医务人员控烟状况调查分析

目的 了解我院医务人员控烟状况,为加强医务人员控烟能力建设,推进全社会控烟工作提供科学依据.方法 采用中国控制吸烟协会<医院控制吸烟指导手册>的"医务人员控烟知识、态度、行为调查表"于2010年1月对广西壮族自治区人民医院医务人员控烟状况进行问卷调查.结果 医务人员总的吸烟率为5.1%,男性吸烟率为18.7%,女性吸烟率为0.1%.烟草危害知识、吸烟和被动吸烟与相关疾病的知晓率以及对医院室内完全禁烟的认同率在70%～98%,有25.4%的医务人员经常询问病人的吸烟情况,知道病人吸烟有51.5%的医务人员经常建议病人戒烟,有3.3%的医务人员使用过戒烟药物.结论 不仅要加强医务人员控烟的健康教育,还要加强医务人员的社会责任感教育,医院还要用行政干预的手段加强医院控烟的执法力度,加强医务人员控烟与戒烟知识和技能的培训,增强医务人员主动为病人提供控烟知识和戒烟服务意识的能力.     

新余市医务人员吸烟现状与控烟能力调查

目的了解掌握我市医生吸烟和医生参加控烟工作的现状及影响因素,为制定项目干预策略提供依据。方法采用现场调查研究的方法对新余市3所医院的500名医生进行问卷调查。结果新余市医生总吸烟率为34．8％,98．9％的医生是赞同医院应该禁烟的,74．7％的医生接诊时会建议病人戒烟或少吸烟,87．2％的医生认为医院控烟政策执行一般或不好。当病人及家属在医生面前吸烟时,有11．1％的医生劝告病人戒烟,57．4％的医生让病人不要吸烟,22．2％的医生会让病人到别处吸烟。结论新余市医生的吸烟率较高,可能与医院控烟政策执行不够有关。医生对被动吸烟危害认识到位,新余市医生具有较强的控烟意识,但缺少劝烟技巧培训。帮助病人戒烟的工作中,多数医生主要是鼓励病人戒烟,但还有相当多的医生没有真正掌握戒烟知识和戒烟方法。因此,要加强对医院员工进行控烟知识、控烟方法和技巧、戒烟知识及方法的培训。     

374名县医院医务人员吸烟行为及控烟态度调查

目的了解河南省某县医院医务人员吸烟行为及控烟态度现状,为实施控烟干预提供依据。方法采用分层随机抽样的方法问卷调查河南省某县医院医务人员吸烟行为及控烟现状。结果共调查374名在职员工,其中临床医生94人,医技人员43人,行政后勤人员39人,护理及其他人员198人,总吸烟率14.71%,男性吸烟率55.67%,高于女性(χ2=175.21,P<0.001)。按性别分层分析显示,不同受教育程度和工作岗位的男性医务人员吸烟率差异无统计学意义(P>0.05)。吸烟者中临床医生与其他医务人员相比,工作时吸烟率差异无统计学意义(χ2=2.01,P=0.156),休息时吸烟率较低(χ2=9.33,P=0.002);在室外、洗手间吸烟率较低(P<0.05);在患者/家属面前吸烟、接受患者/家属敬烟、给别人敬烟等行为差异无统计学意义(P>0.05),在同事面前吸烟率较低(χ2=6.17,P=0.013)。临床医生及护士赞成医生工作时间不应吸烟的比例尚低于其他医务人员(χ2=5.38,P=0.020)。结论县级医院男性医务人员吸烟比例较高,对吸烟危害的认识普遍不足,主动戒烟比例较低,应在加强吸烟危害宣传的同时,在医务人员中开展强制戒烟。     

