某營區尼古丁替代療法與衛生教育在菸害防制的應用

The Effect of Nicotine Replacement Therapy and Health Education on Tobacco Abstinence in an Army Camp

本研究以某一國軍營區選取有意願戒菸的官兵共88人，以隨機分派的方式，將個案分成3組，第1組為門診貼片戒菸班，個案需每週固定至醫院之戒菸門診接受醫師問診及開立尼古丁貼片，第2組為營區貼片班，醫師每週1次至營區內問診並發放尼古丁貼片，第3組為營區衛教班，由醫師、心理師、營養師及藥師每週1次至營區提供1小時的團體衛教。所有個案均完整接受8週療程，治療結束後再經過一個月的追。根據本研究之分析得到以下之結果：(1)門診貼片戒菸班完全戒菸者所佔比例較高，佔20%，其次為營區貼片戒菸班，佔13.3%，營區衛教戒菸班僅佔3.6%。兩個貼片班的戒除率並無統計上的顯著差異，但皆明顯高於衛教戒菸班，並具統計上的意義。(2)經過8週的介入，門診貼片戒菸班的一氧化碳值下降4.0ppm，營區貼片戒菸班下降5.2ppm，營區衛教戒菸班下降3.3ppm，具統計上的顯著意義。(3)戒菸成效與戒菸前之吸菸量有很高的相關，戒菸前之吸菸量愈大者，戒除率愈差。(4)各組未完全戒菸者的繼續戒菸意願普遍都低，門診貼片戒菸班有繼續戒菸意願者佔16.7%，營區貼片戒菸班佔11.5%，營區衛教戒菸班佔25.9%，但未達統計上顯著差異。(5)各組未完全戒菸者中，年齡及菸齡較低者的戒菸個案有較高的意願繼續戒菸，且達統計上的顯著意義。(6)在相關性分析中，年齡與菸齡為高度相關；菸齡與吸菸量、成癮度間有相關；吸菸量與成癮度間亦有相關，且有統計上的顯著意義。根據本研究之結果，以尼古丁替代療法介入國軍部隊的菸害防制是有效的，若能配合足夠的醫療經費及資源的整合，並經由建立持續且多元的戒菸方法與途徑，方能收到更明確且有效的菸害防制效果。

In an army camp, a study of 88 officers and soldiers (randomly assigned in to 3 groups) who were willing to quit smoking was conducted. The first group received their nicotine patches in outpatient services at the hospital, where they were evaluated weekly and received more nicotine patches. The second group received their nicotine patches at the camp, where they were evaluated weekly and received more nicotine patches. The third group attended weekly 1-hour group health education lectures by doctors, psychologists, dietitians and pharmacists at the camp. All of them who completed the treatment course of 8 weeks, and one month after completing treatment, received a follow-up interview. The data showed that (1) the first group of participants had a higher percentage of subjects (20%) who successfully quit smoking, followed by the second group (13.3%) and third group (3.6%). The difference between the first two groups was not statistically significant, but in the quitting rate between the third group and the other two; (2) After 8 weeks of intervention, the CO levels in the first, second, and third groups declined to 4.0 ppm, 5.2 ppm, and 3.3 ppm, respectively, they were significant statistically; (3) The rate of quitting was inversely correlated to the amount they had smoked; (4) The percentage of willing to continue the quitting program among those who failed to quit smoking significantly was low in all three groups (16.7%, 11.5%, and 25.9%, respectively) and was not significantly different between the groups; (5) Among participants who failed to quit completely in the three groups, younger participants were statistically more likely than older participants to want to continue the quitting program; (6) The age of older participants was also highly correlated with longer smoking history, but much less correlated with higher dependency on smoking. Smoking history had minor correlation with smoking amount and dependency on smoking. Those who smoked more were also more dependent on smoking. Therefore, nicotine replacement therapy may be an effective intervention to stop smoking in the Army. With enough medical funding, resource integration and more effective methods to treat smoking addiction, the achievement of longer and better smoking cessation results could be expected.