Cilluffo Giovanna, Ferrante Giuliana, Cutrera Renato, Piacentini Giorgio, Bignamini Elisabetta, Landi Massimo, Martucci Paola, Morcaldi Luigi, Midulla Fabio, Viegi Giovanni, La Grutta Stefania
Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Palermo, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
J Thorac Dis. 2020 Nov;12(11):6868-6879. doi: 10.21037/jtd-gard-20-003.
Paediatricians rarely devote any time to screening and treatment for parental tobacco use. The present project is part of a Global Alliance against Chronic Respiratory Diseases (GARD)-Italy Demonstration Project, aimed to increase the skills of primary care physicians and paediatricians as "promoter of smoking cessation". The aims of this study were: (I) to identify latent classes of barriers and incentives for smoking cessation counseling among paediatricians using latent class analysis (LCA); (II) to investigate risk factors for inclusion into the identified classes.
In 2018, 1,500 Italian paediatricians were invited to complete an online survey on passive smoke exposure in children. LCA was used to discover underlying response patterns, and to identify respondent groups with similar attitudes toward passive smoke exposure in children. Multinomial logistic regression helped investigate which explanatory variables influenced inclusion into a class. A P value <0.05 was considered significant.
The overall response rate was 71% (n=1,071/1,500). Three classes were identified: Class 1 "passive" (n=226, 21.10%); Class 2 "unmotivated" (n=124, 11.58%); and Class 3 "proactive" (n=721, 67.32%). Assuming Class 3 as reference, ever having been a smoker was borderline associated (P=0.052) with increased probability of inclusion into Class 1 (OR =1.43, 95% CI, 1.00-2.06). Having 6-15 or ≥15 years of work experience versus having less than five years was associated with decreased probability of being in the "passive" class (OR =0.46, 95% CI, 0.22-0.96 and OR =0.49, 95% CI, 0.27-0.87, respectively), as was discussing parents' addiction to alcohol/drugs (OR =0.50, 95% CI, 0.33-0.76).
We identified three profiles among Italian paediatricians related to barriers and incentives for smoking cessation promotion. Tailored educational interventions for paediatricians are required to promote smoking cessation programs.
儿科医生很少花时间对家长吸烟情况进行筛查和治疗。本项目是全球抗击慢性呼吸道疾病联盟（GARD）-意大利示范项目的一部分，旨在提高基层医疗医生和儿科医生作为“戒烟推动者”的技能。本研究的目的是：（I）使用潜在类别分析（LCA）确定儿科医生中戒烟咨询的潜在障碍和激励类别；（II）调查纳入已确定类别的风险因素。
2018年，邀请1500名意大利儿科医生完成一项关于儿童被动吸烟暴露的在线调查。LCA用于发现潜在的反应模式，并识别对儿童被动吸烟暴露态度相似的受访者群体。多项逻辑回归有助于调查哪些解释变量影响纳入某一类别。P值<0.05被认为具有统计学意义。
总体回复率为71%（n = 1071/1500）。确定了三个类别：第1类“被动型”（n = 226，21.10%）；第2类“无积极性型”（n = 124，11.58%）；第3类“积极型”（n = 721，67.32%）。以第3类为参照，曾经吸烟与纳入第1类的概率增加存在临界关联（P = 0.052）（比值比[OR]=1.43，95%置信区间[CI]，1.00 - 2.06）。与工作经验少于5年相比，工作经验为6 - 15年或≥15年与处于“被动型”类别的概率降低相关（OR分别为0.46，95%CI，0.22 - 0.96和OR = 0.49，95%CI，0.27 - 0.87），讨论家长对酒精/药物成瘾情况时也是如此（OR = 0.50，95%CI，0.33 - 0.76）。
我们在意大利儿科医生中确定了与戒烟推广的障碍和激励相关的三种类型。需要为儿科医生量身定制教育干预措施以促进戒烟项目。
