입원 환자 금연 진료에 대한 의사 인식도

박일환,정유석 대한임상건강증진학회 2019 Korean Journal of Health Promotion Vol.19 No.3

Background: Smoking cessation services for inpatients can be provided effectively through interdisciplinary collaborations. Physicians could play a central role in smoking cessation counseling and treatment for recovery from illness and health promotion of the inpatient. This study aimed to investigate the perspectives of physicians on inpatient smoking cessation services. Methods: We conducted one personal and two focus group interviews with clinical faculties at a university hospital in Seoul and a university hospital in Chungnam using semi-structured questionnaires. Interviews were recorded, and the transcribed verbatim was analyzed qualitatively. Results: The physicians recognized the need for inpatient smoking cessation services and recognized that smoking cessation was effective when the patient had a smoking-related illness such as respiratory or cardiovascular disease Additionally, the physicians recognized the need for hospital management to support smoking cessation in hospitalized patients and recognized that it was effective to have a dedicated workforce with a smoking cessation coordinator. There was support from four types of physicians in the smoking cessation program: active participant, passive supporter, passive ignorer, and active refuser. Conclusions: The physician is important for the effective implementation of inpatient smoking cessation services. A dedicated team for the smoking cessation of the inpatient, the establishment of evidence-based data on the effectiveness of the inpatient smoking cessation services, and development of customized smoking cessation services will be necessary to strengthen the role of physicians. 연구배경: 입원 환자를 위한 금연지원 프로그램은 다학제간 협력에 의해 이루어질 때 효과적이다. 임상 의사는 입원환자의 금연 상담 및 치료에 있어서 중심적 역할을 한다. 본 연구의 목적은 임상 의사들이 입원 환자의 금연지원 프로그램에 대한 어떤 인식을 갖고 있는지 조사해 보고자 한것이다.방법: 서울 소재 1개 의과대학 병원과 충남 소재 1개 의과대학 임상교수들을 대상으로 개인 면담 및 포커스 그룹 면담을 시행하였다. 면담은 반구조화된 설문지에 의해 이루어졌으며, 면담 내용은 녹화되어 축어적으로 전사되었다. 전사된 자료에 대한 질적 내용분석을 시행하였다. 결과: 의사들은 입원 환자 금연지원 서비스에 대해 필요하다고 인식하였으며, 환자가 호흡기질환, 순환기질환 등과같이 흡연과 연관된 질병을 갖고 있을 때 입원 금연 치료가효과적이었다고 인식하였다. 또한, 병원에서 입원 환자 금연지원을 위한 의지가 필요하다고 인식하였으며, 금연 코디네이터와 같은 전담 인력이 있는 것이 효과적인 것으로 인식하였다. 입원 금연 프로그램에 대한 의사의 요구도를 4가지 지지 유형에 따라 나눌 수 있었으며, 적극적 참여형, 소극적 지지형, 소극적 무관심형, 적극적 거부형이었다. 결론: 입원 환자의 금연 진료의 효과적 시행을 위해서 의사들의 역할이 중요하다. 입원 환자 금연 상담을 위한 금연전담팀, 입원 환자 금연 진료의 효과에 대한 근거자료 구축, 환자의 질병 및 중증도를 고려한 맞춤형 금연 프로그램 개발 등은 의사의 역할 제고를 위해 매우 중요할 것이다

병의원 금연치료프로그램 참여자의 금연 경험: 질적 연구

표지희,옥민수,이재욱,한영주,조민우,이정아 한국보건행정학회 2017 보건행정학회지 Vol.27 No.4

Background: The objectives of this study were to identify the reasons of quitting smoking, to determine the factors that make it difficult or helpful to maintain smoking cessation and to confirm the changes after the smoking cessation. Methods: This study was conducted an in-depth interview with people who participated in the smoking cessation treatment program. There were 10 participants and they were interviewed thoroughly for 14 times. Using the directed content analysis, we analyzed the transcript which was written by recording the interview and the researchers’ note. Results: The results of this study are summarized as ‘the experience while at the verge of smoking cessation and stepping over the verge of smoking cessation,' ‘the changing experience due to smoking cessation,’ and ‘maintaining the changes through overcoming re-smoking.' The smoking cessation treatment program induced the smokers to quit smoking. Participants mentioned drinking alcohol was the major obstacle to maintain smoking cessation. Also, they noted that the money and the time that were already spent to quit smoking helped their smoking cessation as well as the social relations which helped to prevent re-smoking. Participants felt well-cared through the smoking cessation treatment program and that it helped them to maintain smoking cessation. Conclusion: Smoking cessation treatment program has a positive effect on the smoking cessation trial and maintenance. In order for smokers to overcome re-smoking, educations regarding drinking problem, formation of supportive social relationship, and the applications for smoking cessation will be beneficial.

