2015年海南省戒烟门诊试点医院患者戒烟状况与干预效果研究

Study on smoking cessation effect among patients visited tobacco cessation clinic in pilot hospitals of Hainan Province,2015

目的分析海南省首次创建3家戒烟门诊试点医院患者戒烟状况及干预效果。方法按戒烟门诊标准化工作流程,运用5A简单戒烟干预模型(询问、建议、评估、帮助、随访)指导戒烟。对"首诊登记"中"确定戒烟日"的吸烟者进行1周、1个月、3个月电话随访;其中每个干预阶段完全不吸烟者接受下一阶段随访。结果首诊登记吸烟者265例,99.2%为男性。171例习惯在起床后30min内吸第一支烟,占64.5%。"确定戒烟日"的145例吸烟者参加随访,1周持续戒烟率为63.4%; 1个月持续戒烟率为29.7%; 3个月持续戒烟率为22. 8%; 3个月随访结果中复吸者9例吸烟量≤10支的占90.0%,高于1个月23例随访占比(46.9%),复吸者吸烟量> 10支的例数由53.1%下降至10.1%; 3个月随访有93.0%的吸烟者觉得戒烟难度>5分,高于1个月随访65.2%的吸烟者觉得戒烟难度>5分。最后一次随访人群中有46.5%认为戒烟小册子对其帮助最大,39.5%会向其他人推荐这项戒烟服务。结论经戒烟门诊干预后,吸烟者吸烟量逐渐减少;但3个月戒烟成功者较1个月减少明显;戒烟"维持期"越长,戒烟率越低。应继续加强戒烟门诊服务工作。

Objective To analyze the situation of quitting smoking and evaluate the effect of intervention in 3 pilot hospitals in Hainan Province. Methods According to standardized work procedure of the smoking cessation clinic, smokers who volunteered or referred to the smoking cessation clinic for consultation or medical treatment filled in the 'first consultation registration form'. 5 A simple quit smoking intervention model(ask, advise, assess, assist, arrange) was used to guide smoking cessation. In the process of recommending and strengthening smoking cessation, the nurses also conducted a weekly, one-month and three-month telephone follow-up of smokers who had 'defined the quit day'. Nonsmokers at each intervention stage were followed up into next stage. Results There were 265 registered smokers, 99. 2% were men. 171(64. 5%) smokers were accustomed to smoke the fist tobacco within 30 minutes after getting up. A total of 145 smokers who'set quit date' participated in the follow-up, with a continuous smoking cessation rate of 63. 4% in one week follow-up, a continuous smoking cessation rate of 29. 7% in one month follow-up, and a continuous smoking cessation rate of 22. 8% in three months follow-up. Among the three-month follow-up results, 90. 0% of 9 relapsed smokers smoked less than or equal to 10 cigarettes in the three-month follow-up, higher than the one-month follow-up of 23 relapsed smokers(46. 9%). The cases of relapsed smokers who smoked more than 10 cigarettes decreased from 53. 1% to 10.1%. 93. 0% of smokers felt that the score of quitting smoking difficulty was greater than 5 in three-month follow-up, and 65. 2% of smokers felt that the score of quitting smoking was greater than 5 in one-month follow-up. 46. 5% of the last follow-up group believed that the smoking cessation brochure was the most helpful, 39. 5% would recommend the smoking cessation service to others. Conclusion After smoking cessation clinic intervention, smokers gradually reduce the amount of smoking. But 3 mouths of successful quitters decreased significantly compared with 1 month;the longer the ' maintenance period' of smoking cessation, the lower the rate of smoking cessation. Smoking cessation clinic work should continue to be strengthened.