Joo Hyundeok, Cho Mi Hee, Cho Yongjung, Joh Hee-Kyung, Kim Ji Won
Seoul National University College of Medicine.
Samsung C&T Medical Clinic, Kangbuk Samsung Hospital.
Medicine (Baltimore). 2020 Jan;99(5):e18994. doi: 10.1097/MD.0000000000018994.
Many lifelong smokers establish smoking habits during young adulthood. A university can be an effective setting for early smoking cessation. We evaluated long-term predictors of smoking cessation among smokers in a university setting.We longitudinally followed a cohort of smokers enrolled in a university smoking cessation program in Seoul, South Korea. Sociodemographic factors, smoking-related variables, and changes in smoking habits were assessed during 6-week visit sessions and follow-up telephone interviews conducted 1 year or more later.A total of 205 participants were followed up (mean follow-up duration: 27.1 months). Cessation rates were 47.3% at the end of the visit sessions and 28.8% at follow-up. The long-term persistent smoking rate was significantly higher among individuals with peers who smoked (odds ratio [OR] = 8.64; 95% confidence interval [CI] = 1.75, 42.80), with family members who smoked (OR = 3.28; 95% CI = 1.20, 9.00), and who smoked 10 to 19 cigarettes/day (OR = 4.83; 95% CI = 1.49, 15.69). Conversely, persistent smoking was less likely among those who attended the program regularly (OR = 0.84 per visit; 95% CI = 0.72, 0.99) and attempted quitting more frequently (OR = 0.93 per attempt; 95% CI = 0.87, 0.99). Use of smoking cessation medications (varenicline or bupropion) was not significantly associated with long-term quitting (OR = 0.71; 95% CI = 0.26, 1.93).Peer influences were the strongest predictors of failure in long-term cessation among smokers who attempted to quit. Similarly, the existence of smokers in the family was negatively associated with successful quitting. Regular attendance at a smoking cessation program and a high number of attempts to quit were positively associated with successful quitting. Targeting peer and family smoking groups together rather than targeting individual smokers alone, implementing active cessation programs encouraging regular attendance, and providing comprehensive antismoking environments might be effective strategies in a university setting.
许多烟龄较长的吸烟者在成年早期就养成了吸烟习惯。大学可以成为早期戒烟的有效场所。我们评估了大学环境中吸烟者戒烟的长期预测因素。我们对韩国首尔参加大学戒烟项目的一组吸烟者进行了纵向跟踪。在为期6周的访视期间以及1年或更长时间后进行的随访电话访谈中,评估了社会人口学因素、吸烟相关变量以及吸烟习惯的变化。总共对205名参与者进行了随访(平均随访时长:27.1个月)。访视结束时的戒烟率为47.3%,随访时为28.8%。在有吸烟同伴的个体中(比值比[OR]=8.64;95%置信区间[CI]=1.75,42.80)、有吸烟家庭成员的个体中(OR=3.28;95%CI=1.20,9.00)以及每天吸10至19支烟的个体中(OR=4.83;95%CI=1.49,15.69),长期持续吸烟率显著更高。相反,那些定期参加项目的人(每次访视OR=0.84;95%CI=0.72,0.99)以及更频繁尝试戒烟的人(每次尝试OR=0.93;95%CI=0.87,0.99)持续吸烟的可能性较小。使用戒烟药物(伐尼克兰或安非他酮)与长期戒烟没有显著关联(OR=0.71;95%CI=0.26,1.93)。同伴影响是试图戒烟的吸烟者长期戒烟失败的最强预测因素。同样,家庭中有吸烟者与成功戒烟呈负相关。定期参加戒烟项目和大量尝试戒烟与成功戒烟呈正相关。在大学环境中,同时针对同伴和家庭吸烟群体而非仅针对个体吸烟者、实施鼓励定期参加的积极戒烟项目以及提供全面的无烟环境可能是有效的策略。