Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Predictors of smoking Cessation in Outpatients

외래환자에서 금연 성공의 결정요인

  • Kang, Yune-Sik (Department of Preventive Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University) ;
  • Jang, Joung-Soon (Department of Internal Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University) ;
  • Hwang, Young-Sil (Department of Internal Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University) ;
  • Hong, Dae-Yong (Department of Preventive Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University) ;
  • Kim, Jang-Rak (Department of Preventive Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University)
  • 강윤식 (경상대학교 의과대학 예방의학교실 및 건강과학연구원) ;
  • 장정순 (경상대학교 의과대학 내과학교실 및 건강과학연구원) ;
  • 황영실 (경상대학교 의과대학 내과학교실 및 건강과학연구원) ;
  • 홍대용 (경상대학교 의과대학 예방의학교실 및 건강과학연구원) ;
  • 김장락 (경상대학교 의과대학 예방의학교실 및 건강과학연구원)
  • Published : 2003.09.01
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Abstract

Objective : This study was conducted in order to investigate predictors of smoking cessation in outpatients. Method : Subjects were 40f adult smoking patients who saw their doctors in the outpatient setting at a university hospital, regardless of their willingness of otherwise in smoking cessation. Physicians delivered a brief, stop smoking prompt to all patients who smoked one or more cigarettes a day. Then they referred to on-site counselors who provided a brief, nurse assisted intervention with a survey to a randomly assigned intervention group (200 smoking patients), whom the counselors telephoned later to prevent relapse or promote the motivation to quit, or gave only a survey to a control group (201 smoking patients). After at least 5 months, self-reported current smoking cessation was confirmed later using cut-off values of 7 ppm or less in expired alveolar air after breath holding portable CO analyzer. Results : After 5 months, subjects in the intervention group were 1.56 times (95% C.I. 0.89-2.73) more likely to quit smoking than those in the non-intervention group (14.0% vs. 9.0%). Willingness to quit smoking in a month, scheduled admission in a month, self efficacy score and FTND (Fagerstrom Test for Nicotine Dependence) score were all significantly related with smoking cessation. In stepwise multiple logistic regression, previous attempts to quit smoking were significant instead of self efficacy score. In the intervention group who had willingness to quit smoking in a month (132 smoking patients), FTND score, whether quit date was today, and whether quit promise paper was submitting were all significantly related with smoking cessation. In stepwise multiple logistic regression, scheduled admission in a month and whether quit date was today were significant predictor variables, Smoking cessation treatment should be tailored to individual smoking patients considering these predictors.

Keywords

References

  1. Office on Smoking and Health, Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General. DHHS Pub, No. (CDC)89-8411. Washington, DC: U,S. Department of Health and Human Services, 1989
  2. McGinnis JM, Foege WH. Actual causes of death in the United States. lAMA 1993; 270: 2207-2212
  3. Meng KH. Smoking attributable mortality among Korean adults. Korean J Epidemiol 1988; 10: 138-145 (Korean)
  4. Samet JM. The health benefits of smoking cessation. Med ClinN Am 1992; 76: 399414 https://doi.org/10.1016/S0025-7125(16)30359-5
  5. Won YI, Jeon TH, LEE DS, et al. Baseline factors associated with smoking cessation. J Korean Acad Fam Med 1992;13(11):862-868 (Korean)
  6. National Cance Institute. tobacco and the clinician: intervention for medical and dental practice, NIH publication No. 943693. Monogr Natl CancerInst 1994; 5: 122
  7. US Department of Health and Human Services: Clinical practice guideline (No. 18), Smoking cessation. Public Health Service, Agency for Health Care Policy and Research, Centers for Disease Control and Prevention. AHCPR Publication No.960692, p.7, pp.19-65, 1996
  8. 최정수, 남정자, 김태정, 계훈방. 한국인의 건강과 의료이용실태 - 1995년도 국민건강 및 보건의식행태조사-한국보건사회연구원 1995, 186쪽
  9. Cromwell J, Bartosch WJ, Fiore MC, Hasselblad V, Baker T. Cost-effectiveness of the clinical practice recommendations in th AHCPR guideline for smoking cessation lAMA 1997; 278: 1759-1766
  10. West DW, Graham S, Swanson M, Wilkinson G. Five year follow-up of a smoking withdrawal clinic population. Am J Public Health 1977; 67: 536-544 https://doi.org/10.2105/AJPH.67.6.536
  11. DiClemente CC, Prochaska 10, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consulting ClinPsycho 1991; 59: 295-304 https://doi.org/10.1037/0022-006X.59.2.295
  12. Hymowitz N, Sexton M, Ockene J, Grandits G. Baseline factors associated with smoking cessation and relapse. PrevMed 1991; 20: 590-601 https://doi.org/10.1016/0091-7435(91)90057-B
  13. de Vries H, Backbier E. Self-efficacy as an important determinant of quitting among pregnant women who smoke: the phipattern. PrevMed 1994; 23: 167-174 https://doi.org/10.1006/pmed.1994.1023
  14. Rohren CL, Croghan IT, Hurt RD, Offord KP, Marusic Z, McClain FL. Predicting smoking cessation outcome in a medical center from stage of readiness: contemplation versus action. Prev Med 1994; 23: 335-344 https://doi.org/10.1006/pmed.1994.1047
  15. Kim MM, Jin CK, Kim YJ, CHO BM. The disease related factors affecting cessation of smoking. J korean Acad Fam Med 1995;16: 880-890 (korean)
  16. Cho HJ, Yeo JK, Sunwoo S, Predicting factors of smoking cessation in patients visited smoking cessation clinic. J korean AcadFamMed 1996; 17(S): 1211 (Korean)
  17. Sim JY, Han NY, Yoo SM, Jeong YS, Park IH. The factors associated with success of smoking cessation at smoking cessation clinic. J korean Acad Fam Med 2000; 21: S985(Korean)
  18. Kim CH, Seo HG. the factors associated with success of smoking cessation at smoking cessation clinic. J korean Acad FamMed 2001;11: 1603-1611 (Korean)
  19. Kim JR, Lee OJ, Jeon US, Cho JH, Hong DY. Development and evaluation of a smoking cessation program for outpatients. J Korean Public Health Assoc 2001; 27: 59-68(Korean)
  20. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. PsycholRev 1977; 84: 191-215 https://doi.org/10.1037/0033-295X.84.2.191
  21. Coon GM, Pena D, lllich PA. Self-efficacy and substance abuse; assessment using a brief phone interview. J Substance Abuse Treahnent1998;15:385~391 https://doi.org/10.1016/S0740-5472(97)00285-7
  22. Heatherton TF,Kozlowski LT,FreckerRC, Fagerstrom KO, The Fagerstrom test for nicotine dependence:a revision of the Fagerstrom tolerance questionnaire. Br J Addie 1991; 86: 1119-1127 https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
  23. Kawane H, Soejima R. Smoking habits and carbon monoxide concentration in expired air. Proceedings of the 12th Asia Pacific congress on diseases of the chest, Seoul, 1992, p.225
  24. Windsor RA, Orleans CT. Guideline and methodological standards for smoking cessation intervention research among pregnant women: improving the science and art. Health Education Quarterly 1986;13: 131-161 https://doi.org/10.1177/109019818601300203
  25. 예방의학과 공중보건 편집위원회. 예방의학과공중보건 개정2판. 계축문화사; 2001 :550쪽
  26. Normn H, Mary S, Judith 0, Gregory G. Baseline factors associated with smoking cessation and relapse. Prev. Med 1991;20: 590-601 https://doi.org/10.1016/0091-7435(91)90057-B