전국 보건소 금연클리닉 신규등록자의 성별 금연 성공요인

김진실,강수정,김대진,최인영,최병선 사단법인 대한보건협회 2018 대한보건연구 Vol.44 No.1

Objective : The study aimed to identify success factors of smoking cessation among smokers enrolled in smoking cessation clinics at public health centers based on gender differences. Methods : A total of 677,254 smokers in smoking cessation clinics from 250 public health centers for more than 6 months from July 18, 2013 to July 27, 2015 were examined. After classifying enrolled smokers into men and women, univariate and multivariate analyses were performed to identify their smoking cessation rates and factors associated with successful smoking cessation. Results : The study variables of age, occupation, alcohol, past quit-trials, smoked cigarettes daily, nicotine dependence, confidence, motivation and readiness of smoking cessation, total number of visits for counseling, area, motive to register and use of supplemental agents were successful factors of smoking cessation to both genders. On the other hand, past disease, age of starting smoking, and duration of smoking were non-significant. In regard to education level, the level was a significant factor to men, while it wasn't to women. Conclusion : To efficiently manage smoking cessation clinics, different approaches should be required since enrollees had different success factors of smoking cessation based on gender. In particular, male smokers' smoking cessation rates were higher as getting older while females showed lower rates. Thus, it's necessary to promote younger female smokers to enroll the clinics, providing gender differentiated service types for smoking cessation. Also, total number of visits for counseling and use of supplemental agents could play an important role in smoking cessation rates. Therefore, effective management plan for motivating smokers to easily access the clinic services should be required. 연구목적 : 본 연구는 보건소 금연클리닉의 남성등록자와 여성등록자의 금연성공요인을 비교분석하여, 향후 보건소 금연사업의 효과적인 운영방안을 모색하기 위한 개선방안을 제안하고자 하였다. 연구방법 : 2013년 7월 18일부터 ~ 2015년 7월 27일까지 전국 250개 보건소 금연클리닉 등록자 중 6개월 이상 서비스를받은 성인흡연자 677,254명을 남성과 여성으로 구분하여 금연 성공 여부를 파악하고 이와 관련된 요인을 단변수 분석과 다변수 분석을 실시하였다. 연구결과 : 분석결과, 연령, 직업, 음주 횟수, 과거 금연시도 여부, 하루평균 흡연량, 니코틴의존도, 금연 자신감, 금연 동기, 금연 준비, 총 상담횟수, 지역, 등록경로, 보조제 사용 여부가 남성과 여성의 공통적인 금연성공요인으로 나타났고, 질병력과흡연 시작연령, 흡연기간은 남성과 여성 모두 유의하지 않았다. 교육수준은 남성에서 유의하였으나 여성에서는 유의하지 않았다. 결론 : 금연클리닉을 효과적으로 운영하기 위해서는 남성과 여성의 금연 성공 영향요인이 다른 만큼 다르게 접근해야 한다는 것을 확인할 수 있었다. 특히 남성은 연령이 높을 때 성공률이 높지만, 여성은 성공률이 낮으므로 젊은 여성의 등록율을높일 수 있는 전략이 필요할 것으로 사료되어 성별에 따른 차별화된 금연서비스 제공의 필요성을 제언한다. 또한, 금연보조제사용과 상담 횟수는 남성과 여성 모두 금연성공률에 중요한 역할을 할 것으로 나타났다. 따라서 금연클리닉 서비스 이용 동기를 높일 수 있는 운영 방식을 고안해야 할 것이다.

Use and perception of Smoking Cessation in Traditional Medicine: A Survey of Korean Medical Practitioners

Lee, Ju Ah,Jang, Soobin,Park, Sunju Society of Preventive Korean Medicine 2018 대한예방한의학회지 Vol.22 No.2

Objectives : This survey assessed Korean medical doctors' (KMDs') use and perception of smoking cessation therapies in traditional Korean medicine (TKM) and their drawbacks. Methods : A total of 14,485 KMDs affiliated with the Association of Korean Medicine were sent surveys via email. They were asked the use and perception of smoking cessation therapies in TKM and their drawbacks: Present use of Korean medicine treatment for smoking cessation, ideal treatment for smoking withdrawal symptoms, advantages and disadvantages of smoking cessation treatments in Korean medicine were asked with closed-ended questionnaire. Results : Two hundred fifty-three KMDs (1.75%) responded to the questionnaire. According to the results of the study, more than half of KMDs (51.4%) answered that they have practiced smoking cessation therapy. The most frequently used treatments for smoking cessation were ear acupuncture (EA) (74.6%) and acupuncture (15.4%), and the most of TKM doctors said that they were the most effective treatments. The advantages of smoking cessation treatment in TKM were the fewer adverse events (53.4%), availability to stimulate acupoints continuously in everyday life (48.2%), and the possibility of controlling withdrawal symptoms. Disadvantages included the long treatment duration and the necessity of frequent visits to the doctor. The greatest disadvantage was the lack of sufficient evidence for the effectiveness of TKM smoking cessation protocols. Conclusions : Despite of the low response rate, the survey results show that the main treatment modalities for smoking cessation are acupuncture, and this was also estimated effective for stop smoking. However, to improve smoking cessation rate, the more various smoking cessation treatments should be developed.

