國軍醫院免費戒菸門診成效之探討

The effectiveness of a free smoking cessation clinic for military personnel

目標：因國軍人員吸菸盛行率高於一般成年男性，國防部提供補助以增加戒菸門診的利用。本研究旨在比較軍人使用免費戒菸門診與自行戒菸者之戒菸成效，並找出影響戒菸成功的因素。方法：採觀察性研究，研究對象為吸菸軍人且有戒菸意願者，再依據研究對象的意願分為2組，免費戒菸門診組有222人，自行戒菸組405人。免費戒菸門診組會接受8週的醫師諮詢及藥物治療，而自行戒菸組不接受任何協助。研究工具為自擬結構式問卷，以電話方式追蹤一個月及三個月點戒菸率及連續戒菸率。結果：免費戒菸門診組點戒菸率顯著高於自行戒菸組（一個月23.9% vs. 11.6%, p ＜ 0.001；三個月27.9% vs. 5.7%, p ＜ 0.001）。免費戒菸門診組連續戒菸率顯著高於自行戒菸組（一個月20.3% vs. 5.9%, p ＜ 0.001；三個月27.0% vs. 5.7%, p ＜ 0.001）。三個月戒菸成效影響因素為組別（免費戒菸門診組 vs. 自行戒菸組）、教育程度（大學以上 vs. 高中職）、性別（女 vs. 男）、每月收入（＞ 5萬vs. ＜ 3萬）、工作性質（非領導職 vs. 領導職）及自覺戒菸成功的信心。結論：軍人使用免費戒菸門診者的戒菸成效高於自行戒菸者，教育程度、性別、每月收入、工作性質及自覺戒菸成功的信心為影響短期戒菸成效的因素，但本研究無法排除使用藥物之影響。

Objectives: The prevalence of smoking by military personnel is higher than that of the general adult male population. The Ministry of National Defense provides a fee to increase the utilization of smoking cessation clinics. The purpose of the study was to compare the effectiveness of a free smoking cessation clinic and a self-help approach in order to determine the factors which influenced successful quitting by military personnel. Methods: This was an observational study in which participants who intended to quit smoking were assigned to two groups (free smoking cessation clinics and self-help) according to their choice. There were 222 and 405 participants in the free smoking cessation clinics and self-help groups, respectively. The free smoking cessation clinics group received counseling from a physician and 8 weeks of pharmacotherapy for smoking cessation. No support for smoking cessation was provided to the self-help group. Abstinence over the previous 7 days and sustained abstinence were evaluated by telephone using a self-administrated questionnaire 1 and 3 months after the first visit. Results: The 7-day point prevalence cessation rates at 1 month (23.9% vs. 11.6%) and at 3 months (27.9% vs. 5.7%) were higher in the free smoking cessation clinics than in the self-help group. The sustained abstinence rate at 1 month (20.3% vs. 5.9%) and at 3 months (27.0% vs. 5.7%) was higher in the free smoking cessation clinics than in the self-help group. Smokers who attended the free smoking cessation clinics and were more successful in sustained abstinence at 3 months, were characterized by higher education level, female gender, higher monthly income, supervisory position, and more confidence in quitting. Conclusions: Smokers who attended a free smoking cessation clinic had higher abstinence rates than those in a self-help group. Education level, gender, monthly income, job category and confidence in quitting smoking were important factors in successfully quitting; however, the influence of pharmacotherapy could not be ruled out.