| Summary: | 碩士 === 長榮大學 === 護理學研究所 === 97 === The prevalence of male and female smoking in Taiwan in 2006 was 39.1% and 4.12% respectively. It is estimated over 4 million population smoking in Taiwan. A smoking cessation program in clinics has been implemented and funded by the Bureau of Health Promotion, Department of Health since September 1, 2002. The program focuses on dealing with nicotine withdrawal symptoms, in combination of brief counseling and nicotine replacement therapy in outpatient departments. A longitudinal study for smoking cessation program was already conducted in other countries. However, the present studies in Taiwan lack comparison groups and over one-year follow-up. Previous studies showed that the medical center had the highest cessation rate in Taiwan. Most smoking cessation services were implemented in the Family Medicine department. This study is a descriptive and longitudinal study with 3-year follow-up since September 1, 2002. The purposive sampling was used and the effective sample size is 772. The design of another study was two-group comparison with one year follow-up since January 1, 2008. The effective sample size in this pilot study is 80. The subjects were recruited from a medicine center in Family Medicine smoking cessation clinic. The aim of this study is to evaluate smoking cessation therapy in Family Medicine clinics in a three-year telephone follow-up and to determinate the relapse factors influencing cessation rates. In addition, the aim of another study is to compare the cessation rates of outpatient in Family Medicine clinics with other clinics outpatients. The main results of our study revealed that the point abstinence rates after quit day at one month, three months, six months, one year and three years were 99.7%, 49.2%, 37.7%, 30.3% and 22.7%, respectively. The important risk factors to predict relapse are the number of cigarettes per day and the number of attending outpatient services. Our pilot study showed that the smoking cessation rate in intervention group is 1.6 times(95％CI for OR=0.55-4.88) over control group during one year follow up. According to our result, we suggest to develop the effective strategies in the initial 3 months of outpatient treatment to prevent smoking relapse. The clinics can provide effective follow-up strategies in therapeutic period, remind the patients for next visit and implement appropriate counseling to enhance the rates of long term cessation in outpatient services. The results of two-group design showed no significant difference. However, this is the first paper in Taiwan to evaluate the effect of warning system in outpatient service for smoking cessation. It still is in the stage of pilot study. Future research needs to increase the sample sizes and longer follow up to evaluate the effect of the system on smoking behavior. Finally, there are several smoking cessation clinic studies with more than five-year follow up in other countries. Longer follow-up studies are suggested to evaluate the effectiveness of smoking cessation to improve the services of smoking cessation.
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