RESUMO
BACKGROUND: Medical counsel to smokers is an intervention that has proved useful to motivate smokers to stop smoking. This study pretends evaluate the long-term impact (2 years and 9 months) of systematic and structured health counsel on the smoke habit from the primary health care. MATERIAL AND METHODS: In April 1990, in four primary care centers from Barcelona and Zaragoza, Spain, a program of systematic counselling to stop smoking with an offer of subsequent follow-up was initiated in all adult smokers (15-65 years of age). According to the answer, every patient was classified on one of seven established categories that allowed a individualized follow-up. Data from the total population included in the program from the beginning till January 1993, are analyzed. RESULTS: From 683 known smokers (59.2% males and 40.8% women), 20 were excluded for different reasons and 343 were included in the program (56.4% cover). Average age of included smokers was 35.1 years (SE = 0.6) and average number of visits of 5.3 (SE = 0.2) which was significantly higher than those not included in the program (33.4; SE = 0.6, and 2.7; SE = 0.1). An average follow-up of 14.3 months (SE = 0.5) and of 2.6 (SE = 0.1) interventions on each individual were done. The average daily number of cigarettes was 18.4 (SE = 0.6) in the initial period and 13.3 (SE = 0.6) on the last program evaluation. The final answers showed a 18.1% of quitters and a decrease of more than 50% on the initial consume on 32.6%. In 12% the answer was negative. CONCLUSIONS: Programs of systematic help for smokers show a higher level of favourable responses than does normal counselling.
Assuntos
Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Adolescente , Adulto , Aconselhamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , EspanhaRESUMO
OBJECTIVE: To evaluate the impact over a year of a systematic, structured intervention with smokers, called the Smokers' Aid Project (SAP), at a primary care centre in Barcelona. DESIGN: Observational study with a descriptive intervention. SETTING: Urban primary care centre. PATIENTS AND OTHERS PARTICIPANTS: Between April, 1990, and March, 1991, every adult (over 15) who smoked more than one cigarette a day was counselled verbally and/or in writing. The different replies were placed into eight groups and a personal follow-up was made for each category. The groups were: winner, reduction, alone, with help, doubtful, backslider, negative and pending. MEASUREMENTS AND MAIN RESULTS: There was a follow-up on 178 people. Among those monitored, the initial cigarette average was 15.0 (SD 11.4) and the final, 12.45 (SD 11.45). The response was favorable (winner or reduction) in 35.4%, with 10.6% showing a favorable attitude (alone and with help) and 16.3% showing a negative response. A follow-up programme of 7.5 months (SD 3.5) was implemented, with an average of 1.82 (SD 1.05) interventions for each individual. CONCLUSIONS: Programmes of systematic help to the smoker appear to provide more favorable responses than isolated counselling. The SAP can be put into practice within our Primary Care system, although effectiveness will have to be assessed over longer-term follow-ups.
