“我能戒烟”培训干预效果评价

目的:探索社会认知理论指导下的“我能戒烟”小组式戒烟方法,评价干预效果。方法:通过社区动员征集119名吸烟者进行以社会认知理论为指导的小组式戒烟干预,并在干预完成半年、一年后对研究对象进行随访,评价干预效果。结果:一年后学员的戒烟率维持在37.3%,每日吸烟量平均减少了11支,学员的戒烟意愿普遍提高;自我效能有明显提高。对吸烟危害的认识和缺乏毅力分别为学员自我总结的戒烟成功和失败最重要的原因。Logistic回归分析显示,基线时对自己戒烟成功的预测成为是否戒烟的影响因素。结论:“我能戒烟”小组式戒烟法是一种行之有效的方法,值得在社区推广。     

社区小组驻点式干预模式对男男性行为人群的干预效果评价

目的评价社区小组驻点式干预模式对男男性行为人群的干预效果。方法在北京市东城区选取一家男男性行为人群聚集的洗浴中心,实施为期1年的社区小组驻点式干预。干预前后分别对场所的顾客进行关于艾滋病知识知晓率、高危性行为变化、接受艾滋病干预服务的意愿情况进行比较,评价干预效果。结果实施社区小组驻点式干预1年后,该人群艾滋病知识知晓率由干预前的85.25%,上升为干预后的95.50%;最近1年安全套使用情况中,从未使用比例由7.00%下降为1.00%;每次都用的比例由52.00%上升至79.00%;接受艾滋病知识宣传及安全套发放比例由77.00%上升至95.00%;接受艾滋病咨询与检测比例由66.00%上升至92.00%;接受同伴教育比例由33.00%上升至91.00%。上述指标在干预前后的变化差异均有统计学意义(P0.05)。结论社区小组驻点式干预模式提高了男男性行为人群艾滋病防治知识知晓率,减少了其高危性行为发生,是一种较为有效的干预模式。     

基于社会认知理论和传统生物医学的职高生控烟模式比较

评价以社会认知理论和以传统生物医学为基础的健康教育方法对职高生吸烟行为和影响因素的干预效果,为推动和发展职高学校控烟工作提供有效依据.方法 以学校为基础对职高生实施控烟干预,将研究对象随机分为社会认知组、健康知识组和对照组,进行为期0.5a的干预随访并评估干预后效果.结果 职高生总体吸烟率为38.75%.干预后,社会认知组吸烟率从41.60%降为30.41%,差异有统计学意义(x2=17.15,P<0.05);而健康知识组吸烟率从37.65%略下降为37.27%,空白对照组吸烟率从35.32%略上升为36.02%,差异均无统计学意义(x2值分别为0.005,0.051,P值均>0.05).干预后,社会认知组、健康知识组和空白对照组戒烟率分别为51.93%,28.57%和39.07%,社会认知组戒烟率高于对照组,差异有统计学意义(x2=20.65,P<0.05);而健康知识组与对照组戒烟率差异无统计学意义(P>0.05).结论 基于社会认知理论的干预方法能有效建立职高生正确的烟草认知从而减少其吸烟行为,而基于生物医学的干预对于控制职高生吸烟效果较差.     

计划行为理论在吸烟男性戒烟行为干预中的应用

目的探讨计划行为理论(TPB)在吸烟男性戒烟行为干预研究中的应用效果,为不同人群控烟干预积累经验。方法应用TPB设计调查问卷,在生活环境、经济水平等因素相似的2个社区选取吸烟男性进行问卷调查,找出吸烟男性戒烟行为的影响因素,以此拟定干预策略和方案。对照组不进行任何干预,干预组接受半年的社区控烟宣传、戒烟讲座、家庭成员督促教育、社区戒烟公约制定等基于TPB的针对性干预。结果干预后干预组较对照组在戒烟相关行为态度、主观规范和知觉行为控制方面有明显改善,有戒烟意向者从20%提升至40%,认为自己戒烟能成功者从10%提升至26%,差异均有统计学意义(均P0.05)。结论 TPB是吸烟男性戒烟行为的主要影响因素,针对性的干预能有效提高吸烟男性戒烟行为的尝试。     

