新诊断肺癌患者继续吸烟的现状及其影响因素分析

Analysis of the status quo and influencing factors of continued smoking in newly diagnosed lung cancer patients

目的了解新诊断肺癌患者的继续吸烟现状及其影响因素,为制定患者戒烟计划提供支持。方法选取初次诊断肺癌且曾经或正在吸烟的患者215例,在诊断肺癌1个月后,采用自制格式化表格采集人口社会学变量、临床和吸烟特征,应用医院焦虑抑郁量表(HADS)、Velicer拒烟自我效能量表分别评估患者心理状态和拒烟自我效能。调查患者诊断肺癌后仍继续吸烟的发生率,分析肺癌后仍继续吸烟的独立危险因素。结果215名有吸烟史的患者中,94例诊断肺癌后仍继续吸烟。与成功戒烟1年以上的患者相比较,继续吸烟者年龄更小(OR=0.95)、不经常运动(OR=2.74)、与吸烟者共同居住(OR=2.48)以及拒绝吸烟的自我效能低(OR=0.96),均P<0.05。与近1个月内戒烟者相比,继续吸烟者拒绝吸烟的自我效能更低(OR=0.93,P<0.05)。结论在有吸烟史的人群中,44.7%的患者在确诊肺癌后仍继续吸烟。确诊后继续吸烟的危险因素包括不经常运动、与吸烟者共同生活以及拒绝吸烟自我效能低下。建议采取相应措施促进新诊断肺癌患者定期运动和增强自我效能,以提高这一群体的戒烟率。

Objective To understand the current situation and influencing factors of continuous smoking in patients with newly diagnosed lung cancer and to support the formulation of patients'smoking cessation plans.Methods A total of 215 patients with lung cancer who had been or were smoking for the first time were selected.One month after the lung cancer diagnosis,demographic and sociological variables and clinical and smoking characteristics were collected with self-made formatted tables.The patients'psychological status and smoking refusal self-efficacy were evaluated with hospital anxiety and depression scale(HADS)and Velicer smoking refusal self-efficacy scale,respectively.The incidence of continued smoking after lung cancer diagnosis was investigated,and the independent risk factors of continued smoking after lung cancer were analyzed.Results Among 215 patients with a smoking history,94 continued to smoke after being diagnosed with lung cancer.Compared with patients who successfully quit smoking for more than one year,continued smokers were younger(OR=0.95),less exercise(OR=2.74),living with smokers(OR=2.48),and had low self-efficacy in refusing to smoke(OR=0.96),and all P<0.05.Compared with those who quit smoking within the past month,continued smokers had lower self-efficacy in refusing to smoke(OR=0.93,P<0.05).Conclusions Among those with a smoking history,44.7%continued to smoke after being diagnosed with lung cancer.The risk factors for continuing smoking after diagnosis include infrequent exercise,living with smokers,and low self-efficacy in refusing to smoke.It is suggested that corresponding measures should be taken to promote regular exercise and enhance the self-efficacy of patients with newly diagnosed lung cancer to improve this group's smoking cessation rate.