374名县医院医务人员吸烟行为及控烟态度调查

目的了解河南省某县医院医务人员吸烟行为及控烟态度现状,为实施控烟干预提供依据。方法采用分层随机抽样的方法问卷调查河南省某县医院医务人员吸烟行为及控烟现状。结果共调查374名在职员工,其中临床医生94人,医技人员43人,行政后勤人员39人,护理及其他人员198人,总吸烟率14.71%,男性吸烟率55.67%,高于女性（χ2=175.21,P〈0.001）。按性别分层分析显示,不同受教育程度和工作岗位的男性医务人员吸烟率差异无统计学意义（P〉0.05）。吸烟者中临床医生与其他医务人员相比,工作时吸烟率差异无统计学意义（χ2=2.01,P=0.156）,休息时吸烟率较低（χ2=9.33,P=0.002）;在室外、洗手间吸烟率较低（P〈0.05）;在患者/家属面前吸烟、接受患者/家属敬烟、给别人敬烟等行为差异无统计学意义（P〉0.05）,在同事面前吸烟率较低（χ2=6.17,P=0.013）。临床医生及护士赞成医生工作时间不应吸烟的比例尚低于其他医务人员（χ2=5.38,P=0.020）。结论县级医院男性医务人员吸烟比例较高,对吸烟危害的认识普遍不足,主动戒烟比例较低,应在加强吸烟危害宣传的同时,在医务人员中开展强制戒烟     

医务人员吸烟现状及参与控烟干预情况调查

目的：了解商丘市医务人员吸烟状况及参与控烟干预的情况，为提高医务人员的控烟意识，促使其在日常工作中积极参与控烟工作提供依据。方法：采用不记名问卷调查方式，对商丘市三家市级医院400名医务人员进行调查。结果：三家市级医院医务人员的平均吸烟率为40．9％（152人），其中男性吸烟率为57．5％，女性吸烟率为2．7％。72．3％的医务人员认为劝病人戒烟是医生的责任，71．8％常劝说病人戒烟，不吸烟者与吸烟者的态度存在显著差异。结论：我市医务人员对吸烟的认识和控烟知识的掌握情况欠佳，有必要加强对其控烟知识及技能的宣教与培训，端正其控烟态度，使其更有效的参与控烟工作。     

成都市医务人员吸烟状况及控烟干预研究

目的 了解成都市医务人员的吸烟状况及其控烟态度和行为,并对其进行干预及其效果评价。方法 采用问卷形式对成都市3家医院的932名医务人员的吸烟危害知识、控烟态度和行为进行调查,并对一家医院进行干预,同时对干预结果进行评价。结果 男性吸烟率为49．7％,女性为0．2％,男性吸烟者主要集中在外科医生和医技人员中;知识方面,对吸烟与肺癌、缺血性心脏病的关系掌握较好,但对被动吸烟与儿童中耳炎和猝死综合症关系回答正确的仅41．5％和48．2％;86．2％的不吸烟者中反对“被动吸烟无害”,但吸烟者中仅为70．4％,两者的差异有统计学意义;态度方面,对于以经济手段来处罚违反吸烟规定者,不吸烟者和吸烟者赞成的比例分别是87．5％和68．1％,差异有统计学意义（P＜0．001）;行为方面,不吸烟者询问病人吸烟状况的比例高于吸烟者,同时不吸烟者鼓励家人或朋友戒烟的比例明显高于吸烟者,二者差异有统计学意义。通过综合干预,医务人员的吸烟率差异虽无统计学意义,但有好转趋势;控烟态度明显好于干预前,差异有统计学意义（P＜0．05）。结论 目前医务人员的吸烟率较高,控烟意识淡漠,吸烟者和不吸烟者在控烟态度和行为方面存在差异。在医院环境中采取综合干预的方法可以改变医务人员的吸烟行为,提高其控烟意识。     

西安某医学院校教职工、医务人员及学生吸烟状况及相关态度调查

目的了解某医学院校教职工、附属医院医务人员以及在校学生吸烟情况和对控烟工作的态度。方法以自行设计的问卷为调查工具,对医学院全部教职工、附属医院医务人员和在校学生进行调查。结果教职工的吸烟率最高,为25．80％,然后依次为医务人员、研究生和大学生,吸烟率分别为14．29％、4．96％和3．64％;男性吸烟率远高于女性（x^2=668．32P〈0．05）,男性教职工、医务人员、研究生和大学生的吸烟率分别为48．33％、41．56％、14．11％和7．23％。各类人员对控烟工作的支持率均在90％左右。讨论在无烟医学校园和无烟医院的创建工作中,应以男性吸烟者和青年学生为重点,通过环境与制度建设的结合,推进全社会控烟工作的有效开展。     

