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Bitar S, Collonnaz M, O'Loughlin J, Kestens Y, Ricci L, Martini H, Agrinier N, Minary L. A Systematic Review of Qualitative Studies on Factors Associated With Smoking Cessation Among Adolescents and Young Adults. Nicotine Tob Res 2024; 26:2-11. [PMID: 37648287 DOI: 10.1093/ntr/ntad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To summarize findings from qualitative studies on factors associated with smoking cessation among adolescents and young adults. DATA SOURCES We searched Pubmed, Psychinfo, CINAHL, Embase, Web of Science, and SCOPUS databases, as well as reference lists, for peer-reviewed articles published in English or French between January 1, 2000, and November 18, 2020. We used keywords such as adolescents, determinants, cessation, smoking, and qualitative methods. STUDY SELECTION Of 1724 records identified, we included 39 articles that used qualitative or mixed methods, targeted adolescents and young adults aged 10-24, and aimed to identify factors associated with smoking cessation or smoking reduction. DATA EXTRACTION Two authors independently extracted the data using a standardized form. We assessed study quality using the National Institute for Health and Care Excellence checklist for qualitative studies. DATA SYNTHESIS We used an aggregative meta-synthesis approach and identified 39 conceptually distinct factors associated with smoking cessation. We grouped them into two categories: (1) environmental factors [tobacco control policies, pro-smoking norms, smoking cessation services and interventions, influence of friends and family], and (2) individual attributes (psychological characteristics, attitudes, pre-quitting smoking behavior, nicotine dependence symptoms, and other substances use). We developed a synthetic framework that captured the factors identified, the links that connect them, and their associations with smoking cessation. CONCLUSIONS This qualitative synthesis offers new insights on factors related to smoking cessation services, interventions, and attitudes about cessation (embarrassment when using cessation services) not reported in quantitative reviews, supplementing limited evidence for developing cessation programs for young persons who smoke. IMPLICATIONS Using an aggregative meta-synthesis approach, this study identified 39 conceptually distinct factors grouped into two categories: Environmental factors and individual attributes. These findings highlight the importance of considering both environmental and individual factors when developing smoking cessation programs for young persons who smoke. The study also sheds light on self-conscious emotions towards cessation, such as embarrassment when using cessation services, which are often overlooked in quantitative reviews. Overall, this study has important implications for developing effective smoking cessation interventions and policies that address the complex factors influencing smoking behavior among young persons.
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Affiliation(s)
- Sarah Bitar
- Université de Lorraine, APEMAC, Nancy, France
| | | | - Jennifer O'Loughlin
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada
| | - Yan Kestens
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada
- Centre de recherche du CHUM (CRCHUM), Université de Montréal, Montreal, QC, Canada
| | - Laetitia Ricci
- Université de Lorraine, APEMAC, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Hervé Martini
- Service de Médecine L/ Addictologie CHRU de Nancy, Hôpitaux de Brabois - Bâtiment Philippe Canton, Rue du Morvan, Vandœuvre-lès-Nancy, France
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
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Yan K, Feng Y, Liu Z, Shi W, Jiang Y, Liu J. Impulsivity Drives Adolescents to Smoke and Drink: Gender Differences in the Mediating Effects of Resilience and Depression. Psychol Rep 2023:332941231216894. [PMID: 37982432 DOI: 10.1177/00332941231216894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
High and rising rates of smoking and drinking among Chinese adolescents are contributing to increasingly serious physical and mental health issues. While impulsivity has been demonstrated to be significantly related to adolescent cigarette and alcohol use, little is known about the mechanisms behind this association. The current study focused on resilience and depressive symptoms as potential mediators of this link, exploring the indirect pathways connecting impulsivity to teenage tobacco and alcohol use. Possible gender differences in this indirect pathway were also explored. Participants were secondary school students from southern China (N = 3466; 49.2% were female; Mage = 14.18; SDage = 1.57). Results revealed that adolescents who were more impulsive used cigarettes and alcohol more frequently, and that this effect was partially mediated by lower resilience and more depressive symptoms. It is noteworthy that there were gender differences in this mediating effect, with the effect of impulsivity on cigarette use for girls being mediated by resilience and depressive symptoms, whereas this statistically significant association was not identified for boys. These findings show how adolescents' impulsivity drives them to smoke and drink, and also emphasize gender as a crucial consideration for intervening with adolescents' drinking and smoking behaviors.
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Affiliation(s)
- Kai Yan
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yonghui Feng
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Ziyao Liu
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Wei Shi
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yubin Jiang
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Juan Liu
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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DeLay D, Shen M, Cook RE, Zhao S, Logis H, French DC. Peers influence the tobacco and alcohol use of Chinese adolescents. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:591-602. [PMID: 36625141 DOI: 10.1111/jora.12828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 05/25/2023]
Abstract
This two-wave longitudinal study examined peer selection and influence pertaining to tobacco and alcohol use by adolescents and their friends in a sample of 854 Chinese adolescents (384 girls: mean age = 13.33 years). Participants nominated friends and self-reported their tobacco and alcohol use at seventh and again at eighth grade. Longitudinal social network analyses revealed evidence of friend influence but not selection over smoking and drinking. Boys increased their levels of smoking at rates greater than that of girls, but no sex moderation of either selection or influence was found. In interpreting these results, it is important to understand the gender norms for Chinese boys and girls and the cultural context of tobacco and alcohol use.
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Affiliation(s)
- Dawn DeLay
- Arizona State University, Tempe, Arizona, USA
| | | | - Rachel E Cook
- California State University, San Bernardino, California, USA
| | | | - Handrea Logis
- National Institute for Excellence in Teaching, Scottsdale, Arizona, USA
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Soutschek A, Bulley A, Wittekind CE. Metacognitive deficits are associated with lower sensitivity to preference reversals in nicotine dependence. Sci Rep 2022; 12:19787. [PMID: 36396945 PMCID: PMC9671892 DOI: 10.1038/s41598-022-24332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Deficits in impulse control belong to the core profile of nicotine dependence. Smokers might thus benefit from voluntarily self-restricting their access to the immediate temptation of nicotine products (precommitment) in order to avoid impulse control failures. However, little is known about how smokers' willingness to engage in voluntary self-restrictions is determined by metacognitive insight into their general preferences for immediate over delayed rewards. Here, with a series of monetary intertemporal choice tasks, we provide empirical evidence for reduced metacognitive accuracy in smokers relative to non-smokers and show that smokers overestimate the subjective value of delayed rewards relative to their revealed preferences. In line with the metacognitive deficits, smokers were also less sensitive to the risk of preference reversals when deciding whether or not to restrict their access to short-term financial rewards. Taken together, the current findings suggest that deficits not only in impulse control but also in metacognition may hamper smokers' resistance to immediate rewards and capacity to pursue long-term goals.
