慢性歯周炎を持つ喫煙者における禁煙の予測因子：24ヶ月間の研究

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study.

• Gislene Inoue
• Ecinele Francisca Rosa
• Elaine Fueta Gomes
• Mariana Rocha Guglielmetti
• Priscila Corraini
• Ricardo Koji Takano
• Viviane Lé Ferreira
• Giuseppe Alexandre Romito
• João Paulo Becker Lotufo
• Edinalva Tanajura Cruz Souza
• Cláudio Mendes Pannuti

抄録

この 24 ヵ月間の研究の目的は、集学的禁煙プログラムに参加している慢性歯周炎の喫煙者のコホートにおける禁煙の予測因子を同定することであった。対象者286名のうち116名が対象となり、個々のニーズに応じて非外科的歯周治療と講義、認知行動療法、薬物療法からなる禁煙治療を受けた。初期歯周治療時には、動機づけ面接法を用いて積極的に禁煙の動機づけを行った。また，フォローアップ3，6，12，24ヶ月後の歯周メンテナンス時には，歯科医師による禁煙カウンセリングとサポートが行われた．喫煙状況は構造化された質問票によって評価され、呼気中の一酸化炭素（CO）測定によって妥当性が確認された。喫煙依存度の評価には、Fagerström Test for Cigarette Dependenceを用いた。24ヵ月後の検査まで残った61人のうち、3ヵ月後に31人、12ヵ月後に21人、24ヵ月後に18人がそれぞれ禁煙を宣言した。24ヵ月後の禁煙は、男性の性別（OR = 3.77、95％CI = 1.16-12.30）、ベースラインのCO濃度が10ppm未満（OR = 5.81、95％CI 1.76-19.23）、他の喫煙者と同居または勤務していない（OR = 7.38、95％CI 1.76-30.98）、平均ファガーストロームテストスコアが低い（OR = 5.63、95％CI 1.55-20.43）ことと関連していた。禁煙は人口統計学的、喫煙歴、タバコ依存症の変数と関連していると結論づけた。

The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.