Adherence to Varenicline and Abstinence Rates for Quitting Smoking in a Private Health Promotion Center-Based Smoking Cessation Clinic

이진영,김민지,전희정,강미라,박아람,오대은,최윤호,황정혜 대한결핵및호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.5

Background: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. Methods: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. Results: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8∼12 weeks; 22 subjects (28.2%) for 4∼8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052∼1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. Conclusion: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation. Background: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. Methods: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. Results: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8∼12 weeks; 22 subjects (28.2%) for 4∼8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052∼1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. Conclusion: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.

남자 관상동맥질환 진단경험자의 금연 의도와 관련 요인: 지역사회건강조사 자료를 이용한 단면적 연구

이유미 ( Yu Mi Lee ) 한국보건정보통계학회 2016 보건정보통계학회지 Vol.41 No.2

Objectives: Smoking cessation is an important factor for prevention of coronary artery disease. This study examined the extent of smoking cessation intention and the related factors among men with coronary artery disease, to aid in determining intervention strategies for smoking cessation. Methods: Data for 836 male current smokers with coronary artery disease living in a community were collected from the 2013 Community Health Survey in Korea. The association between the extent of smoking cessation intention and related factors was examined using a cross-sectional study design. Univariate analysis and multiple logistic regression analysis were used. Results: In the univariate analysis, young age, high education level, non-manual occupation, lower frequency and less quantity of the cigarettes, physical activity, continuous smoking cessation recommendations from acquaintances, and recent exposure to public advertising regarding smoking cessation were significantly associated with the presence of smoking cessation intention. In the logistic regression analysis, low frequent cigarette smoking (odds ratio [OR], 4.53; 95% confidence interval [CI], 2.23-9.23), continuous smoking cessation recommendations from acquaintances (OR, 3.07; 95% CI, 1.71-5.49), and recent exposure to public advertising regarding smoking cessation (OR, 2.33; 95% CI, 1.07-5.09) were significantly associated with smoking cessation intention. Conclusions: It is necessary to understand the smoking cessation intention for the management of patients with coronary artery disease and to provide a more active intervention using regular recommendations from acquaintances and persistent public advertising. Moreover, demographic factors such as age, education level, and occupation, as well as smokingrelated behaviors and community support should be considered while developing a smoking cessation program.

의사가 의뢰할 수 있는 금연지원서비스

임민경,신동욱,김현숙 대한의사협회 2018 대한의사협회지 Vol.61 No.3

The purpose of this article is to introduce smoking cessation services in the community to which physicians can refer their patients. There are three types of services: smoking cessation clinics at public health centers, regional smoking cessation centers, and quitlines. Smoking cessation clinics were established in 2005 at public health centers to reduce the smoking rate. Tailored counseling, nicotine replacement therapy, and drug treatment can improve the success rate of smoking cessation in clinical settings, and behavioral therapy can promote smoking cessation in the community. Quitlines have been launched and operated throughout the world as effective cessation services that guarantee confidentiality, accessibility, convenience, and cost-effectiveness. Tailored information and intervention programs for smoking prevention and smoking cessation have been offered through the telephone, multimedia messaging services, social networking services, and chatting in Korea. Referrals from other national cessation programs for maintaining cessation are also available. Since 2015, regional smoking cessation centers have administered two types of camps. The target group of intensive-care smoking cessation camps includes heavy smokers, who should receive inpatient care at the regional smoking cessation center for 5 days. The general support smoking cessation camps target smokers who wish to quit or who have unsuccessfully quit, and provide education and consulting programs over 1 to 2 days. These three types of services provide different services and programs to smokers in the community. If physicians refer to their patients to these services, they may prove to be excellent resources for increasing smoking cessation.

