Orleans C T, Resch N, Noll E, Keintz M K, Rimer B K, Brown T V, Snedden T M
Fox Chase Cancer Center, Cheltenham, PA 19012.
JAMA. 1994 Feb 23;271(8):601-7.
To assess transdermal nicotine use patterns and outcomes in a population of low-income older smokers.
A 6-month telephone follow-up survey of smokers filling prescriptions for transdermal nicotine in the first 3 months of 1992.
Pennsylvania's Pharmaceutical Assistance Plan for the Elderly, the nation's largest state-level prescription plan for the elderly.
A total of 1070 noninstitutionalized male and female smokers aged 65 through 74 years.
Self-reported physician/pharmacist advice and adjunctive treatments, concomitant smoking, and 6-month smoking abstinence.
Respondents were predominantly long-term heavy smokers. They used nicotine patches for an average of 5 weeks, with few reporting use beyond 3 months or recalling bothersome side effects. Most of those with previous quit attempts rated quitting with the patch "easier." The 29% self-reported 6-month quit rate observed is encouraging. However, compliance with patch use guidelines was far from ideal in this high-risk population: only 54% of respondents received any initial advice or materials from their physicians or pharmacists, fewer than 2% took part in a formal clinic or one-to-one treatment program, and almost half (47%) smoked while using the patch, including 20% who smoked every day. Concomitant smoking was strongly associated with failure to achieve abstinence (P < .001). More frequent contact with physicians and/or pharmacists was associated with less concomitant smoking (P < .001) and higher quit rates (P = .005).
This survey offers an important first look at problems and prospects for nicotine patch therapy in older adults, with implications for other groups as well. Prospective studies are needed to clarify optimal treatment regimens and adjuncts.
评估低收入老年吸烟者群体中经皮尼古丁的使用模式及效果。
对1992年头3个月开具经皮尼古丁处方的吸烟者进行为期6个月的电话随访调查。
宾夕法尼亚州老年人药物援助计划，这是美国最大的州级老年人处方计划。
共有1070名年龄在65至74岁之间的非机构化男性和女性吸烟者。
自我报告的医生/药剂师建议及辅助治疗、同时吸烟情况以及6个月戒烟情况。
受访者主要是长期重度吸烟者。他们平均使用尼古丁贴片5周，很少有人报告使用超过3个月或回忆起有令人烦恼的副作用。大多数曾尝试戒烟的人认为使用贴片戒烟“更容易”。观察到的29%的自我报告6个月戒烟率令人鼓舞。然而，在这个高风险人群中，对贴片使用指南的依从性远不理想：只有54%的受访者从他们的医生或药剂师那里得到了任何初始建议或材料，不到2%的人参加了正式诊所或一对一治疗项目，几乎一半（47%）的人在使用贴片时仍吸烟，其中20%的人每天都吸烟。同时吸烟与未能戒烟密切相关（P < 0.001）。与医生和/或药剂师更频繁的接触与更少的同时吸烟（P < 0.001）和更高的戒烟率（P = 0.005）相关。
这项调查首次重要地审视了老年人尼古丁贴片疗法的问题和前景，对其他群体也有启示。需要进行前瞻性研究以明确最佳治疗方案和辅助手段。