医务人员控烟干预效果评价

目的了解创建无烟医院前后我院医务人员控烟干预的效果。方法对2011年我院不同科室的医务人员进行为期一年的控烟干预活动,使用中国控制吸烟协会设计的调查表,对我院部分医务人员进行基线调查和终末调查。结果医务人员的吸烟率由干预前的28.5%下降为干预后的15.6%;干预后医务人员控烟知识与态度有所提高,增长率提高较大的吸烟易导致骨质疏松,干预前为51%,干预后84%,差异有统计学意义（P〈0.05）;医生应主动向病人提供戒烟服务的比例由干预前64.7%上升到干预后的86.4%。结论我院通过创建无烟医院,医务人员的控烟知识态度明显改善,效果显著,创建无烟医院是一项利国利民的重要举措。     

银川市某医院医生吸烟及其危害认知状况调查

目的了解银川市某医院医务人员吸烟相关行为和对吸烟危害的认知状况。方法采用随机整群抽样方法,抽取该医院22个科室的所有在岗医生共计330人作为调查对象,采用华西医科大学编制的调查问卷对所有调查对象进行问卷调查。结果 1)调查的医生中尝试吸烟率46.0%,其中男性为61.7%,女性为19.7%;吸烟率为24.1%,其中男性36.4%,女性3.3%;2)男性尝试吸烟率高于女性,麻醉、康复、外科等科室医生的吸烟率均在57%以上,高于其它科室,其差异均有统计学意义(P<0.05);3)90.0%的医生认为主动吸烟及被动吸烟与肺部疾病相关,但对与其他系统疾病关系认识不足;4)95.1%的医生认为医务人员应该在控烟活动中起表率作用;73.1%的被调查者在过去1周里建议过自己的患者戒烟。结论银川市某医院吸烟人群以男性为重点人群,以麻醉、外科等科室为重点科室;应加强对医务人员的健康教育和戒烟、控烟知识培训,以培养其控烟意识,并提高其戒烟服务能力和控烟能力。     

医生吸烟及相关认知状况调查

目的了解某医院医生对吸烟的认知,为该人群烟草控制提供参考依据。方法2009年5月18日-22日以问卷方式调查某综合医院184名医生的吸烟相关知识,包括该医生是否吸烟、是否认为吸烟有害健康和知道哪些戒烟方法等。结果41—50岁组医生吸烟率较高为22％,≤30岁组最低（10．5％）;≥51岁组认为吸烟危害健康比例最高,≤30岁组最低;两种戒烟干预方式的知晓率分别为38．6％、48．6％、29．3％和57．1％。结论被调查医生中15．8％吸烟,应针对其职业特点进一步加强医生控烟教育。     

Therapy for cessation of smoking

Tobacco dependence is a chronic relapsing medical illness. Unfortunately more than 1.1 billion people worldwide smoke tobacco. Tobacco consumption rate is very high in India. Providing three minutes counseling by physicians doubles the cessation rate as compared to no intervention. Nicotine replacement products (gums, transdermal patch, nasal spray, inhaler and lozenge), bupropion and varenicline used with counseling by physicians double the cessation rates at one year. There are drugs like buspirone, naltrexone, mecamylamine and silver acetate; some of which either alone or in combination with any of the above drugs may be routinely used in near future for smoking cessation in at least some specific groups of population. The most difficult problem for patients in smoking cessation is withdrawal symptoms. Counseling with continuous support from physician, family members, friends and overall from the society will help in achieving a higher rate of smoking cessation, with the final aim of making ours a tobacco smoke-free world for future generations.     

