漸進減量法與立即戒斷法之復發狀況研究：以戒菸專線服務中心為例

Relapses of Gradual Nicotine Reduction and Abrupt Nicotine Withdrawal

本研究的目的是在比較漸進減量和立即戒斷兩種方法在戒菸維持效果的差異。主要研究對象為接受戒菸專線服務中心電話戒菸諮商的 名個案，依個案的戒菸目標分為立即戒斷組及漸進減量組，兩組在結束戒菸諮商後的當天、一個月後、三個月後和六個月後等四個時段分別接受電話調查，了解個案的戒菸維持狀況。研究結果顯示，兩組在接受電話戒菸諮商後均得到顯著的效果；立即戒斷組的復發率略高於漸進減量組；兩組皆在諮商結束後的第三個月出現復發高原期，顯示代償作用同時出現在兩組之中；另外，選擇漸進減量為戒菸方法的個案也持續的戒斷中，亦即減量組最終仍以戒斷為主要目標。本研究根據研究結果提出諮商實務上的兩項建議：(1) 延長戒菸目標的達成時間，(2) 漸進減量組小目標的達成能帶來自我效能感。

The purpose of this study was to evaluate the cessation outcome of two major methods of quitting smoking. The first one is gradual nicotine reduction, supported mainly by psychologists. Medical groups promote the other method, which is abrupt nicotine withdrawal. The outcome of this research can aid counselors when approaching cases in the near future. The major objects of this study are divided into a gradual reduction group and abrupt withdrawal group. All of the quitters were surveyed by phone on the first day after counseling sessions ended, as well as one month, three months and six months afterward. According to the results, the two groups all showed remarkable maintenance effects. Over half of the quitters maintained the outcome. The relapse rate of the abrupt withdrawal group was a little higher than that of the gradual reduction group. The two groups both showed a plateau of relapse in the third month and sudden increase in smoking was also observed. This phenomenon showed that the two groups both revealed compensatory reaction. We also observed that the quitters of the gradual reduction group were withdrawing, telling us that the quitters of the gradual reduction were also engaged in nicotine withdrawal. According to the results of this research, some suggestions are made for counseling: (1) Extend the time of quitting courses. (2) Never ignore the feeling of self-efficacy that gradual reduction brings about.