A randomized controlled trial of smoking cessation counseling after myocardial infarction
A randomized controlled trial of smoking cessation counseling after myocardial infarction
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DOI：
10.1006/pmed.2000.0644
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发表时间：
2000-04-01
影响因子：
5.1
通讯作者：
Thompson, PD
中科院分区：
文献类型：
--
作者：
Dornelas, EA;Sampson, RA;Thompson, PD
背景心肌梗死（MI）后戒烟与死亡率降低50%相关，但院内戒烟干预很少作为常规临床实践的一部分。在1996年期间连续入院的100名吸烟者被分配到最低限度护理或以医院为基础的戒烟计划。干预措施包括床边戒烟咨询，然后在出院后6个月内打7个电话。主要结果是在出院后6个月和1年测量的禁欲率。在随访中，43%和34%的最低限度护理参与者和67%和55%的干预参与者在6个月和12个月时禁欲。戒烟率的计算假设参与者在随访时是吸烟者。干预和自我效能是随访时吸烟状况的独立预测因素。低自我效能加上不干预导致1年复发率为93%（P < 0.01）。一个以医院为基础的戒烟计划，包括住院咨询和电话随访，大大提高了MI后患者出院后1年的戒烟率。自我效能感低的患者几乎肯定会复发，而无需干预。这样的戒烟计划应该是MI患者管理的一部分。(C)2000美国健康基金会和学术出版社。
Background. Smoking cessation after myocardial infarction (MI) has been associated with a 50% reduction in mortality but in-hospital smoking cessation interventions are rarely part of routine clinical practice.Methods. One hundred cigarette smokers consecutively admitted during 1996 with MI were assigned to minimal care or to a hospital-based smoking cessation program. Intervention consisted of bedside cessation counseling followed by seven telephone calls over the 6 months following discharge. Primary outcomes were abstinence rates measured at 6 months and 1 year postdischarge.Results. At follow-up, 43 and 34% of participants in minimal care and 67 and 55% of participants in intervention were abstinent at 6 and 12 months. respectively (P < 0.05), Abstinence rates were calculated assuming that participants lost to attrition were smokers at follow-up. Intervention and self-efficacy were independent predictors of smoking status at follow-up. Low self-efficacy combined with no intervention resulted in a 93% relapse rate by 1 year (P < 0.01).Conclusions. A hospital-based smoking cessation program consisting of inpatient counseling and telephone follow-up substantially increases smoking abstinence 1 year after discharge in patients post-MI. Patients with low self-efficacy are almost certain to relapse without intervention. Such smoking cessation programs should be part of the management of patients with MI. (C) 2000 American Health Foundation and Academic Press.