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基层医疗保健中与戒烟相关的因素

Factors Associated with Tobacco Cessation in Primary Health Care.

作者信息

Melnick Ricardo, Rech Gabriela Soares, Rech Rafaela Soares, Faustino-Silva Daniel Demétrio

机构信息

Graduate Program in Assessment and Production of Technologies for the SUS (PPGATSUS), Grupo Hospitalar Conceição (GHC), Porto Alegre, RS, Brazil.

Mathematics and Statistics Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2021 Feb 19;25(4):e551-e556. doi: 10.1055/s-0040-1722164. eCollection 2021 Oct.

Abstract

Cigarettes are the main cause of preventable death in the world, and primary health care services can contribute to the management of this habit.  To describe and analyze the factors associated with tobacco cessation in groups of smokers in primary health care.  The present is a cross-sectional study conducted in 12 primary health care units from July 2016 to May 2017. We investigated sociodemographic and health variables, as well as smoking characteristics and different interventions for tobacco cessation, with the outcome being studied and analyzed after the fourth group care session.  We evaluated 329 smokers, of which 182 quit smoking after the fourth interview. Most of the individuals who quit smoking were women (  = 121, 66.5%), with a monthly income of 2 to 5 minimum wages (  = 88, 77.9%). After the multivariable analysis, we observed that tobacco cessation was significantly associated with depression (prevalence ratio [PR] = 1.11; 95% confidence interval [95%CI] = 1.02 to 1.22), as well as with belonging to the groups which used as approaches motivational interviewing (PR = 1.21; 95%CI = 1.13 to 2.01), patches (PR = 1.36; 95%CI = 1.24 to 1.48), and bupropion (PR = 1.16; 95%CI = 1.03 to 1.31).  Primary health care is the ideal site for the reduction of smoking rates, given that different technologies may be applicable and useful for tobacco cessation. The comprehensiveness and longitudinal care offered in primary care may provide opportunities for health professionals to understand which is the best technology for each health system user, thus contributing to personalized care.

摘要

香烟是全球可预防死亡的主要原因,初级卫生保健服务有助于对这一习惯进行管理。

描述并分析初级卫生保健中吸烟者群体与戒烟相关的因素。

本研究为横断面研究,于2016年7月至2017年5月在12个初级卫生保健单位开展。我们调查了社会人口学和健康变量,以及吸烟特征和不同的戒烟干预措施,并在第四次小组护理会议后对结果进行研究和分析。

我们评估了329名吸烟者,其中182人在第四次访谈后戒烟。大多数戒烟者为女性(n = 121,66.5%),月收入为2至5个最低工资(n = 88,77.9%)。多变量分析后,我们观察到戒烟与抑郁症显著相关(患病率比[PR]=1.11;95%置信区间[95%CI]=1.02至1.22),还与采用动机性访谈(PR = 1.21;95%CI = 1.13至2.01)、贴片(PR = 1.36;95%CI = 1.24至1.48)和安非他酮(PR = 1.16;95%CI = 1.03至1.31)等方法的群体相关。

鉴于不同技术可能适用于戒烟且有用,初级卫生保健是降低吸烟率的理想场所。初级保健提供的全面性和纵向护理可能为卫生专业人员提供机会,以了解哪种技术最适合每个卫生系统使用者,从而有助于提供个性化护理。

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本文引用的文献

1
Smoking reduction interventions for smoking cessation.用于戒烟的减少吸烟干预措施。
Cochrane Database Syst Rev. 2019 Sep 30;9(9):CD013183. doi: 10.1002/14651858.CD013183.pub2.
5
Nicotine receptor partial agonists for smoking cessation.用于戒烟的尼古丁受体部分激动剂。
Cochrane Database Syst Rev. 2016 May 9;2016(5):CD006103. doi: 10.1002/14651858.CD006103.pub7.
9
Antidepressants for smoking cessation.用于戒烟的抗抑郁药。
Cochrane Database Syst Rev. 2014 Jan 8;2014(1):CD000031. doi: 10.1002/14651858.CD000031.pub4.
10
Physician advice for smoking cessation.医生关于戒烟的建议。
Cochrane Database Syst Rev. 2013 May 31;2013(5):CD000165. doi: 10.1002/14651858.CD000165.pub4.

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