臺灣北部某區域教學醫院戒菸門診介入之成效評估

Evaluation of the Smoking Cessation Clinic in a Regional Hospital in Northern Taiwan

目的：探討台灣北部某區域教學醫院門診戒菸之介入評估。方法：以台灣北部某區域教學醫院自2002年10月至2007年2月參加戒菸門診之吸菸個案為研究對象。收案條件為年滿18歲以上，尼古丁成癮度測試分數5分（含）以上或一天吸菸10支（含）以上者納入分析。個案接受戒菸衛教、門診諮詢並以尼古丁貼片治療。追蹤過程中以個案第一次門診戒菸為基準日，於第三個月、第六個月及一年以電話訪問評估其戒菸情況，若受訪時最近七日內有任何吸菸行為或無法聯絡之個案均歸於戒菸失敗。結果：在起始收案479人中，重複52人予以排除，另有101人因電話追蹤任一次無法聯繫故列入戒菸失敗，最終納入分析者共427人，實際追蹤率為76.3% (326/427)。結果顯示三個月、六個月、及一年之戒菸成功率分別為26.0%、18.7%、及15.9%，隨著時間增加戒菸成功率顯著下降(p=0.03)。由邏輯斯迴歸分析則發現，尼古丁成癮度及副作用或戒斷症狀為影響戒菸成功與否的相關因子。結論：戒菸成功率隨時間有明顯下降，尼古丁成癮度與戒菸成功與否有關，但副作用或戒斷症狀對成功戒菸的單獨效果仍有待進一步釐清。

Objective: The aim of this study was to explore the results from the smoking cessation clinic in a regional hospital in northern Taiwan. Methods: We provided health education and counseling services to the patients and also supplied them with nicotine patches. Information about demographic data, number of outpatient visits and smoking status at the 3rd, 6th, and 12th month was confirmed by telephone. The dependent variables were success rates at the 3rd month, 6th month and one year. Independent variables were information about age, gender, smoking experience, health condition and factors related to treatment. Results: We collected a total of 479 cases between October 2002 and February 2007, and excluded 52 cases because of double visits or an inability to contact them by telephone so that 427 cases were subject to the final analysis. The results showed that the success rate for smoking cessation was 26.0% at three months 18.7% at six months and 15.9% at one year. The success rates decreased over time (p=0.03). According to logistic regression, the degree of nicotine dependence and side effects of treatment were significantly related to smoking cessation. Conclusions: The success rate for smoking cessation decreased over time. The degree of nicotine addiction was negatively associated with smoking cessation; however, the association between side effects of treatment and smoking cessation needs to be clarified in further studies.