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Affiliation(s)
- Alexander Soutschek
- grid.5252.00000 0004 1936 973XChair of Experimental and General Psychology, Department of Psychology, Ludwig Maximilian University Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Adam Bulley
- grid.1013.30000 0004 1936 834XThe University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, Australia ,grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, USA
| | - Charlotte E. Wittekind
- grid.5252.00000 0004 1936 973XChair of Clinical Psychology, Department of Psychology, Ludwig Maximilian University Munich, Munich, Germany
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Hohn RE, Shum J, Poureslami I. A risk perception model to promote smoking cessation among adult current smokers: Application of a community-based smoking cessation intervention. Tob Prev Cessat 2022; 8:36. [PMID: 36313191 PMCID: PMC9558149 DOI: 10.18332/tpc/152888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/10/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aims to assess the changes in cigarette consumption CO levels, and importance and self-confidence levels of quitting smoking in adult smokers after participation in a 6-month community-based smoking cessation program. METHODS Participants were enrolled in the intervention (counseling group) or noncounseling group after completing a baseline assessment and receiving educational materials. A final assessment was completed at 6 months and at 8 months. Mixed factorial analyses of variance (ANOVAs) with 2 (condition: counseling vs non-counseling) × 2 (spoken language: Chinese vs English) × 2 (time: initial measurement vs last measurement) designs, were conducted for each of the four outcome measures. RESULTS Seventy smokers (50 males, 20 females; mean age 34 years, SD=9.68) from the Mandarin- and Cantonese-speaking (n=30) and English-speaking (n=40) communities in Vancouver, Canada were enrolled. Cigarette consumption: Both Chinese- and English-speaking participants significantly decreased their cigarette consumption at near equal rates and English-speaking participants smoked significantly more cigarettes than the Chinese-speaking participants did across both the initial and last measurement time points. No significant interactions or main effects related to the study condition variable were observed. CO levels: Average levels of CO also decreased near equally for the English- and Chinese-speaking groups. No significant interactions or main effects related to the study condition variable were observed. Importance ratings: Chinese-speakers in the non-counseling group showed no increase in importance ratings, whereas Chinese-speakers in the counseling group saw an average increase of 0.73 (SD=1.10). For the English-speaking group, importance ratings remained stable over time with no significant changes. Self-confidence ratings: A larger average rating increase for the counseling group compared to the non-counseling group was observed for the study condition and time variables. On average, confidence ratings increased significantly for the whole sample. CONCLUSIONS Our study showed that participation in a community-based smoking cessation intervention study, regardless of study group, resulted in significant decreases over time in self-reported cigarettes smoked per day and measured CO levels; as well as a significant effect on importance ratings depending on the language group, and a significant increase in confidence ratings overall.
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Affiliation(s)
- Richard E. Hohn
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Jessica Shum
- Faculty of Medicine, Respiratory Medicine Division, University of British Columbia, Vancouver, Canada
| | - Iraj Poureslami
- Faculty of Medicine, Respiratory Medicine Division, University of British Columbia, Vancouver, Canada
- Canadian Multicultural Health Promotion Society, Vancouver, Canada
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Ibrahim MS, Sabitu K, Olorukooba AA, Muhammad NS, Abubakar AA, Asuke S. Pattern and Predictors of Tobacco Use Among Undergraduates in Three Tertiary Institutions in North-Western Nigeria. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2022; 43:3-11. [PMID: 33761812 DOI: 10.1177/0272684x211004949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tobacco use is associated with medical, social and economic problems. There is paucity of data on tobacco use among undergraduates in northern Nigeria. This study assessed pattern and predictors of tobacco use among undergraduates in Zaria, North-western Nigeria. METHOD It was a cross-sectional study of undergraduates in three tertiary institutions. Multi-stage sampling technique was used to select 1,080 undergraduates. Data was collected using a questionnaire adapted from Global Adult Tobacco Survey and Global Youth Tobacco Survey. Bi-variate analysis was used to identify independent variables showing statistically significant association with current tobacco use. These were entered into step-wise logistic regression. RESULTS Their median age was 24 years (range:15-47). Prevalence of current tobacco use was 27.0%. About 58.7% smoked tobacco daily and 40.0% used smokeless tobacco daily. Commonest places where tobacco was used were off campus accommodation (30.2%), social center (30.2%) and bar or club (28.1%). Predictors of tobacco use were being a male [2.64(1.82-3.84)], married [2.33(1.49-3.70)], experiencing tobacco promotional activity [1.56(1.12-2.17)], willing to use promotional objects [2.06(1.35-3.14)], using of promotional objects [2.74(1.90-3.96)], and exposure to secondhand smoke [14.10(4.16-47.81)]. Predictors of non-use of tobacco were spending two years or less awaiting university admission [0.65 (0.46-0.91)], parents currently together [0.48(0.33-0.69)], and supporting ban on tobacco [0.34 (0.23-0.48)]. CONCLUSION Prevalence of tobacco use and expenditure on tobacco were high. University authorities should commence programs to identify tobacco users and encourage cessation. The findings also highlight the need to establish effective tobacco surveillance system that includes students of tertiary institutions.