Use and perception of Smoking Cessation in Traditional Medicine: A Survey of Korean Medical Practitioners

이주아,장수빈,박선주 대한예방한의학회 2018 대한예방한의학회지 Vol.22 No.2

Objectives : This survey assessed Korean medical doctors’ (KMDs’) use and perception of smoking cessation therapies in traditional Korean medicine (TKM) and their drawbacks. Methods : A total of 14,485 KMDs affiliated with the Association of Korean Medicine were sent surveys via email. They were asked the use and perception of smoking cessation therapies in TKM and their drawbacks: Present use of Korean medicine treatment for smoking cessation, ideal treatment for smoking withdrawal symptoms, advantages and disadvantages of smoking cessation treatments in Korean medicine were asked with closed-ended questionnaire. Results : Two hundred fifty-three KMDs (1.75%) responded to the questionnaire. According to the results of the study, more than half of KMDs (51.4%) answered that they have practiced smoking cessation therapy. The most frequently used treatments for smoking cessation were ear acupuncture (EA) (74.6%) and acupuncture (15.4%), and the most of TKM doctors said that they were the most effective treatments. The advantages of smoking cessation treatment in TKM were the fewer adverse events (53.4%), availability to stimulate acupoints continuously in everyday life (48.2%), and the possibility of controlling withdrawal symptoms. Disadvantages included the long treatment duration and the necessity of frequent visits to the doctor. The greatest disadvantage was the lack of sufficient evidence for the effectiveness of TKM smoking cessation protocols. Conclusions : Despite of the low response rate, the survey results show that the main treatment modalities for smoking cessation are acupuncture, and this was also estimated effective for stop smoking. However, to improve smoking cessation rate, the more various smoking cessation treatments should be developed.

Effects of a supportive workplace environment on the success rate for smoking cessation camp

Kim Woojin,Kim A Ram,Ock Minsu,Jeon Young-Jee,Lee Heun,Kim Daehwan,Kim Minjun,Yoo Cheolin 대한직업환경의학회 2023 대한직업환경의학회지 Vol.35 No.1

Background: This study was conducted to identify the success rate for smoking cessation over time after participation in a therapeutic smoking cessation camp, and to identify how participant characteristics, including a supportive workplace environment for smoking cessation (SWESC), affect the success rate for smoking cessation. Methods: In all, 296 participants at smoking cessation camps in Ulsan between 2015 and 2020 were investigated. The success rates of smoking cessation after weeks 4, 6, 12, and 24 at camp were investigated. The participants were grouped as workers with an SWESC, and workers without an SWESC, and variables (age, education, household income, marital status, drinking, exercise, body mass index, morbidity, job, number of counseling sessions, cigarettes smoked per day and smoking initiation age) were investigated. Multiple logistic regression analysis was conducted at each time point. In addition, Cox regression analysis was performed to evaluate the variables affecting the success rate for smoking cessation over time. Results: The smoking cessation success rate of workers with an SWESC at week 24 (90.7%) was higher than that for workers without an SWESC (60.5%). Multiple logistic regression was performed to determine the relationship between each variable and the success rates for smoking cessation at week 6, 12, and 24. SWESC was confirmed as significant (p < 0.05) variables for increased success rate for smoking cessation at all 3 time points. After adjusting for all variables, the Cox proportional hazards survival analysis showed a hazard ratio of 6.17 for SWESC (p < 0.001,; 95% confidence interval: 3.08–12.38). Conclusions: At a professional treatment smoking cessation camp, participants with an SWESC showed a significantly higher success rate for smoking cessation. Supportive workplace environment for workers’ health is expected to be an important factor for smoking cessation projects as well as other health promotion projects at workplace.

패널자료를 활용한 종단적 금연 성공요인 분석

송태민(Tae Min Song),이주열(Ju Yul Lee) 한국보건교육건강증진학회 2009 보건교육건강증진학회지 Vol.26 No.3

Objectives: This study has longitudinally analyzed male smokers in order to find out the trend rate of re-smoking after smoking cessation. Methods: The study was conducted with 800 male smokers who were provided with smoking cessation services for 3 years at public health centers from July 16, 2005 to July 15, 2008. Results: The results can be summarized as follows: First, the success rate of smoking cessation for at least 6 months during 3-year period was 54.4%. The failure rate of smoking cessation at the second year was 47.5% and the third 27.2%, which indicates that the failure rate diminishes as the period of smoking cessation extends. Second, the success rate of smoking cessation at the first trial was 35.0%, the second 24.3%, and the third 16.4%. The success rate diminished as the number of trial increased. Third, the continuation rate of smoking cessation for a year was 18.3%, for 2 years 13.4%. For the success group, the continuation rate of smoking cessation for a year was 52.5%, for 2 years 38.2%. For the failure group, the rate for a year was 21.5%. Fourth, in this longitudinal analysis, the most crucial variables that affect the success rate of smoking cessation are total number of consultation and the past experience of successful smoking cessation. Conclusion: This study shows that success of smoking cessation and the continuance of smoking cessation are both difficult, and that the past experience of smoking cessation plays an important role determining the present success of smoking cessation and continuance of smoking cessation. Thus, it is necessary to divide people into success group and failure group based on the results of the past experience of smoking cessation when they consult at smoking cessation clinics at public health centers. Further, in order to increase the continuation rate of smoking cessation, this study suggests that we need to consider ways to take care of those who successfully abstained from smoking for 6 months.