Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain,
Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain,
Eur Addict Res. 2019;25(5):256-262. doi: 10.1159/000500450. Epub 2019 Jun 4.
Smoking cessation in subjects with a severe mental illness (SMI) is a challenging but attainable goal. Furthermore, the identification of variables involved in the quitting process is a highly relevant factor in clinical practice. This study aimed to analyze the influence of smokers' motivation in smoking reduction and cessation and select the most suitable way of measuring motivation.
This is a secondary analysis of a 9-month, multicenter trial examining a Multicomponent Smoking Cessation Program in 82 adult outpatients with SMI. At the end of the preparation stage, the smokers' motivational level was evaluated with the University of Rhode Island Change Assessment Scale. This allowed us to rate subjects using a continuous measure ("Readiness to Change," RTC) and group them in "Stages of Change" (SOC). Regression analyses were carried out to identify predictors of the efficacy outcomes: a reduction in at least 50% of the cigarettes smoked per day (CPD), a reduction in the expired carbon monoxide (CO), and complete abstinence from smoking.
We studied differences in measurements of motivational levels independently (RTC and SOC) for patients who had a reduction in at least 50% of the CPD and for patients who achieved complete abstinence from smoking. However, these differences did not reach statistical significance during the follow-up study with a logistic mixed-effects model. In a linear mixed-effects model, the reduction of expired CO was significantly associated with RTC, at the end of the active treatment phase and during follow-up (β: -1.51; SD 0.82; p < 0.01).
The motivation level achieved in the preparation phase predicted the reduction of expired CO over a given period when calculated by a continuous measure (RTC).
在患有严重精神疾病（SMI）的患者中戒烟是一个具有挑战性但可实现的目标。此外，确定戒烟过程中涉及的变量是临床实践中的一个高度相关因素。本研究旨在分析吸烟者减少和戒烟动机的影响，并选择最合适的测量动机的方法。
这是一项为期 9 个月的多中心试验的二次分析，该试验检查了 82 名患有 SMI 的成年门诊患者的多成分戒烟计划。在准备阶段结束时，使用罗德岛大学变化评估量表评估吸烟者的动机水平。这使我们能够使用连续测量（“改变准备度”，RTC）对受试者进行评分，并将他们分为“改变阶段”（SOC）。进行回归分析以确定疗效结果的预测因素：每天至少减少 50%的吸烟量（CPD），减少呼出的一氧化碳（CO），以及完全戒烟。
我们独立地（RTC 和 SOC）研究了在每天至少减少 50%的 CPD 的患者和完全戒烟的患者中，动机水平测量的差异。然而，在使用逻辑混合效应模型的随访研究中，这些差异没有达到统计学意义。在线性混合效应模型中，呼气 CO 的减少与 RTC 在积极治疗阶段结束和随访期间显著相关（β：-1.51；SD 0.82；p<0.01）。
在准备阶段实现的动机水平通过连续测量（RTC）预测了给定时间段内呼出 CO 的减少。