中国／WHO控烟能力建设社区子项目上海地区一年效果评估

目的　评价中国/WHO控烟能力建设合作项目(社区控烟子项目)在上海市长宁区新华街道社区居民控烟能力建设实施一年的效果,探索今后社区的控烟方法。方法　按照中国/WHO控烟能力建设合作项目(社区控烟子项目)总体安排,统一问卷、统一时间,按照人口2 %的样本量随机抽取2 0～6 0岁社区居民,对其烟草使用和控烟方面的知识、态度和行为及对戒烟服务的需求和获得情况进行了调查与分析。结果　社区男性居民吸烟率高于女性,干预前后居民吸烟率分别为35 1%和4 2 8% ,干预期间社区居民男性吸烟人群戒烟成功率为10 6 % ,以5 5岁以上年龄段、离退休人员、大专以上学历、家庭人均月收入>2 5 0 0元人群中戒烟成功率最高。戒烟失败的主要原因是缺乏意志力,其次是来自周围吸烟者的影响;84 %以上的调查对象都认为吸烟、被动吸烟有害健康,且吸烟者、不吸烟者、戒烟者正确认知率依次增高;干预后男性调查对象劝阻朋友或家人吸烟、表示戒烟后永不吸烟比干预前有明显提高(P <0 0 1) ,且能主动寻求戒烟服务(P <0 0 5 ) ;去治疗机构就医时医务人员主动向男性调查对象介绍戒烟方法和技巧干预后多于干预前(P <0 0 1) ,有显著性差异。结论　对新华街道社区居民实施控烟教育与培训等综合性措施是有效的,提升了社区居民的控烟能     

北京市肿瘤防控示范社区患者戒烟干预研究

目的:探索社区门诊简短戒烟干预和热线戒烟干预相结合的戒烟模式。方法:社区医生采用2A+R模式对吸烟患者进行简短戒烟干预,并将患者转诊至北京12320卫生热线进行戒烟干预。结果:社区转诊患者烟龄较长、重型吸烟者多、成功戒烟者少,在过去一年尝试过戒烟的患者的2周戒烟率(34.0%)高于未尝试过戒烟的患者(23.2%),主动寻求戒烟干预服务患者的2周时点戒烟率(60.0%)高于被动接受戒烟干预服务的患者(27.2%),差异均有统计学意义(P0.05)。结论:可采用社区门诊简短戒烟干预和北京12320卫生热线戒烟干预模式为吸烟患者提供戒烟帮助。     

医务人员控烟干预效果评价

目的评价对医务人员控烟干预的效果。方法对首都医科大学宣武医院不同科室的医生进行为期半年的控烟干预活动,采用自填问卷的方法,在干预前后分别进行调查,评价干预效果。结果医务人员的吸烟率由干预前的15.9%下降为干预后的6.3%,有戒烟打算者由基线的41.4%上升为72%,给病人使用戒烟药由3.8%上升为73.9%。认为医生应主动向病人提供戒烟服务的比例由69.5%上升为78.6%。结论在医务人员中开展控烟干预行动是可行的,值得进一步推广。     

上海市中学生控烟干预研究

目的探索中学控烟的干预模式并评价干预效果。方法采用两阶段整群抽样法,以2所中学的预备班和初一年级学生为研究对象。对干预组进行为期一年的综合控烟干预,并通过干预前、干预后、干预后半年分别进行问卷调查评价干预效果。结果干预后干预组一年内的尝试吸烟率由9·7%下降到4·2%,重度被动吸烟率由15·5%下降到12·2%,有关烟草预防的认知、态度、技能有所提高,并且大部分效果在干预半年后得以持续。结论学校综合性控烟干预可行、有效,但还需要进一步和社区控烟相结合。     

