Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston, Massachusetts.
Am J Prev Med. 2023 Nov;65(5):792-799. doi: 10.1016/j.amepre.2023.05.014. Epub 2023 May 20.
Most hospitalized patients who smoke resume after discharge. Associations of tobacco-related disease and health beliefs with post-hospitalization abstinence were examined.
This was a cohort study using data from a 2018-2020 multicenter trial of hospitalized adults who smoked and wanted to quit. Tobacco-related disease was defined using primary discharge diagnosis codes. Baseline health beliefs included (1) smoking caused hospitalization, (2) quitting speeds recovery, and (3) quitting prevents future illness. Outcomes included self-reported 7-day point prevalence abstinence 1, 3, and 6 months after discharge. Separate logistic regression models for each of the three health beliefs were constructed. Models stratified by tobacco-related disease explored effect modification. Analysis was performed in 2022-2023.
Of 1,406 participants (mean age 52 years, 56% females, 77% non-Hispanic White), 31% had tobacco-related disease, 42% believed that smoking caused hospitalization, 68% believed that quitting speeds recovery, and 82% believed that quitting prevents future illness. Tobacco-related disease was associated with higher 1-month point prevalence abstinence in each health belief model (AOR=1.55, 95% CI=1.15, 2.10; 1.53, 95% CI=1.14, 2.05; and 1.64, 95% CI=1.24, 2.19, respectively) and higher 6-month point prevalence abstinence in models including health beliefs 2 and 3. Quitting speeds recovery was the only belief associated with higher 1-month point prevalence abstinence (AOR=1.39, 95% CI=1.05, 1.85). Among patients with tobacco-related disease, the belief that quitting prevents future illness was associated with higher 1-month point prevalence abstinence (AOR=2.00, 95% CI=1.06, 3.78).
Tobacco-related disease predicts abstinence 1 and 6 months after hospitalization independent of health beliefs. Beliefs that quitting speeds recovery and prevents future illness may serve as targets for smoking-cessation interventions.
大多数住院吸烟患者在出院后会复吸。本研究旨在探讨与烟草相关疾病和健康信念与出院后戒烟的关系。
这是一项队列研究，使用了 2018 年至 2020 年多中心住院成年吸烟者戒烟试验的数据。使用主要出院诊断代码来定义与烟草相关的疾病。基线健康信念包括：(1)吸烟导致住院；(2)戒烟可加速康复；(3)戒烟可预防未来疾病。结果包括出院后 1、3 和 6 个月的自我报告 7 天点患病率。对于每个健康信念，分别构建了单独的逻辑回归模型。按与烟草相关的疾病分层模型，以探讨效应修饰作用。分析于 2022-2023 年进行。
在 1406 名参与者中（平均年龄 52 岁，56%为女性，77%为非西班牙裔白人），31%患有与烟草相关的疾病，42%认为吸烟导致住院，68%认为戒烟可加速康复，82%认为戒烟可预防未来疾病。在每个健康信念模型中，与烟草相关的疾病与更高的 1 个月点患病率（AOR=1.55，95%CI=1.15，2.10；1.53，95%CI=1.14，2.05；和 1.64，95%CI=1.24，2.19，分别）和更高的 6 个月点患病率相关，而在包括健康信念 2 和 3 的模型中，与烟草相关的疾病与更高的 6 个月点患病率相关。戒烟可加速康复是唯一与更高的 1 个月点患病率相关的信念（AOR=1.39，95%CI=1.05，1.85）。在患有与烟草相关疾病的患者中，认为戒烟可预防未来疾病与更高的 1 个月点患病率相关（AOR=2.00，95%CI=1.06，3.78）。
与烟草相关的疾病可预测出院后 1 个月和 6 个月的戒烟情况，独立于健康信念。戒烟可加速康复和预防未来疾病的信念可能是戒烟干预的目标。
