一个吸烟的病人怎么办?
1Department of Medicine and Smoking Cessation Leadership Center, University of California, San Francisco 94143, USA. schroeder@medicine.ucsf.edu
JAMA
|July 28, 2005
概括
大多数临床医生在帮助吸烟者戒烟方面表现不佳,尽管它是可预防的死亡的主要原因. 利用基于证据的策略和资源可以显著提高成功戒烟率.
科学领域:
- 公共卫生 公共卫生
- 临床医学 临床医学
- 药物成科学 药物成科学
背景情况:
- 吸烟是导致死亡和残疾的主要可预防原因,70%的美国吸烟者希望戒烟.
- 尼古丁成使得许多4600万美国吸烟者很难在没有帮助的情况下戒烟.
- 临床医生面临帮助吸烟者的障碍,包括时间,专业知识和对成功率的悲观情绪.
研究的目的:
- 为了突出临床医生在戒烟方面的表现不佳.
- 审查基于证据的戒烟策略及其有效性.
- 解决戒烟障碍并促进更好的临床实践.
主要方法:
- 关于戒烟的当前文献的综述.
- 停止使用的"五个A"模式的描述.
- 讨论药物治疗和咨询干预措施.
主要成果:
- 只有少数医生使用"五个A"模型.
- 成功戒烟通常需要多次尝试和联合治疗 (咨询+药物治疗).
- 向戒烟线或综合系统推的成功率与个人临床医生的努力相美.
结论:
- 临床医生的支持至关重要,但往往缺乏.
- 基于证据的干预措施,包括更简单的转诊途径,可以显著提高戒烟率.
- 用成功数据来解决临床医生的悲观主义对于促进戒烟干预至关重要.
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