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Affiliation(s)
| | - Kabir Sabitu
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Nuru Suleiman Muhammad
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Aisha A Abubakar
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Sunday Asuke
- Department of Community Medicine, College of Health Sciences, Bingham University, Nasarawa State, Nigeria
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Yang S, Huang J, Ye L, Lin J, Xie Z, Guo B, Li Y, Liang B, Zheng Z, Lunze K, Abdullah AS, Liang H, Quintiliani LM. Factors Related to Smoking and Perceptions of a Behavioral Counseling and Messenger Service-Delivered Smoking Cessation Intervention for People with HIV in China: A Qualitative Study (Preprint). JMIR Form Res 2022; 6:e35923. [PMID: 36222795 PMCID: PMC9607887 DOI: 10.2196/35923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/14/2022] [Accepted: 08/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background China, where half of the adult male population smoke tobacco, has one of the highest global burdens of smoking. Smoking rates are even higher among people with HIV. People with HIV can be affected by smoking in multiple ways, including more severe HIV-related symptoms and worse antiretroviral therapy treatment outcomes. However, smoking cessation services targeted for people with HIV are not routinely integrated into HIV care in China. Given the widespread mobile phone ownership, an exploration of factors related to smoking among people with HIV in China who smoke could inform the design and implementation of mobile smoking cessation interventions that target the needs of this vulnerable population. Objective This study aims to explore the perspectives of smoking, barriers and facilitators to quitting, and perceptions related to a smoking cessation intervention delivered through behavioral counseling sessions and brief daily messenger service (WeChat)–delivered messages. Methods We recruited people with HIV from the People’s 4th Hospital of Nanning, Guangxi, China, and conducted semistructured face-to-face interviews. All interviews were audio-recorded, transcribed verbatim in Chinese, and translated into English for data analysis. We conducted a thematic analysis using a codebook, which was guided by a team-based consensus approach to identify 5 main themes. We also explored themes according to the demographic groups. Results A total of 24 participants were enrolled in the study. The mean age was 37.2 (SD=13.5) years. The participants had lived with HIV for a mean of 2.4 years. The majority were male (18/24, 75%) and lived in urban or metropolitan settings (19/24, 79%). We identified five main themes: variable knowledge of the harms of smoking, both related and unrelated to HIV; willpower perceived as the primary quitting strategy; a duality of the effect of social factors on quitting; perceptions about optimal features of the smoking cessation intervention (eg, messages should be brief and most frequent during the first few weeks); and the largely negative impact of their HIV diagnosis on smoking behaviors. In addition, some themes differed according to participant demographic characteristics such as age, sex, and education level. Conclusions We identified barriers to and facilitators of smoking cessation among people with HIV in China by conducting semistructured qualitative interviews. Owing to the adverse impact of smoking on HIV outcomes, targeting cessation interventions to the unique needs and preferences of people with HIV in China may be needed to increase the effectiveness of future interventions. A pilot clinical trial will be conducted in the future to evaluate this behavioral counseling and brief daily messenger service (WeChat)–delivered messages approach among people with HIV who smoke in China.
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Affiliation(s)
- Shanyin Yang
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States
| | - Jiegang Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Nanning, Guangxi, China
| | - Jianyan Lin
- The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Zhiman Xie
- The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Baodong Guo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yanjun Li
- The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Nanning, Guangxi, China
| | - Zhigang Zheng
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Karsten Lunze
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States
- Department of Medicine, Boston Univeristy School of Medicine, Boston, MA, United States
| | - Abu S Abdullah
- Department of Medicine, Boston Univeristy School of Medicine, Boston, MA, United States
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Nanning, Guangxi, China
- Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Lisa M Quintiliani
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States
- Department of Medicine, Boston Univeristy School of Medicine, Boston, MA, United States
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Loud EE, Duong HT, Henderson KC, Reynolds RM, Ashley DL, Thrasher JF, Popova L. Addicted to smoking or addicted to nicotine? A focus group study on perceptions of nicotine and addiction among US adult current smokers, former smokers, non-smokers and dual users of cigarettes and e-cigarettes. Addiction 2022; 117:472-481. [PMID: 34227709 PMCID: PMC8733050 DOI: 10.1111/add.15634] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/23/2021] [Accepted: 06/23/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIMS In 2017, the US Food and Drug Administration (FDA) proposed to reduce nicotine in cigarettes to minimally or non-addictive levels. This study qualitatively explored perceptions of nicotine and addiction, both independently and in response to messages communicating about nicotine reduction. DESIGN Qualitative study using focus groups. Participants described their perceptions of nicotine and addiction and their responses to messages about the nicotine reduction. SETTING Atlanta, GA and San Francisco, CA, USA. Semi-structured focus groups were conducted virtually in Spring 2020. PARTICIPANTS Exclusive smokers (n = 27), dual users (of cigarettes and electronic cigarettes) (n = 25), former smokers (n = 32) and young adult non-smokers (n = 31). MEASUREMENT Inductive thematic analysis of transcripts was conducted, and results were compared across smoking status groups. FINDINGS Participants across all smoking status groups associated nicotine with tobacco products, but consistently misperceived that nicotine caused disease. Perceptions of addiction were largely negative and varied by smoking status. Experienced smokers (exclusive smokers, former smokers and dual users) differentiated tobacco use from other addictions and minimized their own experiences of addiction. Perceptions of addiction across experienced smokers included not only the chemical properties of nicotine, but also the behavioral aspects of tobacco use, including oral fixation, having a smoking routine and response to internal and external cues. In response to messages, many believed that removing the nicotine would not make cigarettes less addictive because of the multi-factorial nature of smoking addiction that includes non-pharmacological cues. CONCLUSIONS Perceptions of nicotine and addiction among non-smokers, former smokers, exclusive smokers and dual users of cigarettes and e-cigarettes vary based on smoking status, but there is a common tendency to believe that nicotine is addictive, that addiction results from more than just nicotine, and that very low nicotine cigarettes will not necessarily reduce the addictiveness of cigarettes.
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Affiliation(s)
- Emily E. Loud
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Hue Trong Duong
- Department of Communication, Georgia State University, Atlanta, GA, 30302, USA
| | - Katherine C. Henderson
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302, USA
| | - Reed M. Reynolds
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302, USA
| | - David L. Ashley
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302, USA
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Xia W, Li WHC, Luo YH, Liang TN, Ho LLK, Cheung AT, Song P. The association between heated tobacco product use and cigarette cessation outcomes among youth smokers: A prospective cohort study. J Subst Abuse Treat 2021; 132:108599. [PMID: 34419325 DOI: 10.1016/j.jsat.2021.108599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/29/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The U.S. Food and Drug Administration authorized the marketing of heated tobacco products (HTPs) with modified-risk information for adults on July 7, 2020. However, the effects of HTP use on cigarette cessation among youth smokers remain unclear. This study aimed to explore the association of HTP use with cigarette abstinence and cessation outcomes among youth smokers in Hong Kong who were willing to receive telephone counseling for smoking cessation. METHODS This prospective cohort study included youth smokers aged ≤25 years who were enrolled in the Hong Kong Youth Quitline service. From December 1, 2016, to September 30, 2019, this study identified as HTP users 106 youth cigarette smokers who reported using HTPs on at least 1 of the past 30 days at enrollment, and identified as non-HTP users 473 smokers who reported smoking at least one conventional cigarette in the past 30 days and never using HTPs. The participants received follow-ups at 1 week and 1-, 3-, and 6-months postenrollment. The primary outcome was self-reported 7-day point prevalence of cigarette abstinence (PPA) at the 6-month follow-up. Secondary outcomes included reduction in cigarette smoking (excluding quitters), the number of cessation attempts, and the level of readiness to quit. RESULTS The self-reported 7-day PPA was statistically significantly lower among HTP users than among non-HTP users after 6 months (19.0% vs. 34.2%; p = 0.009), with an adjusted relative risk of 0.47 (95% confidence interval: 0.24-0.91; p = 0.03). The study identified no significant differences in secondary outcomes between the two groups. CONCLUSIONS Youth HTP users were less likely to abstain from tobacco use than their non-HTP-using counterparts. These results suggest that HTPs should not be promoted as smoking cessation or reduction aids among the youth population.
