年長者戒菸成功影響因子之初探

A Preliminary Study of the Factors Influencing Smoking Cessation among the Elderly

張茵畬(Yin-Yu Chang) ； 劉樹泉(Shu-Chuen Lau) ； 黃獻樑(Hsien-Liang Huang)

《台灣老年醫學暨老年學雜誌》 8卷3期 (2013/08) Pp. 160-171

https://doi.org/10.29461/TGG.201308_8(3).0002

摘要

目的：自從國民健康署推出二代戒菸方案後，民眾參與戒菸的意願大幅提升，各醫療院所也積極推動各項戒菸計劃，卻較少有特定針對年長者的介入計劃。然而戒菸治療中，提升戒菸者之動機及評估尼古丁依賴指數是相當重要的一環。因此本文研究年長者之尼古丁依賴指數是否對戒菸成功率有影響。希望藉此研究致用於年長者戒菸的臨床工作中。方法：以某區域醫院年齡大於65歲的欲戒菸老年人為研究對象，採問卷調查的方式，於戒菸門診中進行調查。問卷包含基本資料、BMI、系統性疾病，戒菸動機、戒菸支持者、尼古丁依賴指數（Fagerström nicotine dependence test）。給予戒菸門診諮詢或藥物治療的一周後，以電話訪問是否有戒菸的症狀。一年以後，電話訪問戒菸是否成功。並以SPSS軟體進行基本資料及尼古丁依賴指數與戒菸是否成功間的的t檢定（student's t- test）。結果：共收案26位，回收有效問卷及電話追蹤18位老年人，含男性15位（83%），女性3位（17%），平均年齡74±8（65－88）歲，平均吸菸49±12（30－70）年。17位（94%）老年人同時有系統系疾病，1位（6%）無系統性疾病。44%老年人的戒菸動機為減少心臟病機會，22%為減少肺氣腫機會；然而33%的動機為醫護人員勸戒，親人勸戒菸的比例為28%。老年人的孩子為最重要的戒菸支持者（56%），配偶為支持者的比例是33%。平均尼古丁依賴指數是5±2分。戒菸成功者有7位，戒菸失敗者有11位，戒菸成功率26.9%。尼古丁依賴指數與戒菸成功與否沒有相關（p=0.831）。但以其中單項來看，回答難以忍受戒菸場所者，有比較容易成功戒菸的趨勢（p=0.077）。結論：相對於一般民眾，本研究的老年族群有較高的戒菸成功率。其中以不能忍受戒菸場所者，比其他老年人有更高成功戒菸率的趨勢。期望以本次前導性研究的方法，收集更多的老年族群樣本，獲得更可信賴的研究結果，以應用於老年族群的戒菸臨床工作中。

關鍵字

老年人 ； 戒菸 ； 影響因子 ； 動機

並列摘要

Objectives: Since the implementation of the second-generation smoking cessation program by Health Promotion Administration, both the general public and medical institutions have worked with greater vitality to practice and promote quitting smoking. However, studies on smoking cessation in the elderly remain inadequate. Increasing cessation motivation for elderly smokers and evaluating their nicotine dependence are essential. In this study, we aimed to explore the factors that might influence the smoking cessation in the elderly.Method: A cross-sectional questionnaire survey was conducted on elderly (aged 65 and over) participants at the smoking cessation clinic of a community hospital. Background information, smoking motivation, social support for smoking cessation, and the results of the Fagerström nicotine dependence test were collected. Smoking status and withdrawal symptoms were assessed one week and one year after enrollment by telephone interviews.Results: A total of 18 participants were included in the final analysis, including 15 males (83%) and 3 females (17%), and the average age was 74±8 (65-88). Motivations for smoking cessation were as follows: 44% of the subjects wanted to decrease the risk of cardiovascular events, 22% wanted to decrease the risk of emphysema, up to 33% was motivated by medical professionals, while 28% was motivated by concerned family members. Children were the most important source of social support (56%), while spouse support accounted for 33%. Average nicotine dependence score in this group was 5±2 points. Seven participants successfully quitted smoking at one year follow up (26.9%). No statistically significant factors were identified in the study, but subjects who could not tolerate being in non-smoking public environments tended to be more capable of quitting successfully (p=0.077).Conclusions: Elderly smokers have a higher success rate of quitting compared to the general population in the study. Those who could not tolerate a non-smoking public environment had a better chance of quitting. Further studies to identify the factors that influence smoking cessation in the elderly are important.

並列關鍵字

elderly ； smoking cessation ； motivation