成都市戒烟门诊1个月随访效果评价

目的:了解、评价成都市戒烟门诊戒烟效果,探讨有效戒烟行为干预方法。方法:1个月后对在6家医院戒烟门诊接受戒烟干预的344名吸烟者进行电话随访,随访内容为个人吸烟习惯的改变、戒烟进度、戒烟过程中遇到的困难、对提供的戒烟服务满意情况等。结果:共有314人接受随访,1个月戒烟率为7.6%,随访者每天吸烟者的所占比例由基线时90.6%降低到48.1%,吸烟量也明显减少。76.1%随访者在过去7天内出现了戒烟症状,72.9%随访者认为门诊提供的辅导服务对其帮助最大。结论:戒烟门诊应充分发挥戒烟专业机构戒烟专业指导作用,为吸烟者提供更好的戒烟建议;在吸烟者戒烟1个月后应强化"帮助"和"随访"策略,预防复吸。     

海南省某企业职工吸烟行为综合干预模式效果评价

[目的]评价控烟项目的干预效果,提高员工对吸烟健康危害的认知,降低吸烟率。[方法]采取整群分层随机抽样方法,通过车间、人员两级随机抽样,抽取某企业660名职工进行问卷调查,运用"讲座+咨询+一氧化碳检测+药物发放"模式对其进行为期6个月的干预,对干预前后吸烟情况、每日吸烟者醒后吸第一支烟的时间分布、戒烟意愿及戒烟帮助情况、烟草知识知晓情况等数据进行比对分析。[结果]干预前、后吸烟率为32.9%、28.0%,差异无统计学意义(χ~2=3.406,P 0.05);戒烟率为14.3%、27.2%,差异有统计学意义(χ~2=11.412,P 0.05)。干预前后年龄组为18~25岁、月收入在4 001~6 000元人群吸烟率均为最高。通过对干预前后130名每日吸烟者"早晨醒来后吸第一支烟"的时间分布研究发现,6个月(4—9月)强化干预后每日吸烟者每天早晨醒来后30 min内吸第一支烟的比例比干预前略高(51.5%、50.8%),而且5 min内吸第一支烟的比例较干预前也增加(14.6%,8.5%),说明对于每日吸烟者,短时间内烟草依赖干预效果不明显。但干预后现在吸烟者中尝试戒烟、考虑戒烟的比例(41.7%、48.5%)均高于干预前(22.9%、40.1%);干预后知晓海南省设置12320戒烟热线和综合性大医院设置戒烟门诊的人群比例(72.4%、73.0%)也分别比干预前大幅度增加(11.5%、12.5%)(P 0.001)。且干预后,职工对"低焦油卷烟的危害和一般卷烟差不多"的正确认知率(28.8%)明显高于干预前(18.7%);认为吸烟与中风、心脏病发作、阳痿有关者的比例明显升高,认为被动吸烟与成人心脏疾病、儿童肺部疾病和成人肺癌有关者的比例亦明显升高,差异均有统计学意义(P 0.001)。[结论]干预后6个月内海南某企业职工吸烟率下降,戒烟率上升。"讲座+咨询+一氧化碳检测+药物发放"的四联戒烟综合干预模式值得推广。     

A randomized controlled trial of group intervention based on social cognitive theory for smoking cessation in China

BACKGROUND: New training programs need to be developed to help Chinese smokers achieve quitting. The objective of this study was to assess the effectiveness of a group smoking cessation intervention based on social cognitive theory among Chinese smokers. METHOD: A total of 225 smokers were eligible for the study and were randomly assigned to an intervention group (n=118) and a control group (n=107). The intervention group received the course soon after a baseline survey, whereas the control group received routine training in the first 6 months, and then took the same course. Effectiveness was evaluated at 6-month and 1-year follow-up from baseline. RESULTS: After 6 months, 40.5% (47/116) in the intervention group and 5.0% (5/101) in the control group quit smoking (absolute risk reduction: 35.5% [95% confidence interval (CI): 24.2-46.8%]). The 6-month continuous abstinence rate was 28.4% (33/116) in the intervention group and 3.0% (3/101) in the control group (absolute risk reduction 25.4% [95% CI: 15.6-35.2%]). At 1-year follow-up, the proportion of quitting and the 6-month abstinence rate in the intervention group were 35.8% and 22.0%, respectively. The factors associated with smoking cessation during the 6 month period were intervention (adjusted odds ratio [OR]=6.42 [95% CI: 2.46-13.28]), as well as anticipation of quitting (adjusted OR=1.46 [95% CI: 1.12-1.91]) and skill self-efficacy score in the baseline (adjusted OR=1.04 [95% CI: 1.01-1.07]). The same intervention was conducted in the control group after the 6-month study, in which a similar intervention effect was observed. CONCLUSION: A smoking cessation intervention based on social cognitive theory among Chinese smokers is highly effective.     

