Smoking cessation among patients in an emergency chest pain observation unit: Outcomes of the Chest Pain Smoking Study (CPSS)
Smoking cessation among patients in an emergency chest pain observation unit: Outcomes of the Chest Pain Smoking Study (CPSS)
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DOI：
10.1080/14622200802326343
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发表时间：
2008-01-01
影响因子：
4.7
通讯作者：
Trask, Peter
中科院分区：
文献类型：
--
作者：
Bock, Beth C.;Becker, Bruce M.;Trask, Peter
本研究旨在探讨戒烟干预对戒烟率和戒烟动机的有效性。参与者是成年吸烟者（N=543），他们因胸痛到急诊科就诊，并被送入观察室进行24小时观察以排除心肌梗死。参与者被随机分配到常规护理或采用动机访谈和电话随访的定制干预。所有选择戒烟的人都接受了尼古丁贴片治疗。在1、3和6个月时进行随访评估。与接受常规护理的参与者相比，接受定制干预的参与者的禁欲率（7天时点患病率）显著更高（OR=1.62，95%CI [1.05-2.50]）。最大的差异发生在1个月：16.8%的常规护理组和27.3%的定制干预组禁欲，随着时间的推移，差异逐渐减小。在第6个月戒烟的参与者中，有三分之一是在1个月的随访后开始戒烟的。除了治疗分配，心理社会变量，包括戒烟的动机，信心，减少诱惑吸烟的负面影响，并认为他们的胸痛与他们的吸烟，戒烟的显着预测。量身定制的干预措施是有效的，以促进初步退出尝试急诊胸痛患者入住观察单位。可能需要额外的干预来帮助晚戒烟者并防止复发。
This study examines the efficacy of a smoking cessation intervention on abstinence rates and motivation to quit smoking. Participants were adult smokers (N=543) who presented to the emergency department with chest pain and who were admitted to an observation unit for 24-hour observation to rule out myocardial infarction. Participants were randomly assigned to either usual care or a tailored intervention employing motivational interviewing and telephone follow-up. All individuals choosing to quit were offered nicotine patch therapy. Follow-up assessments were conducted at 1, 3 and 6 months. Abstinence (7-day point prevalence) rates were significantly greater among participants receiving the tailored intervention compared with those given usual care (OR=1.62, 95% CI [1.05-2.50]). The largest difference occurred at 1 month: 16.8% of usual care and 27.3% of the tailored intervention group were abstinent, with differences decreasing over time. One-third of participants who were quit at month 6 were late quitters whose initial abstinence began after the 1-month follow up. In addition to treatment assignment, psychosocial variables including motivation to quit, confidence, reduced temptation to smoke in response to negative affect, and the perception that their chest pain was related to their smoking, were significant predictors of cessation. Tailored interventions are effective in promoting initial quit attempts for emergency chest pain patients admitted to an observation unit. Additional intervention may be needed to assist late quitters and to prevent relapse.