Changes in smoking associated with an acute health event: Theoretical and practical implications
Changes in smoking associated with an acute health event: Theoretical and practical implications
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DOI：
10.1007/bf02879900
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发表时间：
2007-01-01
影响因子：
3.8
通讯作者：
Ziedonis, Douglas M.
中科院分区：
文献类型：
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作者：
Boudreaux, Edwin D.;Baumann, Brigitte M.;Ziedonis, Douglas M.
背景。经历与不良行为相关的严重后果可能会激发行为改变。目的：研究哨点健康事件与吸烟变化的关系。方法：采用前瞻性队列设计。成人急诊科（ED）患者提供了人口统计数据、吸烟史、戒烟意向评分和自我认定的吸烟相关健康问题的认可。一项图表审查收集了关于视力、ED处置和医疗诊断的数据。随访1个月后重新评估吸烟情况。进行分层回归分析以预测(a)戒烟意图，(b)任何戒烟尝试24小时或更长时间，以及(3)7天戒断。结果：参与研究的717名吸烟者中，189人（26%）打算在下个月内戒烟。在253名随访1个月的参与者中，126名（50%）报告他们曾试图戒烟，44名（19%）报告7天的戒断。在控制了其他预测因素后，一些与事件相关的变量，如与吸烟有关的急诊科就诊和住院，是结果的有力预测因素。结论：与基于社区的估计相比，我们的样本中有更多的吸烟者试图戒烟并实现了7天的戒烟。这一点在那些把自己的急诊科就诊归因于吸烟相关健康问题并被送进医院的吸烟者中尤为明显。我们讨论了在医疗环境中烟草干预设计的含义。
Background. Experiencing a serious adverse behavior-related consequence may motivate behavior change. Purpose: To examine how a sentinel health event is associated with changes in smoking. Methods: We used a prospective cohort design. Adult emergency department (ED) patients provided demographic data, a smoking history, ratings of quit intentions, and endorsement of self-identified smoking-related health problems. A chart review collected data on acuity, ED disposition, and medical diagnoses. Smoking was reassessed I month postvisit. Hierarchical regression analyses were conducted to predict (a) intention to quit, (b) any quit attempt of 24 hr or more, and (3) 7-day abstinence. Results: Of 717 smokers enrolled, 189 (26%) intended to quit within the next month. Of the 253 participants reached I month postvisit, 126 (50%) reported they had attempted to quit, with 44 (19%) reporting 7-day abstinence. After controlling for other predictors, several event-related variables, such as having a smoking-related ED visit and being admitted to the hospital, were strong predictors of outcomes. Conclusion: Compared to community-based estimates, many more smokers in our sample attempted to quit and achieved 7-day abstinence. This was especially true among smokers who attributed their ED visit to a smoking-related health problem and who were admitted to the hospital. We discuss the implications for tobacco intervention design in medical settings.