Tobacco smoking in the Caribbean. The role of dental professionals in smoking cessation programmes

Cigarette smoking constitutes the most common form of tobacco use in the western world. Although the prevalence in the Caribbean is lower compared with Latin American and North American countries, cigarette smoking is gaining popularity with adolescents in the Caribbean. Tobacco smoking is injurious to general and oral health and is responsible for at least ten per cent of all deaths in the English-speaking Caribbean countries. These observations imply an urgent need to implement anti-smoking programmes in this region. Such programmes should focus on prevention of the acquisition of tobacco smoking habits, implementing smoking cessation programmes and providing support for those who have quit smoking. A variety of approaches involving health professionals, government and non-governmental agencies, media and other interest groups is required to address this issue. This paper proposes a strategy for a smoking cessation programme in the Caribbean that should be incorporated in day-to-day general dental practice.     

Study of smoking habits in hospital and attitudes of medical staff towards smoking.

Most hospital policies place little or no restriction on patients' smoking in hospital. In this study patients were surveyed to determine if they smoked and if their doctors advised or ordered them to stop smoking in hospital. As well, the smoking habits and attitudes towards smoking of the medical staff and other hospital workers were explored. Of 741 patients 37% were smokers, and those who responded fully to a questionnaire 86% continued to smoke in hospital. Patients who were advised or ordered not to smoke (59%) were no more likely to stop smoking than those who were not so advised or ordered. Physicians were less likely to smoke than other hospital staff, and those who did smoke were much more likely not to smoke while in the hospital. Physicians appear to have a reasonable appreciation of the health hazards of smoking, and almost two thirds are in favour of stricter restrictions on patients' smoking in hospital. The ineffectiveness of their efforts is primarily due to hospital policies that are not in keeping with physicians' standards of practice and with established knowledge of the deleterious effects of smoking on health.     

女医学生吸烟状况及认知调查分析

目的:调查医学院校女生的吸烟状况以及与吸烟相关的知识、态度及行为。方法:采取分层随机抽样方法,对某医学院398名女生展开问卷调查,进行横断面调查研究。结果:被调查女生中现在吸烟率(5.0%)和戒烟率(6.8%)均较低;在不同的专业中,现在吸烟率的差异无统计学意义(P>0.05);城市生源的女生吸烟率和尝试吸烟率均高于农村生源的女生(P<0.01)。被调查女生对于吸烟危害知识缺乏,>85%的女生知晓吸烟是肺癌和慢性阻塞性肺疾病的危险因素,<45%的女生知晓吸烟是自发性流产、心脏病和多种疾病的危险因素。大部分被调查女生对女性吸烟持消极态度,不同专业的女生在对于女性吸烟的态度上差异无统计学意义(P>0.05)。城市生源的女生对于女性吸烟的态度更积极,她们认为女性吸烟看起来很酷、很有魅力的百分率均高于农村生源的女生(P<0.05)。结论:医学院校的女生对于吸烟相关知识明显缺乏。医学院校应该利用自身的专业优势,采取有效的控烟策略以预防未来的医务工作者吸烟和指导患者戒烟。     

北京上海两城市创建无烟医院效果评价

目的：通过项目干预,项目医院在干预后达到无烟医院的标准,作为全国无烟医院的示范。方法：采用非随机选择的方法在北京、上海两城市医院中各选10家医院,进行无炯医院的创建。以各个医院在职临床医生为重点进行干预。在项目启动前和终末期,分别进行医生控烟知识、态度和行为调查、拦截调查和环境调查,并按照中国控制吸烟协会制订的全国无烟医院评估标准进行评估。结果：各医院按照要求完成了相关调查,被调查医生吸烟率在基线和终末调查时分别为10．7％,6．0％（P〈0．001）。男女医生吸烟率分别从20．1％和0．4％下降到13．0％和0．2％。医生对吸烟与肺癌、肺气肿、脑卒中等相关关系认识方面均有提高,差异有统计学意义（P〈0．001）。拦截调查也显示医院环境内吸烟、见到医生吸烟的频率下降,控烟宣传工作加强。结论：尽管项目医院选择存在一定的偏倚,但通过项目干预,项目结束时,20家医院全部达到无烟医院标准,获“全国无烟医院”称号。     

