Kömür Madeni İşçilerinde Bireysel ve Grup Sigara Bırakma Müdahalelerinin Sigara Bırakma Üzerindeki Etkisinin Karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı, kömür madeni işçilerinde bireysel sigara bırakma BSBM ve grup sigara bırakma GSBM müdahalesinin sigara bırakma üzerindeki etkisini karşılaştırmaktır.Gereç ve Yöntemler: Çalışma iki aşamadan oluşmuştur. Çalışmaya katılmayı kabul eden 1045 kömür madeni işçisinin 877'si çalışmanın ilk aşamasında örneklemi oluşturmuştur. Randomize kontrollü çalışma olarak planlanan 2. aşamada ise, 877 kömür madeni işçisinin 126'sı ikinci aşamaya alındı. Sigarayı bırakmaya hazır olan işçiler, her biri BSBM ve GSBM gibi basit rastgele yöntemlerle 63’er kişilik iki gruba randomize edildi. Bulgular: İlk aşamada; 877 kömür madeni işçisinin %59,6ʼsının sigara içtiği tespit edilmiştir. İkinci aşamada; Sigara bırakmaya hazırlanan, eğitim ve danışmanlık almayı kabul eden 126 işçiden BSBM grubunda ki 63 işçi ve GSBM grubunda ki 63 işçilerin sigara bırakma düzeyleri arasında fark bulunmamıştır p>0,05 . Buna karşın hem BSBM, hem de GSBM grubundaki işçilerden Vareniklin veya Bupropion kullananlar işçiler ilaç kullanmayan işçilere göre anlamlı düzeyde daha yüksek oranda sigarayı bırakmışlardır p

Anahtar Kelimeler

• Maden işçileri, Sigarayı bırakma, Bireysel sigara bırakma müdahalesi, Grup sigara bırakma müdahalesi

Comparison of the Effect of Individual and Group Smoking Cessation Interventions on Smoking Cessation among Coal Miners

Öz

Objective: The aim of this study was to compare the effect of individual smoking cessation ISCI and group smoking cessation GSCI intervention on smoking cessation in coal miners.Material and Methods: The work consisted of two phases. Of the 1045 coal miners who agreed to participate in the study, 877 were included in the first phase of the study while 126 of these 877 were then recruited to the second stage of the study planned as a randomized controlled trial. Workers who were ready to quit smoking were randomized into two groups of 63 subjects each as ISCI and GSCI with simple randomization methods. Results: In the first phase, 59.6% of the 877 coal miners were found to smoke. In the second stage, there was no difference between the smoking cessation levels of 63 workers in the ISCI group and 63 workers in the GSCI group among the 126 workers who were prepared to quit smoking and who agreed to receive training and counseling p>0.05 . In contrast, both ISCI and GSCI group workers who used Varenicline or Bupropion quit smoking at a significantly higher rate than workers who did

Anahtar Kelimeler

• Coal miners, smoking cessation, Individual Smoking Cessation Intervention (ISCI), Group Smoking Cessation Intervention (GSCI)

Kaynakça

1. WHO global report on trends in tobacco smoking https:// www.who.int/tobacco/publications/surveillance/ reportontrendstobaccosmoking/en/ (Erişim Tarihi: 10.11.2019)
2. Centers for Disease Control and Prevention https:// www.cdc.gov/tobacco/data_statistics/fact_sheets/index. htm?s_cid=osh-stu-home-spotlight-001 (Erişim Tarihi: 06.11.2019).
3. Türkiye İstatistik Kurumu (TÜİK), 2016. www.tuik.gov. tr, (Erişim Tarihi: 16.12.2019)
4. Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years’ observations on male British doctors. BMJ 1994; 309:901-11.
5. Gruman J, Lynn W. Worksite and community intervention for tobacco control. In: Orleans CT, Slade J eds. Nicotine addiction: Principles and management. NewYork: Oxford University Pres,1993:396-411.
6. Chapman S, Borland R, Scollo M, Brownson RC, Dominello A, Woodward S. The impact of smoke- free workplaces on declining cigarette consumption in Australia and the United States. Am J Public Health 1999; 89(7):1018-23.
7. Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: Systematic review. BMJ 2002; 325(7357):188.
8. Chhabra A, Hussain S, Rashid S. Recent trends of tobacco use in India. Journal of Public Health 2019; 54;1- 10.