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Affiliation(s)
- Wei Xia
- School of Nursing, Sun Yat-Sen University, RM 613, 4/F, Block of School of Nursing, Sun Yat-Sen University North Campus, No. 74, 2nd Yat-Sen Rd, Yuexiu District, Guangzhou City, Guangdong Province, China; School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - William Ho Cheung Li
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Yuan Hui Luo
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Ting Na Liang
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Laurie Long Kwan Ho
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Peige Song
- School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou 310058, China; Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland, United Kingdom.
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Tregobov N, Poureslami I, Shum J, Aran N, McMillan A, FitzGerald JM. Assessing factors influencing smoking and smoking cessation within Chinese communities in the Greater Vancouver Area: A qualitative exploratory study. Tob Prev Cessat 2020; 6:57. [PMID: 33163703 PMCID: PMC7643582 DOI: 10.18332/tpc/126631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/14/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of smoking is high within Chinese-Canadian communities and there is a lack of culturally and linguistically appropriate smoking cessation resources and services. We aimed to ascertain factors affecting smoking and smoking cessation from the perspectives of current smokers and key informants. METHODS As part of a multistage mixed-methods study taking place from January 2013 to June 2014, a qualitative exploratory study design was conducted applying a community-based participatory research approach. Focus groups and interviews were conducted with adult (aged ≥19 years) Chinese-Canadian current smokers (≥5 cigarettes per day for the past 30 days) and interviews were held with key informants in Vancouver, Canada. A constant comparison method was applied to code data, and an inductive approach was used to identify emergent themes. RESULTS In all, 35 smokers from the target communities (11 female, 24 male) participated in 4 focus group sessions and 17 key informants (14 female, 3 male) were individually interviewed. Internal and external factors influencing smoking onset, continuation, and cessation from the perspectives of smokers and key informants were identified. Male smokers thought that the most influential factor influencing smoking initiation was social pressure, while female smokers thought that it was stress. Female smokers reported refraining from seeking cessation assistance due to a perceived negative image of female smokers within the community. Both key informants and participants indicated that involving friends and family in the quitting process may help to motivate smokers. CONCLUSIONS Smokers from Chinese-Canadian communities may benefit from linguistically appropriate and culturally relevant smoking cessation interventions that consider prevailing attitudes, perceptions, and beliefs. The knowledge gained may inform the development of future smoking cessation programs and resources for the target community, while our approach may be applicable to other ethnocultural or immigrant communities.
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Affiliation(s)
- Noah Tregobov
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada.,Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Iraj Poureslami
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Jessica Shum
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Niloufar Aran
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Austin McMillan
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - J Mark FitzGerald
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
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Poureslami I, Shum J, Aran N, Tregobov N. Chinese- and English-speaking adult current smokers' perspectives on smoking and culturally and linguistically appropriate cessation: a qualitative analysis. Addict Sci Clin Pract 2020; 15:23. [PMID: 32631420 PMCID: PMC7339422 DOI: 10.1186/s13722-020-00197-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A lack of culturally and linguistically appropriate smoking cessation intervention programs exist among Chinese-Canadian communities. Smoking cessation programs that are provided in Canadian mainstream culture and language have shown limited effectiveness in altering smoking behaviours of smokers from these communities. Our study aimed to explore and compare smoking patterns, knowledge, beliefs, and risk perceptions of adult current smokers between Chinese- and English-speaking Canadians participating in a culturally and linguistically tailored smoking cessation program. METHODS AND DESIGN A qualitative study embedded in an effectiveness study using an 8-month quasi-experimental design, was conducted to compare the effects of four one-on-one culturally and linguistically sensitive consultation sessions (intervention group) and three telephone follow-up assessments (control group). All participants were provided take-home educational materials (designed exclusively for this study), and completed study questionnaires at baseline and 6-month post-intervention. An 8-month post-intervention phone assessment was conducted with all participants to assess cessation progress and maintenance. PARTICIPANTS 70 Chinese- and English-speaking adult (aged 19-80) current smokers (≥ 5 cigarettes per day) residing in the Greater Vancouver Area, Canada, were recruited between May 2018 and April 2019. DATA ANALYSIS Thematic analysis was conducted on self-reported qualitative information from study questionnaires and verbatim transcripts of in-person consultations and telephone follow-ups. Cultural- and demographic-related themes were considered. RESULTS Perceptions of smoking patterns, smoking status, triggers, and barriers to smoking cessation were identified. Important elements of smoking cessation program, including facilitator characteristics, duration, procedures, cultural factors, and topics were also identified. Differences in perceptions of smoking were observed between gender and language groups. Stress was a major trigger for smoking in both language groups. An individual's social network was reported as the largest barrier to successful cessation for Chinese-speaking participants. CONCLUSIONS Our study provides knowledge and information to further examine the role of risk perception (realization of the possible harms of smoking) in smoking cessation to facilitate the development of future interventions that could more effectively promote smoking cessation among new immigrants and within ethnocultural communities. We found that our program was generally accepted by smokers in both language groups and the participants reported that they were able to apply the strategies learned in the intervention during their quit smoking plan.
