| BackgroundChronic bronchitis is a highly destructive respiratory disease,the most common in the middle-aged and elderly population,with cough,asthma,phlegm and other symptoms as the main clinical manifestations,with recurrent,slow progression and other characteristics,at the same time often complicated by chronic obstructive pulmonary disease,light can affect the quality of life of patients,severe cases can lead to systemic disease,and even induced pulmonary heart disease,the patient's life and health status poses a serious threat.A large number of studies have confirmed that smoking and age are the main influencing factors of chronic bronchitis.In order to treat the disease effectively,the mechanism of the pathogenesis and the factors that can be induced should be investigated to guide the health care workers carrying out effective treatment and defensive measures,thereby preventing and controlling the spread of chronic bronchitis and chronic obstructive pulmonary disease and improving the quality of life of the patients with chronic bronchitis.Objective1.Through a comparative study,to find a relationship between smoking,age and chronic bronchitis patients andto have a more in-depth understanding of the distribution of smoking among patients in smokers and smoking age structure level.2.Through data analysis,to know the characteristics of smoking behavior in patients with chronic bronchitis after discharge from the hospital;To discuss the change of smoking behavior before and after hospitalization;To explore possible causes of smoking again and the obstacles of smoking cessation;To Evaluate possible sensitive periods of smoking again;To explore the influencing factors of smoking cessation behavior after discharge.3.To provide a theoretical basis for medical workers to be more effective in smoking cessation intervention in chronic bronchitis.Methods1.A total of 160 patients with chronic bronchitis admitted to Jiangyin Traditional Medicine Orthopedic Hospital from August 2015 to August 2016 were collected as randomized questionnaires.The investigation was divided into smoking group and non-smoking group,with 80 cases in each group.The information of daily smoking,smoking duration,general basic information before hospitalization were collected.The t-test,chi-square test and analysis of variance were used to analyze the daily smoking distribution and the factors affecting the daily cigarette smoking in patients with chronic bronchitis.2.Using a prospective investigation,from September 2016 to April 2017,a survey of smokers hospitalized for chronic bronchitis at Jiangyin Traditional Medicine Orthopedic Hospital was conducted.A total of 183 smokers with chronic bronchitis were enrolled and were assessed for epidemiological data,general clinical data,characteristics of pre-hospital smoking behaviors,nicotine dependence,and severity of illness during the first week of hospitalization.At 3 months and 6 months after discharge,the patients were followed up by telephone to assess their smoking after discharge,the surrounding smoking environment,the time and reason of smoking again and so on.Results1.In the group of chronic bronchitis smokers,the 45-59 age group had the highest rates of smoking and the highest rates of severe smoking.With age,the number of smokers gradually decreased,and the proportion of smokers also gradually decreased.2.Comparison of influencing factors of different smoking amount: smoking among different ages,cultures and occupations showed statistically significant differences(P <0.05),smoking in urban areas was not lower than that in rural areas.3.Of 183 patients with chronic bronchitis smokers,175 completed follow-up at 3 months after discharge.80(46.1%)patients chose to quit smoking,81(45.4%)patients reduced their daily cigarette consumption,and 14 patients did not change their smoking behavior.At 6 months after discharge,158 patients completed follow-up,62(37.1%)patients chose to quit smoking,82(53.6%)patients reduced daily smoking and 14 patients remained unchanged.There were no significant differences in smoking cessation rates at 3 months and 6 months after discharge(P> 0.05).There was no significant difference in daily smoking distribution among non-smoking groups(P> 0.05).4.Univariate statistical analysis of influential factors of smoking cessation 6 months after discharge: education,marital status,residence,per capita income,and medical insurance were all statistically insignificant(P> 0.1),age,occupation,daily smoking amount,FTND,family smoking,family smoking restrictions and the severity of pulmonary function were statistically significant(P <0.1).5.Multivariate Logistic regression analysis of influential factors of smoking cessation 6 months after discharge:logistic regression analysis showed that age(OR = 0.012,95% CI = 0.001-0.101),FTND score(OR = 0.007,95% CI = 0.001-0.077),occupation.238,95% CI = 0.139-0.770).Family restriction of smoking(OR = 86.434,95% CI = 9.400-794.787)and the four factors in the final equation had statistically significant effects on smoking cessation after discharge(P <0.05).ConclusionsThe 45-59 age group had the highest percentage of smokers among all age groups and the highest percentage of smokers.With age,the amount of smoking is gradually reduced.Chronic bronchitis in the 71-80 age group had a lower smoking than other age groups.However,due to long smoking years,high smoking expectation and high severity of lung function,this age group should be the focus of smoking cessation intervention.Chronic bronchitis smokers with the following characteristics are more likely to quit smoking more successfully after discharge,nicotine dependence(FTND score)lower in hospitalization,non-physical work,high lung function,family nonsmokers,and family intervention.When medical staffs quit smoking,they should focus on the assessment of patients' relevant factors,strengthen the continuous intervention of patients who have the risk factors of smoking after discharge,and give them targeted smoking cessation support. |
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