上海市公务人员戒烟大赛一年期干预效果研究

【目的】评估2015年度上海市公务人员戒烟大赛的1年随访效果,探讨复吸行为的影响因素,为保持戒烟干预效果提供参考和依据。【方法】采用病例对照研究设计,对阶段性戒烟成功者开展问卷调查。【结果】戒烟大赛1年随访复吸率为19.70%,79.49%的复吸者在戒烟后2个月内复吸,受教育程度为复吸的危险因素。复吸主要原因为吸烟朋友的压力、烟瘾发作。【结论】本次大赛1年随访复吸率处于较低水平,戒烟效果良好。受教育程度为复吸行为的危险因素。     

综合性医院开展戒烟干预方法研究的设计和初步结果

为探索综合性医院开展戒烟干预的方法并评价其效果,采用戒烟门诊专科干预、简单干预、义诊干预和集体干预等模式对不同吸烟人群进行包括健康咨询、心理干预和药物治疗等不同形式及内容的戒烟干预,以统一规范的指标和方法评价干预效果.在项目实施的20个月中,共对690名吸烟者进行干预,对其中402名完成6个月随访的干预对象进行的初步统计分析发现:目前已完成的戒烟门诊专科干预、集体干预和戒烟义诊时的简单干预3种模式均有一定干预效果,吸娴者的吸烟量有不同程度下降,吸烟者戒烟的动机、医生采用的干预模式及强度是影响干预效果的主要影响因素;戒烟门诊专科干预和集体干预的效果优于戒烟义诊的简单干预,其6个月随访时的时点戒烟率分别为31.6%、30.9%和15.1%.戒烟者的戒烟动机和医生的态度、戒烟方法的选择及干预技能水平对戒烟成功率影响较大,因此探索适合国情的戒烟服务模式及个体化干预方法十分必要.

Abstract：

To study the intervention programs on smoking cessation in a general hospital and to evaluate its effects of the programs. Four methods including: a) the intervention through specialists in the smoking cessation clinic, b) short-time intervention in the out-patient department,c) free medical intervention, d) group intervention, were adopted for different smokers, with health counseling, psychological intervention and drug treatment. Intervention effect was evaluated by standard methods. During the 20-month period of the project, we treated 690 cases and 402 completed 6-month follow-up. Preliminary results in 402 cases showed that the three methods of smoking cessation interventions could reduce the amount of cigarette smoking and increase the quitting rate. Motivation to quit smoking, intervention methods and intensity of intervention seemed cessation clinic (31.6%) and in the group intervention (30.9%) was higher than short-time intervention in free medical events (15.1%). The successful rate of smoking cessation depended on the motivation of quitters, and the attitude, methods and intervention skills of the physicians.Therefore, it is necessary to explore and develop smoking cessation service models suitable to national context and individual intervention methods in China.     

Cognitive changes in cardiovascular patients following a tailored behavioral smoking cessation intervention

BACKGROUND: Action aimed at changing smoking behavior to prevent cardiovascular patients from further impairing their health is advisable. Cognitive behavioral interventions can be effective in this regard since they attempt to influence cognitive determinants that presumably lead to smoking cessation. The Minimal Intervention Strategy for Cardiology patients (C-MIS) is such an intervention, tailored to the patients' readiness to change. Our aim is to investigate whether the C-MIS is successful in changing patients' cognitions such as attitudes, social influence, self-efficacy and intention to quit during a 1-year period. METHODS: Smoking outpatients (N = 315) with cardiovascular disease were included. They were randomized and received either Nicotine Replacement Therapy (NRT) or NRT + C-MIS. At baseline (T1), sociodemographic and clinical characteristics were measured. Cognitions and quitting behavior were assessed at baseline and at four follow-up measurements. RESULTS: Comparing treatments, the C-MIS did not affect pros of quitting, pros of smoking and social influence. We did find small effects of the C-MIS on intention to quit and self-efficacy, although only for higher-educated patients. CONCLUSION: The C-MIS appears successful in affecting intention to quit and self-efficacy abilities, but only for patients with higher education levels. Initial positive changes in cognitions may also emerge in a medical intervention, such as the provision of NRT.     

