某區域醫院認知行為團體戒菸班課程之成效

背景：幫助吸菸者戒菸已成為一重要的公衛政策。雖然已有許多戒菸方案，但再吸率仍偏高。 目的：研究醫院採認知行為團體治療方式 (cognitive behavioral group therapy) 幫助有意願戒菸的民眾戒菸。本研究目的為評估戒菸班教育課程後對菸害認知、反菸的態度和吸菸行為的成效。 方法：採單組有前後測的實驗設計。第一週(前測)填寫問卷、測量呼出一氧化碳 (CO)，提供三週共12小時的戒菸課程。第六週 (後測) 先填寫問卷、測量呼出CO。三個月後以電話詢問戒菸情況。 結果：2007 年 6 月共 16 位有意願戒菸民眾參加我們的戒菸班，三個月後有 6 個人成功戒菸，戒除率為 26.1% (95%信賴區間=4.6%-47.6%)。每天平均吸菸量有減少，授課前 24.7 根、授課中 16.1 根、第六週 9.5根。授課前呼出 CO 值 10.9ppm，第六週呼出CO值為 7.4ppm，達統計顯著意義 (p=.011)。菸害認知前測平均答對率 75.0%，第六週提升至 92.6%，達統計顯著意義 (p < .001)。在前測時反菸態度平均為3.4分，第六週平均得分為 4.0，達統計顯著意義(p < .001)。尼古丁依賴程度總分從前測平均的5.6分，第六週顯著下降 2.6 分 (p < .001)。 結論：運用戒菸支持團體及認知行為治療和學習心理調適技巧，來幫助有意願戒菸的民眾戒菸。三個月後成功戒菸率為 26.1%，菸害認知及反菸態度均提升，尼古丁依賴程度減少。
Background: Helping smokers break nicotine addiction is important to public health. Although many smoking cessation program have been established, relapse rate remains very high. Purpose: This study assessed the effect of cognitive behavioral group therapy in a smoking cessation program at our hospital on participants’ knowledge, attitude, and behaviour. Method: The one-group pretest-posttest design intervention trial was used. Before the trial, the participants were administered a questionnaire and had their exhalation of carbon monoxide (CO) measured. They then took part in a twelve-hour smoking cessation program in 3 weeks. Exhaled CO and the questionnaire was assessed again at week 6. Telephone follow-up was performed after three months. Results: In 2007 June, 16 people attended the program. Six individuals (26.1%) had successfully stopped smoking after three months (95% CI =4.6% - 47.6%). The number of cigarettes smoked daily reduced from an average of 24.7 at baseline to 16.1 in week 2 to 9.5 in week 6. The average exhaled CO level of these smokers was 10.9 ppm at the beginning of the program, and had decreased significantly in week 6 (7.4 ppm; p=.011). The average cognitive score on the smoking harm subscale, which was 75.0% at baseline, had significantly increased to 92.6% in week 6 (p<.001). The average anti-smoking attitude score, which was 3.4 at baseline, had increased to 4.0 in week 6 (p<.001). The nicotine dependent score, which was 5.6 at baseline, had decreased to 2.6 in week 6 (p<.001). Conclusion: In this study, we evaluated the effects of cognitive behavioral group therapy on smoking cessation and found a success rate of 26.1% after three months. We also found an increase in cognitive score on the smoking harm subscale and anti-smoking attitude as well as a decrease in nicotine dependence score.