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目的探索组织改变理论模型在中国工厂戒烟干预应用的可行性和效果。方法于2008～2009年对上海市两家工厂进行对照研究。对照组246人(男204,女42),平均年龄(34.7±13.2)岁,干预组233人(男203,女30),平均年龄(31.1±11.9)岁。将组织改变理论模型的4个阶段应用到干预组的戒烟干预中。分别在干预前和干预后,以问卷调查表的形式收集员工每日吸烟量、吸烟率、危害认知和戒烟意愿等方面的改变。在干预6个月后以戒烟者尿液中可的宁浓度的生物学检测判定是否成功戒烟。结果干预组的现在吸烟率由干预前的59.8%下降到干预后的39.1%(P<0.01),每日吸烟量由(15.0±8.6)支/天下降到(11.9±7.9)支/天(P<0.01)。对照组则无显著改变;干预组吸烟者中愿意接受同事戒烟帮助的比例由干预前的3.7%上升到干预后的15.6%(P<0.01),认为吸烟对健康有严重危害的比例也由干预前的36.5%上升到干预后的64.4%(P<0.05),对照组则均无显著改变(P>0.05);干预组吸烟者中打算在1个月内戒烟的比例由干预前的11.0%提高到干预后的41.5%(P<0.01),而对照组则无显著改变(8.5%vs9.5%);干预组和对照组6个月的戒烟成功率分别为24.6%和6.4%(P<0.01)。结论组织改变理论模型在中国工厂开展戒烟干预中的应用是可行的;该模型的应用对降低工人的吸烟率和每日吸烟量,提高吸烟者的戒烟意愿是显著的,6个月的戒烟成功率也显著提高。
Objective To explore the feasibility and effect of the theoretical model of organizational change in smoking cessation interventions in Chinese factories. Methods From 2008 to 2009, two factories in Shanghai were compared. The average age was (34.7 ± 13.2) years old in the control group. There were 246 males (204 males and 42 females) in the control group and 233 males (30 females and 30 females) in the intervention group with an average age of (31.1 ± 11.9) years. The four stages of the organizational change theory model were applied to quit smoking intervention in the intervention group. Respectively before and after the intervention, questionnaires were collected in the form of daily smoking among employees, smoking rates, hazard perceptions and willingness to quit and so on. After 6 months of intervention, the bioassay of cotinine in urine of quitting smokers was used to determine whether smoking cessation was successful. Results The current smoking rate in the intervention group decreased from 59.8% before intervention to 39.1% after intervention (P <0.01), and the daily smoking consumption decreased from 15.0 ± 8.6 to 11.9 ± 7.9 days / P <0.01). The proportion of smokers willing to take part in quitting smoking in intervention group rose from 3.7% before intervention to 15.6% after intervention (P <0.01), and the proportion of smoking serious harm to health was also affected by intervention (P <0.05). The proportion of smokers who intend to quit smoking in one month did not change significantly from 11.0% before intervention to 36.4% before intervention (P <0.05) (P <0.01), but no significant change in the control group (8.5% vs9.5%). The smoking cessation success rates of the intervention group and the control group were 24.6% and 6.4% at 6 months (P <0.01). Conclusion The application of this model to smoking cessation interventions in factories in China is feasible. The application of this model is significant in reducing smoker’s rate of smoking and daily smoking intake, and increasing smokers ’willingness to quit smoking. Six months’ smoking cessation success The rate is also significantly higher.