组织改变理论在工厂戒烟干预中的应用研究

目的探索组织改变理论模型在中国工厂戒烟干预应用的可行性和效果。方法于2008～2009年对上海市两家工厂进行对照研究。对照组246人(男204,女42),平均年龄(34.7±13.2)岁,干预组233人(男203,女30),平均年龄(31.1±11.9)岁。将组织改变理论模型的4个阶段应用到干预组的戒烟干预中。分别在干预前和干预后,以问卷调查表的形式收集员工每日吸烟量、吸烟率、危害认知和戒烟意愿等方面的改变。在干预6个月后以戒烟者尿液中可的宁浓度的生物学检测判定是否成功戒烟。结果干预组的现在吸烟率由干预前的59.8%下降到干预后的39.1%(P<0.01),每日吸烟量由(15.0±8.6)支/天下降到(11.9±7.9)支/天(P<0.01)。对照组则无显著改变;干预组吸烟者中愿意接受同事戒烟帮助的比例由干预前的3.7%上升到干预后的15.6%(P<0.01),认为吸烟对健康有严重危害的比例也由干预前的36.5%上升到干预后的64.4%(P<0.05),对照组则均无显著改变(P>0.05);干预组吸烟者中打算在1个月内戒烟的比例由干预前的11.0%提高到干预后的41.5%(P<0.01),而对照组则无显著改变(8.5%vs9.5%);干预组和对照组6个月的戒烟成功率分别为24.6%和6.4%(P<0.01)。结论组织改变理论模型在中国工厂开展戒烟干预中的应用是可行的;该模型的应用对降低工人的吸烟率和每日吸烟量,提高吸烟者的戒烟意愿是显著的,6个月的戒烟成功率也显著提高。     

Randomized controlled trial for smoking cessation among city office employees

To evaluate the effect of a smoking cessation program by health professionals, a randomized intervention study was carried out in the Omihachiman city office in 1993. Participants (n = 53), volunteers from current smokers in the city office, were randomly divided into intervention and control groups. The intervention group received intensive education for five months (i.e., the effect of smoking on health, the beneficial aspects of quitting smoking, how to stop smoking and how to deal with the withdrawal symptoms). Group lectures (two times) and individual counseling (three times) were used for health education. After five months, the control group was also given the same advice on smoking cessation. Comparison of smoking cessation rates between the two groups was performed at the end of the intervention period. Follow-up of all participants occurred at six and 12 months post intervention. After the five months of intervention, smoking cessation rate in the intervention group (19.2%) tended to be higher than that in the control group (7.4%), but was not significant (chi 2 = 1.62). Over all smoking cessation rates of all participants (n = 53) at the end of the 10 month intervention was 32.1% and at six months and 1 year after the end of the 10 month intervention were 24.5% and 13.2%, respectively. Comparison of participants who successfully stopped smoking and those who did not, it was revealed that younger age, lower expired air CO concentration (p < 0.01), and attitude for smoking cessation at the beginning were significantly related to smoking cessation. In our study, after five months, smoking cessation rate in the intervention group was about two times that of the control group, although the effectiveness of our smoking cessation program could not be validated due to small sample size. Taking into account the rate of smoking cessation after one year, We believe that programs by health professionals are effective for smoking cessation.     

Do patients' preferences predict smoking cessation?

