Introducing smoking cessation to Indonesian males treated for tuberculosis: The challenges of low-moderate level smoking.
Introducing smoking cessation to Indonesian males treated for tuberculosis: The challenges of low-moderate level smoking.
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向接受结核病治疗的印度尼西亚男性介绍戒烟：中低水平吸烟的挑战。
DOI：
10.1016/j.socscimed.2016.01.028
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Ng,Nawi
中科院分区：
文献类型：
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作者：
Nichter,Mark;Padmawati,Siwi;Ng,Nawi
关于低收入和中等收入国家目前和以前接受结核病治疗的人的吸烟习惯的信息缺乏。在本文中，我们描述了2007年至2011年期间在印度尼西亚进行的研究，旨在调查结核病诊所和家庭中针对结核病的戒烟信息的影响，以及以前接受过结核病治疗但继续吸烟的人吸烟模式的变化。介绍了一项涉及87名接受直接观察短程治疗（DOTS）的结核病患者的适度两臂戒烟试验的结果。在一组中，患者接受了医生提供的针对结核病的戒烟信息，以及结核病和吸烟教育小册子和戒烟指南。在第二个家庭支持组中，患者还收到了由经培训成为DOTS支持者的家庭成员传递的持续的戒烟信息。该研究在患者接受DOTS治疗的6个月期间对其进行了两次随访，在治疗后6个月对其进行了两次随访。研究的两组患者在结核病治疗期间和治疗后的吸烟率都显著降低，在治疗结束（第6个月）时，医生组中73%的患者和家庭支持组中71%的患者仍然戒烟。当治疗后6个月完全戒断作为主要结果测量时，两组干预的有效性没有统计学差异。值得注意的是，67%的高水平吸烟者和33%的低中度吸烟者在基线时完全戒烟。许多重新开始吸烟的人都是中低水平的（每天少于6支）。在治疗期间戒烟的患者中，84%的患者在治疗后6个月保持了戒烟，13%的患者恢复了中低水平（<6支）的吸烟，只有3%的患者恢复了更高水平的吸烟。有目的的样本是15名患者，他们在治疗后从重度吸烟（每天20-40支）转变为中低水平吸烟，随访了12个月。我们报告了他们维持较低吸烟水平和自我认知吸烟状况的能力，因为他们的卷烟消费量大幅减少。这是在东南亚任何地方对曾经接受过结核病治疗的患者中低水平吸烟进行的第一项研究。
There is a dearth of information about the smoking habits of people currently and formerly treated for tuberculosis (TB) in low- and middle-income countries (LMICs). In this paper we describe research carried out in Indonesia between 2007 and 2011 designed to investigate both the impact of TB-specific quit smoking messages in the TB clinic and at home, and shifts in patterns of smoking among those formerly treated for TB who continue to smoke. The results of a modest two-arm smoking cessation trial involving 87 patients undergoing Directly Observed Therapy Short course treatment (DOTS) for TB are presented. In one arm patients received a TB-specific quit smoking message delivered by doctors and a TB and smoking educational booklet and quit smoking guide. In the second, family support arm, patients also received on-going cessation messages delivered by family members trained to be DOTS supporters. The study followed patients twice during their six months of DOTS treatment and twice six months post treatment. Both arms of the study reduced rates of smoking during and following TB treatment significantly with 73% of patients in the doctor arm and 71% in the family support arm remaining quit at the end of the treatment (month 6). When complete abstinence at six months after treatment was taken as a primary outcome measure, no statistical difference was found in the effectiveness of the two arms of the intervention. Notably, 67% of higher-level smokers at baseline and 33% of low–moderate level smokers at baseline quit entirely. Many of those who resumed smoking did so at low–moderate levels (<6 cigarettes a day). Eighty-four percent of patients who quit during treatment maintained their abstinence six months after treatment, 13% resumed smoking at a low–moderate level (<6 cigarettes), and only 3% resumed smoking at a higher level. A purposeful sample of 15 patients who shifted from heavy smoking (20–40 cigarettes per day) to low–moderate levels of smoking post treatment were followed for an additional 12 months. We report on their ability to sustain lower levels of smoking and self-perceived smoking status given their dramatic reduction in cigarette consumption. This is the first study of low–moderate level smoking among patients formerly treated for TB conducted anywhere in South-East Asia.