입원 환자를 대상으로 한 체계적 금연 교육과 금연 성공률
Inpatient Smoking Cessation Program and Its Success Rate for Abstinence among Korean Smokers
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초록
연구배경: 흡연이 주요 질병과 사망의 원인으로 널리 알려져 있음에도 불구하고, 우리나라 성인 흡연율은 세계최고 수준 이다. 외국에는 입원 환자를 대상으로 한 체계적인 금연 교육 의 효과를 평가한 연구 결과가 다수 있으나, 국내에는 거의 없 다. 이에 본 연구에서는 입원 환자를 대상으로 한 체계적 금연 교육이 금연 성공에 미치는 효과를 알아보기 위해 권고 수준 의 최소 금연 교육과 비교해 보았다. 방법: 2008년 3월 1일부터 4월 30일까지 일개 대학 병원에 입 원하였던 18세 이상의 환자 중 흡연 중이며, 금연 교육이 가능 한 70명을 대상으로 설문과 교육을 포함하는 무작위 대조 연 구를 시행하였다. 금연 교육은 입원 중에 실시하는 1회의 대면 교육과 퇴원 후 3개월 동안 실시하는 총 3회의 전화 상담으로 구성되었다. 퇴원 후 1주, 1개월 및 3개월째 금연 성공을 전화 설문으로 평가하였다. 결과: 퇴원 후 3개월째 시험군인 체계적 금연 교육군의 금연 성공률(37.1%)은 대조군인 최소 금연 교육군의 금연 성공률 (14.3%)보다 유의하게 높았다(P=0.029). 단순 로지스틱 회귀 분석 결과, 시험군이 금연에 성공할 교차비는 대조군과 비교 하여 3.5배(95% CI, 1.10-11.41) 높았으며, 다중 로지스틱 회귀 분석 결과, 시험군이 금연에 성공할 교차비는 대조군과 비교 하여 11.4배(95% CI, 1.38-99.61) 높았다. 결론: 입원 환자를 대상으로 한 체계적 금연 교육은 권고 수준 의 최소 금연 교육과 비교하여 높은 금연 성공률을 보였다.
Abstract
Background: Inpatient smoking cessation programs have been known to be quite effective for smoking cessation, but it was rarely conducted among Koreans. This study was to investigate the effect of inpatient smoking cessation program among Korean smokers. Methods: From March 1 to April 30, 2008, we carried out a randomized controlled trial for inpatient smoking cessation program among 70 smokers who were 18 years of age or over and admitted to a university hospital in Seoul, Korea. For the intervention group, a trained doctor conducted the systematic educational program for smoking cessation of 30 minutes to an hour. For the control group, they were advised with a 3-minute explanation for smoking cessation. We assessed the abstinence rates of study participants at 1 week, 1 month, and 3 months after discharge. Results: In 3 months after the discharge, the abstinence rate for the intervention group was 37.1% while that of the control group was 14.3%. In simple logistic regression analysis, the smokers among the intervention group were 3.5 times more likely to abstain than those in the control group. After controlling for confounding factors, the smokers among the intervention group was 11.4 times more likely to abstain than those in the control group. Conclusion: For Korean smokers, the inpatient smoking cessation program showed a higher success rate of abstinence compared to simple advice and limited counselling.
참고문헌 (28)
- "Ministry for Health, Welfare and Family affairs" (2008)[URL]
- Fauci AS, "Harrison's principles of internal medicine. 17th ed", pp.2736~2739 (2007), McGraw-Hill
- 이호, "입원했던 환자의 퇴원 후 흡연율 변화", 가정의학회지, 27(7), pp.556~560 (2006), 대한가정의학회
- Pederson LL, "The effects of counseling on smoking cessation among patients hospitalized with chronic obstructive pulmonary disease: a randomized clinical trial", Int J Addict, 26, pp.107~119 (1991)
- Feeney GF, "Randomized controlled trial of two cigarette quit programmes in coronary care patients after acute myocardial infarction", Intern Med J, 31, pp.470~475 (2001)
- Sivarajan Froelicher ES, "High rates of sustained smoking cessation in women hospitalized with cardiovascular disease: the Women’s Initiative for Nonsmoking (WINS)", Circulation, 109, pp.587~593 (2004)
- Hennrikus DJ, "The TEAM project: the effectiveness of smoking cessation interventions with hospital patients", Prev Med, 40, pp.249~258 (2005)
- Fiore MC, "Treating tobacco use and dependence: a clinical practice guideline" (2000), US Dept. of Health and Human Services
- Heatherton TF, "The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire", Br J Addict, 86, pp.1119~1127 (1991)
- Bandura A, "Self-effi cacy: toward a unifying theory of behavioral change", Psychol Rev, 84, pp.191~215 (1977)
- DiClemente CC, "Self-effi cacy and the stages of self-change of smoking", Cognit Ther Res, 9, pp.181~200 (1985)
- 이언숙, "금연시도자 중 금연 성공과 관련된 요인들", 가정의학회지, 28(1), pp.39~44 (2007), 대한가정의학회
- Centers for Disease Control and Prevention, "Cigarette smoking among adults: United States, 1998", MMWR Morb Mortal Wkly Rep, 49, pp.881~884 (2000)
- Hymowitz N, "Baseline factors associated with smoking cessation and relapse", Prev Med, 20, pp.590~601 (1991), MRFIT Research Group
- McIntyre KO, "Self-efficacy and relapse in smoking cessation: a replication and extension", J Consult Clin Psychol, 51, pp.632~633 (1983)
- Gulliver SB, "An investigation of self-efficacy, partner support and daily stresses as predictors of relapse to smoking in self-quitters", Addiction, 90, pp.767~772 (1995)
- Stuart K, "Self-efficacy, health locus of control and smoking cessation", Addict Behav, 19, pp.1~12 (1994)
- Won YI, "Baseline factors associated with smoking cessation", J Korean Acad Fam Med, 13, pp.862~868 (1992)
- Kim YJ, "The disease related factors affecting cessation of smoking", J Korean Acad Fam Med, 16, pp.880~890 (1995)
- Solberg LI, "A systematic primary care office-based smoking cessation program", J Fam Pract, 30, pp.647~654 (1990)
- Kim BJ, "Factors associated with the stages of change of smoking cessation behavior in military officers", 박사, pp.2001
- Clements-Thompson M, "Relationships between stage of change in cigarette smokers and healthy lifestyle behaviors in a population of young military personnel during forced smoking abstinence", J Consult Clin Psychol, 66, pp.1005~1011 (1998)
- DiClemente CC, "The process of smoking cessation: an analysis of precontemplation, contemplation and preparation stages of change", J Consult Clin Psychol, 59, pp.295~304 (1991)
- Rosenbaum P, "Large-scale study of freedom from smoking clinics-factors in quitting", Public Health Rep, 107, pp.150~155 (1992)
- Kim CH, "The factors associated with success of smoking cessation at smoking cessation clinic", J Korean Acad Fam Med, 22, pp.1603~1611 (2001)
- Rigotti NA, "Interventions for smoking cessation in hospitalised patients", Cochrane Database Syst Rev, (3), pp.CD001837~ (2007)
- Shin HC, "Experiment of smoking cessation clinic management", J Korean Acad Fam Med, 14(4), pp.S25~S28 (1993)
- Timmreck TC, "Smoking cessation: clinical steps to improve compliance", Geriatrics, 48, pp.63~70 (1993)