BACKGROUND: Social cognitive theories (e.g., ASE-model) propose that smoking cessation can be accomplished by changing underlying cognitive determinants such as attitudes, social influence, and self-efficacy. Others have argued that people's preferences for a health state can also predict behavior. In this study, preferences constitute the degree to which one is willing to give up a valuable good, that is survival, to obtain a desirable behavior (e.g., to quit smoking). The aim of this study is to investigate the impact of cognitive determinants and patients' preferences on the prediction of smoking cessation. METHODS: Data were collected as part of a randomized clinical trial. Smoking outpatients (N = 217) with cardiovascular disease were included. At baseline (T0), socio-demographic and clinical characteristics were measured. Social cognitions (pros of quitting, pros of smoking, social influence, and self-efficacy) and preferences (using a paper time trade-off measure (TTO)) were assessed at T1 (1 week). Smoking cessation was assessed at T2 (8 weeks). RESULTS: Logistic regression analysis showed that socio-demographic (P = .92) and clinical (P = .26) factors did not predict smoking cessation, whereas social cognitions (P = .02) and preferences did (P = .00). On average, quitters are willing to give up an appreciable amount of survival years in order to quit smoking. CONCLUSION: Preference for quitting was the strongest single predictor of smoking cessation.     

Does a health plan effort to increase smokers' awareness of cessation medication coverage increase utilization and cessation?

PURPOSE: To test whether a mailing describing new coverage for smoking cessation medications increases benefit knowledge, utilization, and quitting. METHODS: This randomized controlled trial assigned participants to benefit communication via (1) standard contract changes or (2) enhanced communication with direct-to-member postcards. A sample of 1930 self-identified smokers from two Minnesota health plans took surveys before and 1 year after the benefit's introduction. The follow-up response rate was 80%. A multilevel logistic estimator tested for differences in benefit knowledge and smoking behavior from baseline. RESULTS: More enhanced than standard communication respondents knew about the benefit (39.0% vs. 22.2%, p < .0001) at follow-up. Groups did not differ on bupropion utilization (24.6% vs. 23.1%, p = .92); nicotine replacement therapy utilization (26.9% vs. 25.9%, p = .26), or cessation (12.8% vs. 15.6%, p = .32). CONCLUSION: Although limited by the low intervention intensity and potential social desirability bias, information about new coverage alone does not appear to increase quitting behaviors.     

Do social influences contribute to occupational differences in quitting smoking and attitudes toward quitting?

PURPOSE: To examine occupational differences in social influences supporting quitting smoking and their relationships to intentions and self-efficacy to quit smoking and to quitting. DESIGN: Data were collected as part of a large worksite cancer prevention intervention trial. SETTING: Forty-four worksites. SUBJECTS: Subjects included 2626 smokers from a total baseline survey sample of 11,456 employees (response rate = 63%). MEASURES: Differences by job category in social support for quitting, pressure to quit smoking, rewards for quitting, and nonacceptability of smoking were measured using mixed model analysis of variance and the Cochran-Mantel-Haenszel test. Their association to self-efficacy, intention to quit, and quitting smoking was assessed using mixed model analysis of variance and linear logistic regression modeling. RESULTS: Compared with other workers, blue-collar workers reported less pressure to quit (p = .0001), social support for quitting (p = .0001), and nonacceptability of smoking among their coworkers (p < .001). Intention to quit was associated with higher levels of social pressure to quit smoking (p = .0001) and social support for quitting (p = .002). Self-efficacy was associated with social pressure to quit (p = .0001), social support for quitting (p = .004), and perceiving greater rewards for quitting (p = .0001). CONCLUSIONS: Although these results are limited somewhat by response and attrition rates, these results suggest that differing social environments may contribute to the differences by occupational category in smoking prevalence and smoking cessation.     

中国六城市医务人员戒烟服务的效果评价

目的评价6个城市医务人员提供戒烟服务的实施效果,探讨我国医务人员戒烟服务的工作模式。方法在北京、上海、天津、长沙、深圳和濮阳6个城市7个社区的所有医疗机构负责人和医务人员做戒烟服务研究,进行现场问卷调查。结果干预后共有25家医疗机构开展戒烟服务。医务人员对烟草危害相关知识的知晓率增加了12.8%(P<0.05),掌握戒烟方法和技巧的比例增加了9.2%(P<0.05),主动向病人提供戒烟服务的比例增加了7.3%(P<0.05)。结论培训不但是提高医护人员烟草相关知识和促进医护人员主动提供戒烟服务的有效措施,而且是其获得戒烟方法和技能的有效途径。