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Affiliation(s)
- Iraj Poureslami
- UBC, Faculty of Medicine, Respiratory Medicine Division, Centre for Clinical Epidemiology and Evaluation (C2E2), Vancouver General Hospital - Research Pavilion, 716-828 West 10th Ave, Vancouver, BC, V5Z 1M9, Canada.
| | - Jessica Shum
- UBC, Faculty of Medicine, Respiratory Medicine Division, Centre for Clinical Epidemiology and Evaluation (C2E2), Vancouver General Hospital - Research Pavilion, 716-828 West 10th Ave, Vancouver, BC, V5Z 1M9, Canada
| | - Niloufar Aran
- UBC, Faculty of Medicine, Respiratory Medicine Division, Centre for Clinical Epidemiology and Evaluation (C2E2), Vancouver General Hospital - Research Pavilion, 716-828 West 10th Ave, Vancouver, BC, V5Z 1M9, Canada
| | - Noah Tregobov
- UBC, Faculty of Medicine, Respiratory Medicine Division, Centre for Clinical Epidemiology and Evaluation (C2E2), Vancouver General Hospital - Research Pavilion, 716-828 West 10th Ave, Vancouver, BC, V5Z 1M9, Canada
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12
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Pfeffer D, Wigginton B, Gartner C, Morphett K. Smokers' Understandings of Addiction to Nicotine and Tobacco: A Systematic Review and Interpretive Synthesis of Quantitative and Qualitative Research. Nicotine Tob Res 2018; 20:1038-1046. [PMID: 29059355 DOI: 10.1093/ntr/ntx186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 08/17/2017] [Indexed: 11/13/2022]
Abstract
Background Despite the centrality of addiction in academic accounts of smoking, there is little research on smokers' beliefs about addiction to smoking, and the role of nicotine in tobacco dependence. Smokers' perspectives on nicotine's role in addiction are important given the increasing prevalence of nontobacco nicotine products such as e-cigarettes. We conducted a systematic review of studies investigating smokers' understandings and lay beliefs about addiction to smoking and nicotine. Method We searched PubMed, Embase, CINAHL, and PsycINFO for studies investigating lay beliefs about addiction to smoking. Twenty-two quantitative and 24 qualitative studies met inclusion criteria. Critical interpretive synthesis was used to analyze the results. Results Very few studies asked about addiction to nicotine. Quantitative studies that asked about addiction to smoking showed that most smokers believe that cigarettes are an addictive product, and that they are addicted to smoking. Across qualitative studies, nicotine was not often mentioned by participants. Addiction to smoking was most often characterized as a feeling of "need" for cigarettes resulting from an interplay between physical, mental, and social processes. Overall, we found that understandings of smoking were more consistent with the biopsychosocial model of addiction than with more recent models that emphasize the biological aspects of addiction. Conclusion Researchers should not treat perceptions of addiction to smoking interchangeably with perceptions of addiction to nicotine. More research on lay beliefs about nicotine is required, particularly considering the increasing use of e-cigarettes and their potential for long-term nicotine maintenance for harm reduction. Implications Quantitative studies show that most smokers believe that smoking is addictive and that they are addicted. A feeling of "need" for cigarettes was central to qualitative accounts of addiction, but nicotine was not often discussed. Overall, smokers' understandings of addiction reflect a biopsychosocial model rather than a neurobiological one. Given the growing market for e-cigarettes and therapeutic nicotine, more research is required on lay beliefs about nicotine and addiction.
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Affiliation(s)
- Daniel Pfeffer
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Australia
| | - Britta Wigginton
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Australia
| | - Kylie Morphett
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Australia
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13
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Zhao X, Young RMCD, White KM. 'I'm not a smoker…yet': a qualitative study on perceptions of tobacco control in Chinese high schools. BMJ Open 2018; 8:e019483. [PMID: 29678968 PMCID: PMC5914720 DOI: 10.1136/bmjopen-2017-019483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Chinese adolescents' perceptions about tobacco control at schools are rarely researched. We explored how current antismoking strategies work in middle school environments, as well as the attitudes towards these strategies held by students and teaching staff members. METHODS Four focus groups (24 eleventh graders; Mage=16 years) and five indepth interviews (teaching staff members with tobacco control experience in schools) were conducted in Kunming, Yunnan Province, China. We used thematic analysis combining inductive and deductive processes, along with field observations and research group discussions, for data analysis. RESULTS With educational approaches and practical strategies, antismoking education reported in the middle schools had limited effectiveness. Although smoking is banned in schools, students can circumvent schools' controls easily. Notably salient is the pessimistic attitude towards school-based antismoking strategies at school. Detrimental influences within (teachers' smoking) and beyond schools (high societal smoking prevalence) largely challenged the efforts to manage students' smoking. CONCLUSIONS Current antismoking approaches in schools fail to curb smoking among Chinese high school students. Their effectiveness is undermined by both within-campus and off-campus influences. Students' perceptions of smoking should be valued as their knowledge of smoking is actively constructed. Future antismoking education at school should incorporate interactive sessions rather than merely didactic approaches about the harms of smoking. Although stricter rules for teachers' smoking are needed, complementary strategies such as population-level interventions and policy measures in wider society will assist in efforts within schools.
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Affiliation(s)
- Xiang Zhao
- School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ross M cD Young
- Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Katherine M White
- School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Shaheen K, Oyebode O, Masud H. Experiences of young smokers in quitting smoking in twin cities of Pakistan: a phenomenological study. BMC Public Health 2018; 18:466. [PMID: 29636043 PMCID: PMC5891956 DOI: 10.1186/s12889-018-5388-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 03/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking is highly prevalent in Pakistan claiming the lives of over 100,000 individuals every year. A significant proportion of smokers (24.7%) make an attempt to quit each year but 97.4% fail to quit successfully. Little is known about the reasons for, and experiences of, failed quit attempts. This study was carried out to explore the experiences of young male smokers in quitting smoking in the twin cities of Pakistan METHOD: A qualitative study was carried out using a phenomenological approach in Rawalpindi and Islamabad. A total of 11 participants were interviewed. All study participants were male and had made at least one quit attempt. Study participants were a mix of smokers who failed to quit smoking, intermittent smokers and successful quitters. Streubert's (1991) method of phenomenology was followed during data analysis. RESULTS The experiences of smokers while smoking "the smoking phase" have major effects on their journey towards quitting smoking. The smoking phase consists of three major stages: contact with initial smoking stimuli, the journey from first puff to enjoying smoking and then finally smoking becoming part of life. However, the journey towards quitting smoking is not as simple as the journey towards becoming a smoker. Instead, smokers get trapped in three overlapping cycles of smoking and quit attempts: smoking & forced quitting, smoking & intentional quitting, and smoking & intermittent smoking before successful quitting. Breaking the cycle is not easy in the presence of trapping factors (addiction, high availability, easy affordability, conducive social setup and low perceived risks of smoking). Three factors play a major role in breaking these cycles which are strong will power, continuous peer support and avoidance of smokers' company. CONCLUSION A young smoker, during his experience of quitting smoking gets entrapped in several overlapping cycles of smoking & quit attempts before successful quitting. There are known entrapping factors as well as factors which help in breaking these cycles. Targeted interventions are needed to facilitate smoking cessation among young smokers in Pakistan.