吸烟对健康的危害及控烟策略

烟草严重威胁中国民众的身体健康，必须采取科学有效的措施对吸烟进行预防与控制。本文探讨了吸烟对健康的危害及控烟策略，研究吸烟在中国的流行状况及影响因素，并提出控烟策略和措施。有效的控烟运动有赖于政府积极主导控烟规划，社会政治、经济和文化等各个领域积极构建控烟支持环境，从而切实减少烟草对我国公民健康的危害。     

Initial results from the Arkansas Smoking Cessation Network program

Tobacco use is the single most costly health risk behavior today. Although Arkansas has seen a significant decrease in smoking prevalence (28.5% in 1997 to 25.2% in 2000), low-socioeconomic (SES) populations in Arkansas continue to use tobacco at a high rate and suffer disproportionately from tobacco-related diseases. In 1998, nearly 14% of all Medicaid expenditures in Arkansas, a total of dollars 189 million, were spent on smoking-related illnesses. Smoking cessation programs produce greater short-term public health benefits than any other component of a tobacco control program. As part of a statewide tobacco control program, the Arkansas Foundation for Medical Care, in partnership with the Arkansas Department of Health, has established intensive smoking cessation programs in 10 Community Health Centers and five rural hospitals throughout the state. Among the 852 participants enrolled in the first budget period, 221 completed a treatment program thus far, 180 terminated without completion and 451 are in treatment. Of those participants who completed treatment, 75% had quit smoking. This cessation program is clearly filling a demand for services and has the potential to significantly reduce the cost of smoking-related illness in Arkansas.     

美国军事人员烟草使用率增加

2009年12月出版的《临床医师肿瘤杂志》（CA CancerJ Clin））2刊载了一篇题为“美国的烟草控制——最新进展和机会”的文章,回顾了过去30年美国青少年和成年人的烟草使用率以及政府在控制烟草方面的举捎。我们对该论文进行研读后,就该文指出的“过去30年,吸烟率在整体人群中持续下降”这一观点提出了疑问,认为南于美国军事人员越来越多地参与军事或救援行动,在这些人群中,吸烟率应当是不降反升的。我们将自己的观点撰写成文．并提供支持这一观点的证据,这篇Letter于2010年2月8日在该杂志的网站上发表。     

Passive Smoking in China： Contributing Factors and Areas for Future Interventions

Objective To reduce tobacco consumption and exposure to passive smoking in China. Methods Discussion consisting of 80 focus groups and 35 interviews were held in three rural intervention counties of Jiangxi, Henan, and Sichuan Provinces. Participants came from hospitals, schools, rural areas, and urban areas. Results Tobacco use and exposure to passive smoking were widely prevalent in the investigated schools, hospitals, county towns, and rural areas. Knowledge of the risks for passive smoking on health is lacking, especially in rural areas. Barriers to the control of tobacco use in public places include reluctance of administrators to implement tobacco control policies, lack of consistent policies, difficulties with regulations and enforcement, and reluctance of non-smokers to exercise their right to clean air. Conclusion To curb the current tobacco epidemic in China, tobacco control efforts must focus on reducing exposure to passive smoking. A strategy should be formulated to reduce the factors that contribute to tobacco use and exposure to passive smoking.     

社区心血管病患者戒烟成功的影响因素分析

目的调查社区心血管病患者吸烟和戒烟行为,探讨影响戒烟成功的影响因素。方法对管辖社区心血管病患者研究组670例,以及同期在我院门诊就诊的非心血管病患者对照组668例,采用调查问卷方式,对患者吸烟状况,戒烟意愿,戒烟行为等调查。结果研究组吸烟率37.2%高于对照组26.3%(P<0.01),以研究组15～45岁患者吸烟率最高(47.7%),大多数心血管病患者曾尝试戒烟,经logistic回归分析,年龄越大戒烟成功率越高,而重度尼古丁成瘾率高者戒烟成功率低。结论年龄、尼古丁成瘾程度和医务人员对戒烟干预是心血管病患者戒烟成功的重要影响因素。