PHYSICIAN-DELIVERED INTERVENTIONS FOR SMOKING CESSATION - STRATEGIES FOR INCREASING EFFECTIVENESS
PHYSICIAN-DELIVERED INTERVENTIONS FOR SMOKING CESSATION - STRATEGIES FOR INCREASING EFFECTIVENESS
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DOI：
10.1016/0091-7435(87)90054-5
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发表时间：
1987-09-01
影响因子：
5.1
通讯作者：
OCKENE, JK
中科院分区：
文献类型：
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作者：
OCKENE, JK
如果医生和其他医疗保健提供者能够帮助每 10 名吸烟者中就有 1 名吸烟者长期戒烟（这是基于随机医生干预研究结果的安全估计），那么近 400 万吸烟者将成为戒烟者。随机试验和观察性研究的证据表明，对吸烟者进行干预的医生会对他们的吸烟行为产生影响。随着医生干预的加强和接触的频繁，戒烟率会提高。添加咨询、自助小册子和含尼古丁口香糖等方式似乎可以单独提高建议的有效性。后续行动的必要性和多种方式的可能使用的一致证明与高血压等医疗问题的有效整体管理方法的组成部分没有什么不同。调查表明，医生通常不会进行干预，因为他们对吸烟者的治疗成功率很低。教育计划在培训医生向吸烟者提供咨询方面取得了巨大成功；因此，医学教育、住院工作人员培训和继续医学教育的新目标需要包括培养技能和办公室管理实践，供提供者用来促进患者的健康促进行为。本文回顾了医生提供的吸烟干预措施对吸烟者的影响、医生对干预措施的态度以及医生报告的干预措施。它确定了那些已被证明在门诊办公室环境中有效的策略，并强调需要将每个吸烟者视为干预的候选人。
If physicians and other health-care providers were able to facilitate long-term cessation in 1 of every 10 smokers-a safe estimate based on the outcomes of randomized physician-delivered intervention studies-almost 4 million smokers would become former smokers. Evidence from randomized trials and observational studies demonstrates that physicians who intervene with smokers have an impact on their cigarette-smoking behavior. Greater smoking cessation occurs as physician interventions become more intensive and contacts more frequent. Adding modalities such as counseling, self-help booklets, and nicotine-containing chewing gum appears to augment the effectiveness of advice alone. The consistent demonstration of the need for follow-up and the possible use of several modalities is not unlike the demonstrated components of effective overall management approaches to such medical problems as hypertension. Surveys have indicated that physicians often do not intervene because they experience a low success rate with smokers. Educational programs have demonstrated substantial success in training physicians to counsel smokers; therefore, new goals for medical education, house-staff training, and continuing medical education need to include the development of skills and office management practices that can be used by providers to facilitate health-promoting behaviors among their patients. This article reviews the impact of physician-delivered smoking interventions on smokers, physician attitudes toward intervention, and physicians'' reported intervention practices. It identifies those strategies that have been demonstrated to be effective in an out-patient office setting and emphasizes the need for every smoker to be considered a candidate for intervention.