The Effectiveness of Pharmacotherpay and Self-Management at Tobacco Cessation

Yin-Ming Li

《台灣老年醫學暨老年學雜誌》 9卷2期 (2014/05) Pp. 15-15(2)

並列摘要

Objectives: Quit smoking is important for chronic disease prevention and management. Failure to quit smoking is not uncommon even with pharmacotherapy. Smokers' motivation and self management are crucial at behavior change. In this report, we shared our experience of combined motivational interviewing, self-management and medications to assist smokers quit smoking. Methods: Smokers who met the criteria of pharmacotherapy were referred for tobacco cessation. Demographic characteristic, medical history, smoking characteristics and outcome, and perceived benefit and barrier of quit smoking were assessed at the first visit. For those who reported low motivation and readiness to quit, motivational interviewing was integrated into usual brief consultation. Mean tobacco smoked, behavior changes and their difficulty were assessed at each visits. Participants who decide to quit are provided with a self-help guide to quitting, help with a quit plan, and 8 weeks of pharmacotherapy. Self-report of one or more quit attempts lasting at least 24 hours and smoking abstinence was assessed at 3 and 6 months following baseline. Results: Totally thirty-five smokers received intervention. Most were male (85.5%), with a mean age of 47 years old and 26.8 years of smoking history. During the first visit, we gathered the clinical and individual experience and tried to build up a collaborative relationship. Motivational interview technique included: expressing empathy, developing discrepancies, backing off when encountering resistance and supporting self-efficacy were used if indicated. At the 3- months followed up, 14 (40%) smokers failed, 12 (34.3%) quit smoking and 9 (25.7%) smokers lost followed up. Of 24 smokers followed up at 6 months, 33.3% reported smoking abstinence. Participants perceived autonomy support and greater self efficacy more likely to smoking abstinence. Conclusion: Quit smoking is very challenging for chronic smokers. Pharmacotherapy does not warrant the success of tobacco cessation. Motivational interviewing increase intentions and self efficacy. Combining behavioral support and pharmacotherapy is recommended to help people to quit smoking where possible. Primary care givers need more training of partnering in self-management support.