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Affiliation(s)
- Kanwal Shaheen
- Al-Shifa School of Public Health, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Oyinlola Oyebode
- Warwick Medical School, the University of Warwick, Coventry, CV4 7AL UK
| | - Haleema Masud
- Al-Shifa School of Public Health, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
- Warwick Medical School, the University of Warwick, Coventry, CV4 7AL UK
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15
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Wang J, Abdullah AS, Ma Z, Fu H, Huang K, Yu H, Wang J, Cai L, He H, Xiao J, Quintiliani L, Friedman RH, Yang L. Building capacity for information and communication technology use in global health research and training in China: a qualitative study among Chinese health sciences faculty members. Health Res Policy Syst 2017; 15:59. [PMID: 28659155 PMCID: PMC5490156 DOI: 10.1186/s12961-017-0222-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/07/2017] [Indexed: 12/02/2022] Open
Abstract
Background The demand to use information and communications technology (ICT) in education and research has grown fast among researchers and educators working in global health. However, access to ICT resources and the capacity to use them in global health research remains limited among developing country faculty members. In order to address the global health needs and to design an ICT-related training course, we herein explored the Chinese health science faculty members’ perceptions and learning needs for ICT use. Methods Nine focus groups discussions (FGDs) were conducted during December 2015 to March 2016, involving 63 faculty members working in areas of health sciences from six universities in China. All FGDs were audio recorded and analysed thematically. Results The findings suggest that the understandings of ICT were not clear among many researchers; some thought that the concept of ICT was too wide and ambiguous. Most participants were able to cite examples of ICT application in their research and teaching activities. Positive attitudes and high needs of ICT use and training were common among most participants. Recommendations for ICT training included customised training programmes focusing on a specific specialty, maintaining a balance between theories and practical applications, more emphasis on the application of ICT, and skills in finding the required information from the bulk information available in the internet. Suggestions regarding the format and offering of training included short training programmes, flexible timing, lectures with practicum opportunities, and free of charge or with very minimal cost to the participants. Two participants suggested the linking of ICT-related training courses with faculty members’ year-end assessment and promotion. Conclusions This study among health sciences faculty members in China demonstrated a high level of need and interest in learning about ICT use in research and training. The results have important implications for the design and implementation of ICT-related educational programmes in China and other developing countries.
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Affiliation(s)
- Jie Wang
- Department of Preventive Medicine & Fudan Health Communication Institute, School of Public Health, Fudan University, Shanghai, 20032, China
| | - Abu S Abdullah
- Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, United States of America. .,Duke Global Health Institute, Duke University, Durham, NC, 27710, United States of America. .,Global Health Program, Duke Kunshan University, Jiangsu, 215347, China.
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Hua Fu
- Department of Preventive Medicine & Fudan Health Communication Institute, School of Public Health, Fudan University, Shanghai, 20032, China
| | - Kaiyong Huang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Hongping Yu
- School of Public Health, Guilin Medical University, Guilin, Guangxi, 541004, China
| | - Jiaji Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, 511436, China
| | - Le Cai
- School of Public Health, Kunming Medical University, Kunming, Yunnan, 650500, China
| | - Huimin He
- School of Information and Management, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Jian Xiao
- School of Medicine, Guangxi University of Chinese Medicine, Nanning, Guangxi, 530021, China
| | - Lisa Quintiliani
- Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, United States of America
| | - Robert H Friedman
- Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, United States of America
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China.
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16
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Ma Z, Yang L, Yang L, Huang K, Yu H, He H, Wang J, Cai L, Wang J, Fu H, Quintiliani L, Friedman RH, Xiao J, Abdullah AS. Developing a Curriculum for Information and Communications Technology Use in Global Health Research and Training: A Qualitative Study Among Chinese Health Sciences Graduate Students. JMIR MEDICAL EDUCATION 2017; 3:e11. [PMID: 28606894 PMCID: PMC5484790 DOI: 10.2196/mededu.6590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/05/2017] [Accepted: 02/11/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND Rapid development of information and communications technology (ICT) during the last decade has transformed biomedical and population-based research and has become an essential part of many types of research and educational programs. However, access to these ICT resources and the capacity to use them in global health research are often lacking in low- and middle-income country (LMIC) institutions. OBJECTIVE The aim of our study was to assess the practical issues (ie, perceptions and learning needs) of ICT use among health sciences graduate students at 6 major medical universities of southern China. METHODS Ten focus group discussions (FGDs) were conducted from December 2015 to March 2016, involving 74 health sciences graduate students studying at 6 major medical universities in southern China. The sampling method was opportunistic, accounting for the graduate program enrolled and the academic year. All FGDs were audio recorded and thematic content analysis was performed. RESULTS Researchers had different views and arguments about the use of ICT which are summarized under six themes: (1) ICT use in routine research, (2) ICT-related training experiences, (3) understanding about the pros and cons of Web-based training, (4) attitudes toward the design of ICT training curriculum, (5) potential challenges to promoting ICT courses, and (6) related marketing strategies for ICT training curriculum. Many graduate students used ICT on a daily basis in their research to stay up-to-date on current development in their area of research or study or practice. The participants were very willing to participate in ICT courses that were relevant to their academic majors and would count credits. Suggestion for an ICT curriculum included (1) both organized training course or short lecture series, depending on the background and specialty of the students, (2) a mixture of lecture and Web-based activities, and (3) inclusion of topics that are career focused. CONCLUSIONS The findings of this study suggest that a need exists for a specialized curriculum related to ICT use in health research for health sciences graduate students in China. The results have important implications for the design and implementation of ICT-related educational program in China or other developing countries.
