สถานการณ์การใช้บุหรี่และการรับรู้ของผู้ป่วยโรคไม่ติดต่อเรื้อรังถึง ความเสี่ยงต่อการเกิดภาวะฉุกเฉินจากการสัมผัสควันบุหรี่ในชุมชน Tobacco use situation and community awareness of acute illness associated with smoking among people chronic illnesses

บทคัดย่อ

This study reports results of a situational analysis of a participatory action research conducted to identify
tobacco smoke contact among people with diabetes and hypertension and assess the awareness of the patients,
caregivers and community leaders related to risk of developing acute complications from contact with smoking in
11 villages under Ban Phue health promoting hospital service in Tambon Pralab, Muang District, Khon Kaen
Province. Participants were purposively selected to include 5 groups; 1) 200 people with hypertension and Type
II diabetes, 2) 90 caregivers, 3) 50 village health volunteers, 4) 50 community leaders, and 5) 5 health personnel.
Data collection was completed with 10 focus group discussions of people with chronic illnesses, in-depth interviews
of 10 patients, participatory and non-participatory observations, and 10 village meetings. Data analyses used both
descriptive statistics and content analysis.
Results of smoking screening among 9574 villagers age 15 years and older revealed that 810 people (12.98%)
smoked and 488 (60.25%) of these individuals received smoking cessation therapy. However, only 3 of them
(0.37%) successfully quit smoking. Thirty five (17.5%) chronically ill patients smoked and every patients in the
community reported contact with tobacco smoke through 4 channels; family members smoked, neighbors smoked
in front of their houses or while walking pass by, friends and relative smoke while visiting at home and contact
with smoke at convenient stores in the village. Experience in prevention of contact with tobacco smoke among
people with chronic illnesses included 1) 20 patients (10%) quitted smoking, 2) 30 family members of the patient
(15%) quitted smoking, 3) patients’ avoidance of tobacco smoke and request for family members to reduce and
quit smoking, and 4) community displayed smoking prohibition in public areas such as village halls, temples, and
the health promoting hospital. Community awareness of acute illness associated with smoking among people
chronic illnesses included 1) participant’s awareness that smoking led to lung cancer and emphysema and
tobacco smoke was dangerous to non-smokers, 2) all participants were unaware of tobacco smoke’s danger on
diabetes and hypertension control, and 3) all participants had witnessed people with diabetes and hypertension
developing acute complications such as cerebrovascular or cardiovascular diseases and eventually led to
disabilities and death. However, none of the participants were aware of the link between these acute complications
and smoking. Subsequently, the community expressed desires to collaborate to prevent dangers associated with
tobacco smoke among people with chronic illnesses to reduce disabilities, death and cost of care in the future.