Bahar KURT, Osman ÖRSEL, Sibel ALPAR, Nazire UÇAR, Sibel ÖRSEL, Tuğrul ŞİPİT

Sigarayı bırakmada nikotin replasman tedavisi ve davranış eğitimi yöntemlerinin karşılaştırılması: Doğal izlem çalışması

Bu çalışmada, sigara bırakma polikliniğimize başvuran hastaların özellikleri ve uygulanan tedavilerin [nikotin replasman tedavisi (NRT)/davranış eğitimi-motivasyonel destek (DE)] birinci yıl izlem sonuçlarının karşılaştırılması amaçlanmıştır. Ekim 1999-Nisan 2002 tarihleri arasında başvuranlara (n= 610), rutin ve spirometrik değerlendirmeleri yapılarak Fagerstrom Testi uygulanmış, sigarayı bırakma yöntemleri konusunda bilgilendirilmiş ve anket uygulanmıştır. İkinci görüşme sonunda tedaviye alınan olguların (n= 561) bir yıllık izlem sonuçları ve demografik verileri gruplar arası ki-kare,Student’s t-testi ve tek yönlü ANOVA, tukey post-hoc testleriyle değerlendirilmiştir. Üçyüzyetmişbeş (%66.8) kişiye NRT veDE, 186 (%33.2) kişiye ise yalnızca DE verilmiştir (Fagerstrom skoru < 6, NRT istemeyenler, tıbbi kontrendikasyon, ekonomik nedenler). İki grup arasında Fagerstrom bağımlılık puanı dışında yaş, cinsiyet, başlama yaşı, paket yılıaçısından istatistiksel olarak anlamlı farklılık saptanmamıştır. NRT uygulananlarda bırakma oranı birinci yıl sonunda%31.5 iken, uygulanmayanlarda %24.2, tüm grupta ise %29.1’dir (x2= 3.19, p> 0.05). Bırakma oranları açısından demografik özellikler, sigara içme öyküsü ve nikotin bağımlılığı açısından anlamlı fark olmadığı görüldü. Yan etkilerden cilt reaksiyonları (%7) birinci sıradaydı. Önümüzdeki yıllarda sigara içmenin medikal ve ekonomik boyutları giderek artacaktır. Sigarayı bırakma başarısında NRT kadar davranış eğitimi ve yoğun motivasyonel destek de etkilidir.

The comparison of nicotine replacement therapy and behavioral education in smoking cessation: A study of naturalistic follow-up

In this study, we aimed to compare quitting smoking rates after behavioral education (BE) and/or nicotine replacement therapy (NRT). 610 patients applied between October 1999-April 2002 have been acknowledged and evaluated by a questionnaire including demographic variables, smoking history, smoking habits and attitudes, motivation; biochemical assayand spirometric measures were examined. One-year follow-up results and demographic variables of patients who recruitedto treatment (n= 435) were analyzed by chi-square, Student-t test, one-way ANOVA and post-hoc tests. 375 (%66.8) case were given NRT and BE; only BE (Fagerstrom < 6, not want to use of NRT, medical and economic reasons) was recommendedto 186 (%33.2) case. There was not difference between NRT and BE groups with regards to age, sex, packet year,smoking beginning age except Fagerstrom score. Smoking cessation rates for 1-year were %31.5 in NRT group, %24.2 in BEgroup, and %29.1 in whole group (x2= 3.19, p> 0.05). Quitting rates were similar between age, sex, education, occupation,and complaint groups. Two groups were not statistically different with regards of smoking history and nicotine dependence. The most frequent side effect was skin reactions (%7). The economical and medical burden of smoking increase astime goes on. According to our results, NRT and behavioral education are both efficient in smoking cessation.

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