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Affiliation(s)
- Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Lan Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Kaiyong Huang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Hongping Yu
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Huimin He
- School of Information and Management, Guangxi Medical University, Nanning, China
| | - Jiaji Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Le Cai
- School of Public Health, Kunming Medical University, Kunming, China
| | - Jie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Hua Fu
- School of Public Health, Fudan University, Shanghai, China
| | - Lisa Quintiliani
- Boston University School of Medicine, Department of Medicine, Boston Medical Center, Boston, MA, United States
| | - Robert H Friedman
- Boston University School of Medicine, Department of Medicine, Boston Medical Center, Boston, MA, United States
| | - Jian Xiao
- School of Medicine, Guangxi Univeristy of Chinese Medicine, Nanning, China
| | - Abu S Abdullah
- Boston University School of Medicine, Department of Medicine, Boston Medical Center, Boston, MA, United States
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Duke Kunshan University, Global Health Program, Kunshan, China
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Li WHC, Chan SSC, Wang MP, Ho KY, Cheung YTY, Chan VWF, Lam TH. An Evaluation of the Youth Quitline Service Young Hong Kong Smokers. J Adolesc Health 2017; 60:584-591. [PMID: 28111012 DOI: 10.1016/j.jadohealth.2016.11.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/19/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The psychological and social factors associated with smoking initiation and continuation are different for young and adult smokers. Before 2005, there were no population-based smoking cessation interventions targeting young smokers in Hong Kong, China. This study describes the processes and outcomes of an individualized "Youth Quitline" service for young Hong Kong Chinese smokers over a 10-year period. METHODS A retrospective population-based study was conducted to evaluate the effectiveness of the Quitline and identify the predictors of quitting. Telephone records were used to obtain information of each call. Young smokers of the Quitline completed a questionnaire at baseline and 6-month follow-up. Data were collected between August 2005 and August 2015. RESULTS Over the 10-year period, the Youth Quitline received 7,720 telephone inquiries and provided smoking cessation counseling to 1,684 young smokers. At the 6-month follow-up, 16.9% had reduced cigarette consumption by more than 50%, 33.8% had tried quitting, and 23.6% had successfully quit smoking. Logistic regression analyses indicated that 7 factors, including (1) age; (2) daily cigarette consumption; (3) level of nicotine dependence; (4) intention to quit; (5) having made at least one quit attempt; (6) level of self-efficacy; and (7) adherence to telephone counseling, significantly predicted smoking cessation at 6 months. CONCLUSIONS During the first 10 years of the Youth Quitline, we trained many youths to become smoking cessation peer counselors. The Youth Quitline successfully increased youths' awareness of the risks of smoking and smoking cessation services and provided individualized smoking cessation counseling services to young smokers.
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Affiliation(s)
- William H C Li
- School of Nursing, University of Hong Kong, Hong Kong SAR, China.
| | - Sophia S C Chan
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Ka Yan Ho
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | | | - Vivian W F Chan
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
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18
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Racic M, Tanovic S, Joksimovic VR, Joksimovic BN, Ristic S. Prevalence and determinants of smoking initiation among school students in Bosnia and Herzegovina. Int J Adolesc Med Health 2016; 27:397-403. [PMID: 25427060 DOI: 10.1515/ijamh-2014-0041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 08/09/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tobacco smoking amongst the young is a matter of public health concern because of the immediate and long-term health consequences associated with tobacco use, such as asthma, cancers, and cardiovascular diseases. The purpose of this study was to identify the determinants of smoking initiation among a sample of high school students in Bosnia and Herzegovina. METHODS The study was conducted among 198 high school students in Zvornik, Bosnia and Herzegovina, during April 2013. A self-administered, pre-tested, structured, close-ended questionnaire was used for data collection. RESULTS Fourth grade students mainly initiated smoking in high school (45%), while the majority of third and second grade students initiated smoking in primary school. Among students who smoke, an average duration of the smoking habit was <2 years. A multivariate analysis showed that males were 5.27 times more likely to have initiated smoking. For every unit increase in pro-smoking attitude towards smoking, students were 5.3 times more likely to have initiated smoking. Those with parents and friends who are smokers were 6.106 and 5.175 times, respectively, more likely to have initiated smoking. CONCLUSION This study indicates that a high proportion of 15-18 year olds in the town of Zvornik are current smokers. Gender, age, and parent and peer influence were identified as important associations with smoking. Interventions should not only be confined to the secondary school environment but they should also extend to their places of residence so that influences in the home environment and social surroundings that contribute to tobacco use are also tackled.
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Smith AL, Carter SM, Dunlop SM, Freeman B, Chapman S. The views and experiences of smokers who quit smoking unassisted. A systematic review of the qualitative evidence. PLoS One 2015; 10:e0127144. [PMID: 26010369 PMCID: PMC4444295 DOI: 10.1371/journal.pone.0127144] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 04/13/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Unassisted cessation - quitting without pharmacological or professional support - is an enduring phenomenon. Unassisted cessation persists even in nations advanced in tobacco control where cessation assistance such as nicotine replacement therapy, the stop-smoking medications bupropion and varenicline, and behavioural assistance are readily available. We review the qualitative literature on the views and experiences of smokers who quit unassisted. METHOD We systematically searched for peer-reviewed qualitative studies reporting on smokers who quit unassisted. We identified 11 studies and used a technique based on Thomas and Harden's method of thematic synthesis to discern key themes relating to unassisted cessation, and to then group related themes into overarching concepts. FINDINGS The three concepts identified as important to smokers who quit unassisted were: motivation, willpower and commitment. Motivation, although widely reported, had only one clear meaning, that is 'the reason for quitting'. Willpower was perceived to be a method of quitting, a strategy to counteract cravings or urges, or a personal quality or trait fundamental to quitting success. Commitment was equated to seriousness or resoluteness, was perceived as key to successful quitting, and was often used to distinguish earlier failed quit attempts from the final successful quit attempt. Commitment had different dimensions. It appeared that commitment could be tentative or provisional, and also cumulative, that is, commitment could be built upon as the quit attempt progressed. CONCLUSION A better understanding of what motivation, willpower and commitment mean from the smoker's perspective may provide new insights and direction for smoking cessation research and practice.
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Affiliation(s)
- Andrea L. Smith
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Stacy M. Carter
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sally M. Dunlop
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Cancer Screening and Prevention, Cancer Institute NSW, Sydney, New South Wales, Australia
| | - Becky Freeman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Simon Chapman
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Secondhand smoke exposure assessment and counseling in the Chinese pediatric setting: a qualitative study. BMC Pediatr 2014; 14:266. [PMID: 25316512 PMCID: PMC4287587 DOI: 10.1186/1471-2431-14-266] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 10/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background Assisting smoking parents to quit smoking and eliminating the secondhand smoke (SHS) exposure of their children is a global health priority. Engaging healthcare workers in developing countries to address this priority has been a challenge. This study intends to explore issues around current practice related to SHS exposure assessment and counseling and identify barriers to SHS exposure reduction counseling in the Chinese pediatric setting. Methods We conducted qualitative interviews (11 focus groups discussions (FGDs) with pediatricians, 6 FGDs with pediatric nurses and 11 in-depth interviews (IDIs) with hospital administrators) among 101 health-care professionals (HCP) from 5 hospitals in four major cities of Guangxi Province, China. All FGDs/ IDIs were audio recorded and analysed thematically. Results The findings suggest that few Chinese pediatricians routinely address the SHS exposure of children in their usual practice. All HCPs felt the need for clinical interventions to promote SHS exposure reduction for children. Primary barriers to SHS exposure reduction counseling in the Chinese pediatric setting included: lack of skills and training in tobacco use reduction and cessation counseling; time constraints and heavy workloads, uncertainty about the usefulness of smoking cessation interventions and lack of hospital-wide systems requiring pediatricians to record tobacco use or SHS exposure information. Ideas for overcoming these barriers were building capacity of pediatricians, collaboration with international organization to initiate training, engaging top level leaders in the effort and ensuring financial resources to support the program. Conclusions This study among hospital administrators and service providers in China demonstrated a high level of interest in delivering SHS exposure reduction interventions in the pediatric setting. The findings can inform the creation and delivery of clinical interventions in China to promote SHS exposure reduction to children in the pediatric setting. Electronic supplementary material The online version of this article (doi:10.1186/1471-2431-14-266) contains supplementary material, which is available to authorized users.
