PROMOTING SMOKING CESSATION IN HOSPITAL PATIENTS

吸烟是一个极其重要的公共卫生问题。这是一个 是心血管疾病的主要诱因，也是 癌症和呼吸道疾病的风险过去一年的初级保健研究 二十年的研究表明，医疗领域的戒烟干预措施 设置可以是有效的。然而，很少有公开报道 研究戒烟干预措施的有效性 在医院里住院患者戒烟干预可以 可能会接触到大量吸烟者。住院也可以是 一个有效的戒烟建议的“可教时刻”。禁烟 使之成为强制禁欲的时间， 因此，有机会克服身体成瘾的症状。 患者被从他们通常的吸烟环境线索中移除， 使最初的戒烟更容易，他们可能特别容易接受， 在健康状况不佳的时候提供预防性健康信息。最后还有 增加患者认为有效的医疗保健提供者的服务， 健康信息的知识来源。拟建项目 实验测试方法，以促进长期戒烟， 住院病人。三家医院收治的27岁以上的吸烟者- 一个月的时间将被确定为招生过程的一部分。那些 符合资格要求的患者（n= 4177）将被随机分配至 三种治疗条件之一：最低限度的护理;低强度 干预，其核心是卫生保健部门的简短坚定建议 提供者和吸烟者图表的标签（PA干预）;以及 PA干预加上更密集的咨询和后续行动后， 由研究护士进行出院（PA+NC干预）。干预 包括提供戒烟手册和培训 医疗保健提供者（所有条件）;结构性健康提醒 护理提供者提供戒烟建议和提供吸烟 各种医疗保健提供者对几个问题的戒烟建议 不同的场合（PA和PA+NC）;和住院咨询， 根据患者特征定制，关于生物标志物的反馈 吸烟，阶梯式护理方法，以及之后的后续电话咨询 放电（仅PA+NC）。所有参与者将被随访12个月 出院后检查相对有效性 戒烟计划的成本效益。此外，本发明还提供了一种方法， 关于研究患者接受的戒烟建议的信息 出院后12个月内的初级保健医生 将被聚集在一起，以评估建议可能产生的协同效应， 在住院病人和门诊病人中提供。

Cigarette smoking is a vitally important public health problem. It is a major contributor to cardiovascular disease and one of the leading causes of cancer and respiratory disease. Research in primary care over the last two decades has indicated that smoking cessation interventions in medical settings can be effective. However, there have been few published reports of research examining the effectiveness of smoking cessation interventions in hospital settings. In-patient smoking cessation interventions can potentially reach a large number of smokers. A hospital stay can also be an effective "teachable moment" for smoking cessation advice. Smoking bans in place in hospitals make it a time of enforced abstinence and, therefore, an opportunity to overcome the symptoms of physical addiction. Patients are removed from their usual environmental cues for smoking, making initial cessation easier, and they might be particularly receptive to preventive health messages at a time of ill-health. Finally, there is increased access to health care providers whom patients see as valid and knowledgeable sources of health information. The proposed project experimentally tests methods to promote long-term smoking cessation in hospitalized patients. All smokers admitted to three hospitals over a 27- month period will be identified as part of the admissions process. Those who meet eligibility requirements (n=4l77) will be randomly assigned to one of three treatment conditions: minimal care; a low intensity intervention whose centerpiece is brief firm advice by health care providers and labelling of the smokers' charts (PA intervention); and the PA intervention plus more intensive counseling and follow-up after discharge performed by a research nurse (PA+NC intervention). Intervention components include provision of smoking cessation manuals and training of health care providers (all conditions); structural reminders to health care providers to give smoking cessation advice and provision of smoking cessation advice by a variety of health care providers on several different occasions (PA and PA+NC); and in-hospital counseling that is tailored to patient characteristics, feedback about a biological marker of smoking, a stepped care approach, and follow-up telephone counseling after discharge (PA+NC only). All participants will be followed for l2 months after discharge from the hospital to examine the relative effectiveness and cost-effectiveness of the smoking cessation programs. In addition, information about smoking cessation advice given to study patients by primary care physicians in the 12 months after discharge from hospital will be gathered to assess the possible synergistic effects of advice provided in in-patient and out-patient settings.