암 진단이 금연 행동에 미치는 영향
Effect of Cancer Diagnosis on Smoking Behavior
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연구배경: 흡연은 예방 가능한 위험요인으로 가장 중요하며, 암 환자에서도 예외는 아니다. 암 진단 후 환자들의 흡연 습관 변화를 파악하여 금연 교육과 치료 필요성을 알아 보기 위해 본 연구를 시행하게 되었다. 방법: 2007년 8월부터 한달 간 한 종합 병원에 입원한 암 환자 279명을 대상으로 흡연 행동과 관련된 1차 자기기입식 설문 조사를 하고, 3개월과 7개월 후에 전화 면담으로 추적 관찰 하 여 조사가 완료된 246명에 대하여 흡연 습관의 변화를 관찰하 였다. 설문 항목은 공통적으로 흡연력과 니코틴 의존도, 흡연 혹은 금연 여부 및 동기, 행동변화 단계였으며, 3차 설문에는 금연 교육과 금연 치료 필요성을 묻는 설문을 추가 하였다. 결과: 연구 시작 당시 흡연자의 28%는 7개월 후에도 흡연을 지속하고 있었으나, 1차 설문 시기에 비해 니코틴 의존도가 낮 아 졌으며, 행동 변화 단계는 대부분 준비 혹은 고려 단계이었 다. 이들이 흡연을 지속하는 이유로 든 것은 습관, 스트레스, 치료 후 증상 호전 등이었다. 암 환자의 80%는 과거 흡연경험 과 무관하게 의사의 금연 권고나 치료가 필요하다고 응답하 였다. 결론: 암 환자에게 흡연은 분명한 건강의 위협 요소이며, 암 진단 후 흡연을 지속하는 환자 군이 있다는 사실을 확인하였 고 이들에 대한 금연 권고나 치료에 관심을 가져야 한다.
Abstract
Background: Smoking is universally recognized as the foremost preventable cause of cancer. And smoking behavior causes many negative effects in cancer patients. Based on the mounting evidence that smoking affects cancer treatment outcomes and survival, we studied whether the cancer diagnosis affects smoking behavior. Methods: During August 2007, 279 patients who were hospitalized with the diagnosis of cancer were surveyed by a questionnaire and a follow up survey was performed at 3 months and 7 months afterwards. Follow up survey was performed via telephone and finally 246 patients were enrolled. Questions in the survey included smoking history, nicotine dependence, stage of change and the reason for quit smoking or keep smoking. In the follow up survey at 7 month, we asked whether they needed smoking cessation interventions. Results: At the end of the study, the subjects who kept smoking were 27 patients, but the degree of nicotine dependence was decreased compared to the preceding 2 surveys and contemplation as well as preparation stage turned out to be the most prevalent stage of change. The main reasons to keep smoking were behavioral habits and stress. Regardless of their smoking history, almost all cancer patients wanted smoking cessation interventions. Conclusion: Smoking is a critical variable that affects cancer treatment and outcome. We surely found there is a smoking subgroup after cancer diagnosis and we should advise them to quit smoking.
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