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KMID : 0371020030360030248
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Journal of Preventive Medicine and Public Health
2003 Volume.36 No. 3 p.248 ~ p.254
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Predictors of Smoking Cessation in Outpatients
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Kang Yoon-Sik
Kim Jang-Rak
Jang Joung-Soon
Hwang Young-Sil
Hong Dae-Yong
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Abstract
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Objective: This study was conducted in order to investigate predictors of smoking cessation in outpatients.
Method: Subjects were 401 adult smoking patients who saw their doctors in the outpatient setting at a university hospital, regardless of their willingness of otherwise in smoking cessation. Physicians delivered a brief , stop smoking prompt to all patients who smoked one or more cigarettes a day. Then they referred to on-site counselors who provided a brief, nurse assisted intervention with a survey to a randomly assigned intervention group (200 smoking patients), whom the counselors telephoned later to prevent relapse or promote the motivation to quit, or gave only a survey to a control group (201 smoking patients). After at least 5 months, self-reported current smoking cessation was confirmed later using cut-off values of 7 ppm or less in expired alveolar air after breath holding portable CO analyzer.
Results: After 5 months, subjects in the intervention group were 1.56 times (95% C.I. 0.89-2.73) more likely to quit smoking than those in the non-intervention group (14.0% vs. 9.0%). Willingness to quit smoking in a month, scheduled admission in a month, self efficacy score and FTND (Fagerstrom Test for Nicotine Dependence) score were all significantly related with smoking cessation. In stepwise multiple logistic regression, previous attempts to quit smoking were significant instead of self efficacy score. In the intervention group who had willingness to quit smoking in a month (132 smoking patients), FTND score, whether quit date was today, and whether quit promise paper was submitting were all significantly related with smoking cessation. In stepwise multiple logistic regression, scheduled admission in a month and whether quit date was today were significant predictor variables.
Smoking cessation treatment should be tailored to individual smoking patients considering these predictors.
외래를 방문한 환자들을 대상으로 5개월 후 금연 성공에 영향을 미치는 요인을 조사해 보고자 2000년 1월부터 3월 사이에 경상대학교 내과 외래를 방문한 401명의 환자를 대상으로 연구를 시행하였다. 이들 중 200명은 금연 권고 후 추후 금연 개입을 시행하였으며, 201명은 외래에서 금연 권고만을 시행하였다. 5개월 금연 성공률은 개입군에서 14.0, 비개입군에서 9.0%였으나 유의하지는 않았다. 금연 성공에 영향을 미친 요인으로는 한달내에 담배를 끊을 의사, 한달 내 입원예정 여부, 자기효능 점수 및 FTND (Fagerstrom Test for Nicotine Dependence) 점수였다. 단계선택 다중로지스틱 회귀분석에서는 자기효능점수 대신에 이전 금연시도 횟수가 유의한 변수로 선정되었다. 담배를 끊을 의사가 있고 니코틴 의존도가 낮으며 한달내에 입원할 예정인 사람들의 금연 성공률이 높았다.
한달 내 금연할 의사가 있으면서 금연개입을 받은 개입군 132명의 경우, 단변량 분석에서는 FTND 점수, 금연일을 오늘로부터 설정했는지 여부 및 서약서 제출 여부가 금연 성공에 영향을 미치는 유의한 변수였으며, 단계선택 다중로지스틱 회귀분석에서는 한달내 입원예정 여부 및 금연일을 오늘부터로 설정했는지 여부가 유의한 변수로 선정되었다. 이러한 금연성공결정요인들을 고려한다면 외래 흡연환자들에게 적합한 금연개입이 가능할 것이다.
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KEYWORD
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Smoking cessation, Determinants, Outpatients
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