社區藥局戒菸諮詢站之成效評估初探

Abstract

目標：本研究欲評估社區藥局戒菸諮詢站之成效，以供日後政策推動與進行宣導教育時作為依據與參考。方法：台北縣市30位社區藥師接受16小時的訓練後提供民眾戒菸諮詢服務，以上網登錄方式蒐集個案相關資料，收案當天有485人，持續完成於收案當天、收案後第1、3和7天共四次諮詢有279人，追蹤完成率為57.53%。而在第6個月追蹤到209人。結果：研究發現民眾接受諮詢後的第3天、第7天及第6個月追蹤，其點戒菸率分別為32.3%，48.7%，22.6%。於第7天時，重度菸癮者較輕度菸癮者的戒菸比例低（勝算比＝0.33），藥師評估需要替代療法者較不需要者的戒菸比例低（勝算比＝0.32）。於第6個月時，已婚者相較之下戒菸的比例較高（勝算比＝2.25），重度菸癮者較輕度菸癮者在戒菸的比例為低（勝算比0.25），藥師評估需要替代療法者、或近期再評估者較不需要者的戒菸比例低（勝算比＝0.03, 0.04）。結論：本研究4次共約1小時的總諮詢時間即能在第7天有近5成的個案戒菸，是將來宣導或藥師研習時可強化藥師推動社區藥局戒菸諮詢的動機。然而第6個月的戒菸個案降至22.6%，如何協助民眾持續戒菸將是未來藥師執行戒菸諮詢時需努力之處。

Objectives: The aim of the study is to assess the effects of a smoking cessation counseling program provided by community pharmacists. Methods: Thirty community pharmacists from the municipality and county of Taipei participated in a 16-hour training course, and then offered a smoking cessation counseling service. Data on participants were collected through online registration. A total of 485 volunteers were recruited on the first visit. Upon completion of recruitment, three consecutive follow-ups were conducted on the first, third and seventh days after the first visit. By the third follow-up, 279 volunteers remained in the program, achieving a completion rate of 57.53%. At the end of the sixth month, a total of 209 participants remained in the program. Results: Study results revealed that the smoking cessation rates on the third and seventh day, as well as the sixth month after receiving counseling, were 32.3%, 48.7% and 22.6%, respectively. On the seventh day, the smoking cessation rate was significantly lower in participants with a severe tobacco addiction than those with a minor addition (odds ratio=0.33). Participants who required nicotine replacement therapy (NRT) as assessed by pharmacists had a lower smoking cessation rate than those who didn’t (odds ratio=0.32). In the sixth month, married smokers tended to have a higher smoking cessation rate than single smokers (odds ratio=2.25). The recurrent cessation rate was also lower in participants with severe tobacco addiction compared with those of minor addiction (odds ratio=0.25). Compared with participants who did not require an NRT, a lower cessation rate was observed in participants in need of a NRT and those in need, but to a lesser extent (odds ratio=0.03, 0.04). Conclusions: The findings serve as a foundation for the implementation and promotion of a smoking cessation policy and related education. Four counseling sessions with a total of approxmate, one hour of counseling resulted in nearly half of the participants quitting smoking by the seventh day. The results of this study will serve as an incentive to encourage the promotion of smoking cessation counseling services at community pharmacies; however, the smoking cessation rate declined to 22.6% in the sixth month after counseling. When pharmacists provide smoking cessation counseling in the future, a focus on how to assist smokers to quit permanently is needed.