EFFECTIVENESS OF SMOKING CESSATION INTERVENTIONS INTEGRATED INTO PRIMARY CARE PRACTICE
EFFECTIVENESS OF SMOKING CESSATION INTERVENTIONS INTEGRATED INTO PRIMARY CARE PRACTICE
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DOI：
10.1097/00005650-198801000-00007
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发表时间：
1988-01-01
期刊：
影响因子：
3
通讯作者：
STORER, B
中科院分区：
文献类型：
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作者：
THOMPSON, RS;MICHNICH, ME;STORER, B
使用完全析因设计，我们测试了三种干预措施，在常规的初级保健实践中戒烟。测试的干预措施是1）医生咨询，2）邮寄信件和由国家癌症研究所（NCI）设计的教育材料，3）推荐戒烟课程。37名家庭医生在三个集团健康的门诊设施参加。患者参与率为95%，92%的参与者完成了随访。没有干预措施对8-9个月后通过自我报告确定的戒烟率有任何影响。然而，医生咨询和NCI材料的组合使那些接受该组合的个体在随后的8-9个月内发生显著反吸烟行为（戒烟，戒烟和复发，或减少）的几率增加了一倍。在这种情况下，推荐戒烟课程是非常无效的。在研究设计指定的369人中，只有14%的人甚至调查了这些课程。相比之下，在我们的研究设计中，那些没有被指定为转诊的人的自我转诊率为10%。我们的研究结果和其他最近的工作表明，基于复吸预防策略的多次更密集的干预措施有望在初级保健戒烟工作中取得未来的成功。
Using a complete factorial design, we tested three interventions for smoking cessation in routine primary care practice. The interventions tested were 1) physician counseling, 2) mailed letters and educational materials designed by the National Cancer Institute (NCI), and 3) referral to smoking cessation classes. Thirty-seven family practice physicians at three of Group Health's outpatient facilities participated. Patient participation rates were 95%, and follow-up was complete for 92% of those participating. None of the interventions had any effect on point prevalence of quitting as determined 8-9 months later by self-report. However, the combination of physician counseling and NCI materials doubled the odds of occurrence of significant antismoking behavior (quit, quit and relapse, or cut down) during the ensuing 8-9 months in those individuals receiving that combination. Referral to smoking cessation classes was strikingly ineffective in this setting. Of 369 individuals designated by study design for referral, only 14% even investigated the classes. This compares with a 10% self-referral rate for those persons not designated for referral by our study design. Our results and other recent work suggest that more intensive interventions on multiple occasions based on relapse prevention strategies hold promise for future success in smoking cessation efforts in primary care.