不同戒菸服務模式之成效及戒菸成功相關因子之研究：以某無菸醫院為例

Effectiveness of Different Service Models and the Factors Correlated with Cessation Success: Taking a Tobacco-Free Hospital as an Example

目標：探討醫院提供的各種戒菸服務參與民眾的特性，並了解不同戒菸服務模式的成效及戒菸成功的因子，可讓醫療及公衛人員建立更有效率的諮詢與政策。
方法：本研究對象為某無菸醫院2017年所有戒菸民眾，依戒菸服務模式分為四類：門診戒菸治療（門診戒菸組）、門診戒菸加上戒菸衛教（戒菸衛教組）、醫院戒菸週的戒菸活動（戒菸活動組）、職場的行動戒菸門診（職場戒菸組），由衛生福利部國民健康署戒菸治療管理中心網站查詢戒菸結果，比較各種戒菸服務模式的成功率與效率及民眾特性，並探討戒菸成功相關因子。
結果：醫院舉辦的戒菸活動合併治療與衛教可以吸引年紀較大、成癮度較低的民眾嘗試戒菸，不但戒菸成功率與門診戒菸成功率無顯著差異，且可有效率地服務更多民眾。此外，每日吸菸支數較少、成癮分數較低、一氧化碳呼氣值較低、使用戒必適藥物、門診次數超過1次為6個月點戒菸成功相關因子。
結論：醫院若能將戒菸服務深入社區與職場，可以成功協助更多民眾戒菸。醫師可參考「醫療院所戒菸服務補助計畫」個案管理紀錄表中吸菸者的特性，使用適合藥物並鼓勵回診以增加戒菸成功率。

Background: Discussing on the characteristics of participating smokers in various cessation services provided by the hospital and understanding the effectiveness of different service models as well as the factors correlated with cessation success, can enable medical and public health personnel to establish more efficient consultations and policies.
Method: This study collected and categorized all smokers seeking to quit smoking in a medical center in the year 2017. According to the cessation service models, they were divided into four groups: (1) outpatient cessation treatment (outpatient cessation group), (2) outpatient cessation plus smoking cessation education (outpatient + education group), (3) hospital-sponsored smoking cessation activities (cessation activity group), (4) mobile workplace cessation treatment (workplace cessation group). We checked the smoking cessation results from the website of Liaison Office of Management of Smoking Cessation, Health Promotion Administration, Ministry of Health and Welfare, compared the success rates and service efficiency of various service models, and explored the characteristics of the smokers and factors correlated to cessation success.
Results: The smoking cessation activity carried out by the hospital combined with cessation treatment and health education could attract the people who are older and/or less addicted. The cessation activity group serves smokers more efficiently and their success rate was not significantly different from that of outpatient cessation group. The study also found that fewer daily cigarette consumption, lower addition score, lower carbon monoxide expiratory concentration, taking smoking cessation drug champix and more than one outpatient visits were correlated with higher six-month success rate of smoking cessation.
Conclusion: When the hospital provides smoking cessation services to the community and workplace, it helps more people take the first step to quit smoking. Physicians can take personal factors as a reference in the case management and drug choosing with as well as encourage follow-up visits, which will increase the success rate of smoking cessation.