PPA at 2-month follow-up (OR = .27, 95% CI [.16, -.46], p < .001), even after controlling for nicotine dependence and motivation to quit. Among recent quitters, emotional exhaustion progressively increased over the first 6 weeks since quit initiation. Elevated exhaustion was associated with greater lapse (HR = 1.65, 95% CI [1.06, 2.56], p < .05) and relapse (HR = 2.33, 95% CI [1.37, 3.97], p < .01) risk, and lower likelihood of 7-day PPA at 2-month follow-up (OR = .39, 95% CI [.16, .94], p < .05), even after controlling for nicotine withdrawal and motivation to quit.
CONCLUSIONS
Cessation fatigue, as measured by the CFS's emotional exhaustion subscale, prospectively predicted important cessation milestones. Findings suggest that cessation fatigue is a novel process that undermines smoking cessation and a viable target for intervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
目的
戒断疲劳可能会破坏长期戒烟效果，这是由于戒烟而导致的应对资源枯竭。本研究旨在检验戒断疲劳量表（CFS）的预测效度（包括三个子量表）。我们假设，在当前吸烟者中，更高的疲劳水平会预测更长的戒烟潜伏期和实现 7 天点流行率戒烟（7 天 PPA）。在最近戒烟者中，我们预计更高的戒断疲劳会导致更大的复吸/复发风险。对于那些疲劳水平较高的人，在 2 个月的随访中，预期的戒烟率较低。
方法
在接下来的一个月内有戒烟意愿的当前吸烟者（n=301）和最近戒烟者（n=242）在 2 个月的时间内进行了两周一次的评估。保留率很高（>85%）。Cox 和逻辑回归分析检验了假设。
结果
在吸烟者中，较高的情绪耗竭预测了实现 7 天 PPA 的时间更长（HR=.53，95%CI[.40，-.68]，p<.001），以及在 2 个月随访时 7 天 PPA 的可能性更低（OR=.27，95%CI[.16，-.46]，p<.001），即使在控制了尼古丁依赖和戒烟动机之后也是如此。在最近戒烟者中，情绪耗竭在戒烟后前 6 周内逐渐增加。较高的疲劳水平与更大的复吸（HR=1.65，95%CI[1.06，2.56]，p<.05）和复发（HR=2.33，95%CI[1.37，3.97]，p<.01）风险相关，以及在 2 个月随访时 7 天 PPA 的可能性更低（OR=.39，95%CI[.16，.94]，p<.05），即使在控制了尼古丁戒断和戒烟动机之后也是如此。
结论
用 CFS 的情绪耗竭子量表测量的戒断疲劳，前瞻性地预测了重要的戒烟里程碑。研究结果表明，戒断疲劳是一个破坏戒烟效果的新过程，也是一个可行的干预目标。（PsycINFO 数据库记录（c）2018 APA，保留所有权利）。
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