9. McEwen A, West R, McRobbie H. Effectiveness of specialist group treatment for smoking cessation vs. one- to-one treatment in primary care. Addict Behav 2006; 31:1650-60.
10. Swaina SK, Chatterjeeb K, Basannar DR. Efficacy of group intervention on tobacco cessation among male employees in health-care setting: A randomized controlled trial. Medical Journal Armed Forces India 2019; (Erişim Tarihi: 16.10.2019).
11. Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev 2005; 18:1-78.
12. Know N. Stars AN. (Ed). Working life and smoking. Tobacco Combat Information Series. Buzgan T, Çelik İ, Cutter C, Karakaya C, Erdoğan A. Ankara: Ministry of Health Publication, 2008:47-54.
13. Yeşildal E, Oğuz G, Güven M, Sungur, MZ, Üstünuçar İ. Cognitive behavioral group therapy in the treatment of smoking addiction. Journal of Dependence 2014; 15:76- 84.
14. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. American Journal of Health Promotion 1997; 2:38-48.
15. Erol S, Erdogan S. Application of a stage based motivational interviewing approach to adolescent smoking cessation: The transtheoretical model-based study. Patient Educ Couns 2008; 72:42-8.
16. Fagerstrom KO. Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addictive Behaviors 1978; 3:235-41.
17. Uysal MA, Kadakal F, Karşıdağ Ç, Bayram NG, Uysal Ö, Yılmaz V. Fagerstrom test for nicotine dependence: Reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004; 52:115-21.
18. Tütün bagimliligi ile mucadele el-kitabi. https:// docplayer.biz.tr/104253-Tutun-bagimliligi-ile-mucadele- el-kitabi.html (Erişim Tarihi: 16.12.2019)
19. Sigara Birakma Tani ve Uzlasi Raporu. https://www. toraks.org.tr/ebook.aspx (Erişim Tarihi: 16.12.2019)
20. Unalacak M, Altin R, Kart L, Tor M, Ornek T, Altunel, H. Smoking prevalence. Behavior and nicotine addiction among coal workers in Zonguldak, Turkey. J Occup Health 2004; 46:289-95.
21. Demirel Y, Güler N, Sezer H. et al. Smoking status of workers in Sivas cement factory. Journal of CU Faculty of Medicine 2001; 23:37-42.
22. Durusoy R, Davas A. A one-year outcome of a smoking cessation program at a workplace in a disadvantaged group. Ege Journal of Medicine 2012; 51:143-50.
23. Yılmazel G, Çetinkaya F, Naçar M. Smoking habits of factory workers and their thoughts about cessation of smoking. Dicle Medical Journal 2014; 41:717-23.
24. Schmitz JM, Sayre SL, Stotts AL, Rothfleisch J, Mooney ME. Medication compliance during a smoking cessation clinical trial: A brief intervention using MEMS feedback. Journal of Behavioral Medicine 2005; 28(2):139-47.
25. Orsel O, Orsel S, Alpar S, Ucar N, Güven SF, Sipit T, Kurt B. The effect of nicotine dependence stages on smoking cessation treatment results. Respiratory Diseases Journal 2005; 16:112-8.
26. Yaşar Z, Kar Kurt O, Talay F, Kargı A. One-year follow up results of smoking cessation outpatient clinic: Factors affecting the cessation of smoking. Eurasian J Pulmonol 2014; 16:99-104.
27. Jackson SE, McGowan JA, Ubhi HK et al. Modelling continuous abstinence rates over time from clinical trials of pharmacological interventions for smoking cessation. Addiction 2019; 114(5):787-97.
28. Hollis JF, Lichtenstein E, Vogt TM, Stevens VJ, Biglan A. Nurse-assisted counseling for smokers in primary care. Ann Intern Med 1993; 118:521-5.
29. Cahil K, Lancaster T. Workplace interventions for smoking cessation. Cochrane Database Syst Rev 2014; 26:127-8.