Abstract：Objective To investigate the nicotine dependence of patients with chronic obstructive pulmonary disease (COPD) who smoke and analyze its influencing factors, so as to provide insights into targeted smoking cessation interventions for smoking COPD patients. Methods The smoking COPD patients were selected from three hospitals in Lanzhou City using the convenience sampling method from October 2022 to April 2023. Demographic data, smoking status, and willingness to quit smoking were collected using questionnaire surveys. Nicotine dependence was assessed according to Fagerstrom Test for Nicotine Dependence. The influencing factors of nicotine dependence in smoking COPD patients were analyzed using a multiple linear regression model. Results A total of 200 questionnaires were distributed, and 171 valid questionnaires were collected, with a response rate of 85.50%. The median age was 48.00 (interquartile range, 10.00) years. There were 158 males, accounting for 92.40%; 53 cases with a college degree or above, accounting for 30.99%. The median smoking duration was 15.00 (interquartile range, 11.00) years. There were 73 patients (42.69%) smoking 21 to 30 cigarettes per day, and 159 patients (92.98%) with the willingness to quit smoking. The median nicotine dependence score was 3.00 (interquartile range, 1.00) points. There were statistically significant differences in nicotine dependence scores among smoking COPD patients with different ages, educational levels, occupations, interpersonal relationships, smoking duration, daily cigarette consumption, awareness of smoking hazards and willingness to quit smoking (all P<0.05). Multiple linear regression analysis revealed that nicotine dependence was related with educational level (β=-0.251), interpersonal relationship (β=-0.246), smoking duration (β=0.038), daily cigarette consumption (β=0.518) and willingness to quit smoking (β=-0.173) among smoking COPD patients (all P<0.05). Conclusion The nicotine dependence among smoking COPD patients was influenced by educational level, interpersonal relationships, smoking duration, daily cigarette consumption and willingness to quit smoking.
[1] 严永锋,杨娟,高玲玲,等.启东市40岁及以上居民慢性阻塞性肺疾病调查[J].预防医学,2023,35(12):1084-1088. [2] 雷凯春,岳红梅.吸烟对慢性阻塞性肺疾病患者肺功能的影响[J].中国药物滥用防治杂志,2021,27(3):294-297. [3] LI X L,WU Z,XUE M Y,et al.An observational study of the effects of smoking cessation earlier on the clinical characteristics and course of acute exacerbations of chronic obstructive pulmonary disease[J/OL].BMC Pulm Med,2022,22(1)[2024-06-28].https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-022-02187-5. [4] 薛慧颖,喻兆阳.铁杆吸烟者与戒烟行为研究进展[J].中华保健医学杂志,2019,21(2):187-189. [5] 卫玉齐,王瑞瑞,杨霞,等.脑卒中吸烟患者尼古丁依赖现状及影响因素分析[J].护理学报,2022,29(18):1-5. [6] 李燕,崔妙玲,农荧.男性吸烟者尼古丁依赖及影响因素分析[J].职业与健康,2021,37(5):624-627,634. [7] 赵洁雯,要鹏韬,刘黎香.北京市吸烟人群尼古丁依赖程度影响因素的横断面调查研究[J].中华疾病控制杂志,2018,22(4):358-362. [8] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205. [9] 中华人民共和国国家卫生和计划生育委员会.中国临床戒烟指南(2015年版)[J].中华健康管理学杂志,2016,10(2):88-95. [10] 陈海德,竺颖华,卞涵琨,等.吸烟者尼古丁依赖与戒烟意向的关系:身份认同和吸烟合理化信念的链式中介作用[J].中国临床心理学杂志,2023,31(3):672-676. [11] 陈果,李小惠,李蔚.应用改良版英国医学研究委员会呼吸问卷、自我评估测试问卷和临床问卷评估慢性阻塞性肺疾病患者健康状况的比较研究[J].实用医院临床杂志,2015,12(1):59-60. [12] HEATHERTON T F,KOZLOWSKI L T,FRECKER R C,et al.The Fagerström Test for Nicotine Dependence:a revision of the Fagerström Tolerance Questionnaire[J].Br J Addict,1991,86(9):1119-1127. [13] 潘珏,金文婷,王晓丹,等.中文版尼古丁依赖检测量表信度和效度的初步研究[J].国际呼吸杂志,2010,30(5):266-269. [14] 马含俏,刘涵,金倩莹,等.社区吸烟者心理特质及其对尼古丁依赖程度的影响研究[J].中国全科医学,2020,23(15):1889-1894,1903. [15] 张励. 烟草依赖的慢阻肺高危人群戒烟治疗研究[D].沈阳:中国医科大学,2021. [16] 李星明,崔小波.北京市吸烟人群中礼品烟接受情况及其相关社会因素分析[J].中国健康教育,2016,32(11):967-971. [17] HALPERN-MANNERS A,HERNANDEZ E M,WILBUR T G.Crossover effects of education on health within married couples[J].J Health Soc Behav,2022,63(2):301-318. [18] 张艳艳,赵莹颖,胡建功,等.北京市某区吸烟者戒烟意愿及行为研究[J].预防医学,2023,35(7):632-635. [19] 崔紫阳. 我国烟草依赖、酒精依赖流行情况及吸烟-饮酒的相关性研究[D].北京:北京协和医学院,2023. [20] 赵艳婷,彭柟,刘熹,等.成都市现在吸烟成年人高度烟草依赖状况调查[J].预防医学,2021,33(3):295-298. [21] 李自敏,黎倩伶,谢倩倩,等.香烟中的尼古丁对吸烟行为的影响[J].中国药物依赖性杂志,2020,29(3):176-180. [22] ZHANG Y Y,TANG W T,ZHANG H,et al.Barriers and facilitators for smoking cessation in Chinese smokers with chronic obstructive pulmonary disease:a qualitative study[J].Int J Chron Obstruct Pulmon Dis,2022,6(17):1107-1120. [23] GOODWIN R D,LAVOIE K L,LEMESHOW A R,et al.Depression,anxiety,and COPD:the unexamined role of nicotine dependence[J].Nicotine Tob Res,2012,14(2):176-183. [24] HASHIMOTO R,TOMIOKA H,WADA T,et al.Outcomes and predictive factors for successful smoking cessation therapy in COPD patients with nicotine dependence[J].Respir Investig,2020,58(5):387-394. [25] BARRECHEGUREN M,GONZÁLEZ C,MIRAVITLLES M.What have we learned from observational studies and clinical trials of mild to moderate COPD?[J/OL].Respir Res, 2018, 19 (1) [2024-06-28].https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-018-0882-0.
