不同戒菸服務模式之成效及戒菸成功相關因子之研究-以某無菸醫院為例

Abstract

本研究的目的在探討醫院所提供的各種戒菸服務民眾參與的情況，嘗試瞭解不同戒菸服務模式的成效及戒菸成功的相關因子。研究對象為在2017年參與某醫學中心戒菸服務的民眾，共計773名吸菸者。戒菸服務模式分類為四組：門診戒菸治療組、門診戒菸結合戒菸衛教組、醫院戒菸活動組、職場戒菸組，比較四組戒菸服務模式參與民眾的特性、戒菸成功率、服務效率及戒菸成功的相關因子。 結果發現四組戒菸服務模式參民眾的特性有所差異，醫院戒菸活動組可以吸引年紀較大、成癮度較低吸菸者嘗試戒菸。另主動戒菸服務模式如醫院戒菸活動組與職場戒菸組較門診戒菸組呈現更具服務效率，然各組戒菸成功率並無顯著差異。此外，影響戒菸成功的因素包括：吸菸者每日吸菸支數、成癮度、一氧化碳呼氣值、戒必適戒菸藥物使用、戒菸門診次數等。在控制其他因素後，吸菸者參與超過一次的戒菸門診與使用戒必適藥物較可能戒菸成功。 本研究建議醫院提供主動戒菸服務深入社區與職場，以協助更多民眾踏出戒菸的第一步。醫師可依吸菸者的特性提供諮商，考慮使用成功率較高的藥物，並鼓勵民眾多回診以提高戒菸成功率。This study aims to assess the effectiveness of different smoking cessation services provided by the hospital and examine the factors correlated with smoking cessation success. In 2017, a total of 773 smokers who participated in various smoking cessation services delivered by a medical center were included to analyze. Smoking cessation services were categorized into four groups: outpatient smoking cessation group, outpatient smoking cessation combined with education group, hospital smoking cessation activity group, and workplace smoking cessation group. Participants’ characteristics, smoking cessation success rates and service efficiency were compared between the four groups. The results indicated that the characteristics of smokers who participated in the four smoking cessation groups were different, while smokers who participated in the hospital smoking cessation activity group were older with lower addiction level. In addition, proactive smoking cessation services such as hospital smoking cessation activity group and workplace smoking cessation group showed higher levels of service efficiency. Factors correlated with smoking cessation included daily cigarette use, addiction level, carbon monoxide expiratory concentration, Champix medication and cessation outpatient visits. After controlling other factors, smokers who used Champix drug and had more cessation outpatient visits were more likely to have smoking cessation success. It was suggested that hospitals could provide proactive services in community and workplace to promote smoking cessation. Physicians could provide counseling based on smokers’ characteristics, prescribe drugs with higher success rates and encourage follow-up visits to increase quit rates.