Evaluating the Program of a Smoking Cessation Support Group for Adult Smokers: A Longitudinal Pilot Study

評值成人戒菸支持團體方案：初步的長期追蹤研究

黃芷苓(Chih-Ling Huang)

戒菸 ； 成人 ； 支持團體 ； smoking cessation ； adult ； support group

The Journal of Nursing Research

13卷3期（2005 / 09 / 01）

197 - 205

英文

吸菸是國人健康危害的重要成因，為了降低成人吸菸率，衛生署國民健康局開辦「門診戒菸治療服務計畫」，補助成人戒菸者尼古丁替代藥物的藥品費用，然而多重戒菸措施比單一使用尼古丁替代藥物的戒菸率高。本研究的目的是發展和評價一個成人戒菸支持團體計畫，本戒菸計畫乃結合心理和生理治療，透過地方電視台7天的廣播及發出一千張宣傳單，宣傳內容為免費戒菸治療，共招募志願戒菸者10名，支持團體在南台灣的一個衛生所進行，計畫措施包括每月一次的團體討論、免費尼古丁貼片、公共衛生護士的電話諮商和社區健康志工的電話追蹤。而且戒菸者要記錄每天的吸菸行為，列出戒菸的好處，在戒菸合約上簽名以示決心，也要邀請家人協助監督戒菸行為。戒菸者學習行為改變技巧，包括演練戒菸情形、放鬆技巧、多運動、轉移注意力等。計畫結果測量為前後測的CO及前後測和9個月追蹤時的一個月內吸菸量。以Wilcoxon signed-rank test檢定CO前後測值，有統計上顯著的降低。以Friedman test檢定前後測和9個月追蹤時的一個月內吸菸量，也有統計上顯著的降低。9個月追蹤時有5人仍在戒菸狀態，有3人比起前測時的一個月內吸菸量至少降低了49%。因此，共有8人改變了吸菸行為。結果顯示結合心理和生理治療的戒菸支持團體是有效的，將來的研究應該招募較多的戒菸者，才能進一步推論此結果。

Tobacco use is the leading cause of preventable death in Taiwan. In order to increase cessation rates among adult smokers, the Department of Health in Taiwan has begun providing financial support for nicotine replacement therapy (NRT). However, therapies based on multiple interventions can lead to significantly higher cessation rates than NRT alone. This study develops and evaluates the outcomes of a smoking cessation program that provides a combination of physiological and psychological treatment in the context of a short-term support group. In this study, ten adult smokers were recruited by means of advertisements broadcast on local television over a seven-day period and one thousand flyers that advertised free assistance with quitting smoking. The smoking cessation support group was carried in Tainan County, in southern Taiwan. The three-month program consisted of three, monthly group sessions, free nicotine patches, telephone counseling by public health nurses, and telephone interviews by community health volunteers. Those participating in the group were encouraged to keep a record of all smoking behavior and its ”triggers” in a diary, list the personal benefits of quitting, draw up a quitting contract, and enlist significant family members to monitor their quitting behavior. Participants were also trained in behavioral strategies to avoid smoking, including imagery rehearsal, relaxation techniques, exercise, and distraction. The outcome of the project was assessed by the following two criteria: (1) carbon monoxide (CO) level in the breath before and after the three-month program, as measured by percentage of carboxyhemoglobin (%COHB), and (2) the self-reported number of cigarettes smoked per month, taken at the outset of the three-month program, at the conclusion of the program, and six months after the termination of the program. The Wilcoxon signed-rank and Friedman tests respectively revealed that there were significant decreases both in the subjects' %COHB level at the 3-month data-point, and in the number of cigarettes smoked at one month from the pretest, at the 3-month test and at the 9-month follow-up test. At the 9-month follow-up, five of the ten participants (50%) were abstinent, and three (30%) had decreased cigarette consumption by at least 49% of their pretest levels. Eighty percent of participants had, therefore, changed their smoking behavior. These results demonstrate the promise of integrated smoking cessation therapy in a group support context and indicate the need to pursue implementation and evaluation of this type of therapy on a larger scale.

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