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Abdullah AS, Ma Z, Liao J, Huang K, Yang L, Zhang Z, Winickoff JP, Nong GM. Addressing parental smoking in pediatric settings of chinese hospitals: a qualitative study of parents. BIOMED RESEARCH INTERNATIONAL 2014; 2014:382345. [PMID: 24982874 PMCID: PMC4058835 DOI: 10.1155/2014/382345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/17/2014] [Indexed: 12/04/2022]
Abstract
This study explored factors associated with SHS exposure from parental smoking in Chinese families and assessed nature of antismoking discussions parents had with their children's pediatricians and how pediatricians might best engage with parents in an effort to reduce children's exposure to SHS. Six focus group discussions (FGDs) were conducted among 33 Chinese parents attending six major hospitals in Guangxi province, China. Most participants (32/33) had family members who smoke, and only 21% had strict restriction on smoking at home. Some parents did not know about health consequences of smoking and effects of SHS exposure on children. Situations that made it especially hard to avoid the child's SHS exposure were having an elderly smoker at home and having a visitor who smoked. Only few parents were asked by pediatricians about child's exposure to SHS at home, but only when child's illness was related to smoking. Parents believed that suggestions coming from pediatricians about smoke-free home and parental quitting would be acceptable to parents and other household members. The findings provide insight into SHS exposure reduction effort among Chinese parents and underscore the demand for pediatrician's engagement in addressing parental tobacco use.
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Affiliation(s)
- Abu S. Abdullah
- School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
- Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Jing Liao
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Kaiyong Huang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Zhiyong Zhang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Jonathan P. Winickoff
- MGH Center for Child and Adolescent Health Research and Policy, Harvard Medical School, Boston, MA 02114, USA
| | - Guang-Min Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
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Shi HJ, Jiang XX, Yu CY, Zhang Y. Use of mobile phone text messaging to deliver an individualized smoking behaviour intervention in Chinese adolescents. J Telemed Telecare 2013; 19:282-7. [PMID: 24163238 DOI: 10.1177/1357633x13495489] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated the effectiveness of a mobile phone text-messaging based smoking cessation intervention package among Chinese adolescent smokers. Students aged 16-19 years were recruited from six vocational high schools located in Shanghai. We assigned the six schools to an intervention group or a control group by cluster randomization. The 92 participants in the intervention group were given tailored information via mobile phone text-messaging for 12 weeks. The 87 participants in the control group were provided with a self-help pamphlet about smoking cessation instead. After the intervention, attitudes towards the disadvantages of smoking were significantly improved, and the level of nicotine dependence and cigarette dependence significantly decreased in the intervention group. The intervention group had a relatively higher self-reported 7-day abstinence compared to the control group and 30-day abstinence, but the differences were not significant. However, the intervention group had a significantly higher rate of smoking reduction (66% vs. 35%) and moving forward in quitting stages (52% vs. 18%) compared to the control group. The interactive and tailored assistance provided by the mobile phone text-messaging was effective in smoking behaviour intervention in Chinese adolescent smokers.
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Affiliation(s)
- Hui-Jing Shi
- School of Public Health, Fudan University, Shanghai, China
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Marya CM, Vijay G, Jnaneshwar A, Nagpal R, Pruthi N. Tobacco consumption among 12- to 15-year-old schoolchildren in Delhi. Int J Adolesc Med Health 2013; 26:13-8. [PMID: 23314516 DOI: 10.1515/ijamh-2012-0104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 09/20/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims to assess the knowledge, attitude, and practice of tobacco use and its cessation among children in schools of Delhi. METHODS A cross-sectional study involving 1094 schoolchildren (577 boys and 517 girls), 12-15 years old, was conducted using the modified Global Youth Tobacco Survey questionnaire. Mann-Whitney U-test and Kruskal-Wallis test were applied (p<0.05). RESULTS Among these, 132 boys (22.87%) and 120 girls (23.21%) were smokers. "Ever smokers" were 13.80% and "current smokers" were 9.23%, whereas 76.97% were "never smokers". CONCLUSION Interventions that raise awareness at a young age, equip students to overcome peer influence, and provide counseling to quit using tobacco need to be designed.
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Reda AA, Moges A, Yazew B, Biadgilign S. Determinants of cigarette smoking among school adolescents in eastern Ethiopia: a cross-sectional study. Harm Reduct J 2012; 9:39. [PMID: 23227891 PMCID: PMC3541105 DOI: 10.1186/1477-7517-9-39] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 12/06/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) attributes more than 4 million deaths a year to tobacco, and it is expected that this figure will rise to 10 million deaths a year by 2020. Moreover, it is now a growing public health problem in the developing world. OBJECTIVE To assess the prevalence of cigarette use and its determinant factors among high school students in eastern Ethiopia. METHODS A cross-sectional study was conducted using structured self-administered questionnaires among 1,721 school adolescents in Harar town, eastern Ethiopia. Univariate and multivariate logistic regression analyses were performed to examine associations. RESULTS The analysis revealed that prevalence of ever cigarette smoking was 12.2% (95% CI 10.8% - 13.9%). Reasons mentioned for smoking cigarettes were for enjoyment (113, 52.8%), for trial (92, 42.9%), and for other reasons (9, 4.3%). The main predictors of cigarette smoking were sex (OR 4.32; 95% CI 2.59-7.22), age (OR 1.20; 95% CI 1.05-1.38) and having friends who smoke (OR 8.14; 95% CI 5.19-12.70). Living with people who smoke cigarettes was not significantly associated with smoking among adolescents (OR 1.25; 95% CI 0.81-1.92). CONCLUSION This study concluded that high proportion of school adolescents in Harar town smoked cigarettes. Sex, age and peer influence were identified as important determinants of smoking. There is a need for early cost-effective interventions and education campaigns that target secondary school students.
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Affiliation(s)
- Ayalu A Reda
- Department of Public Health, College of Health Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Asmamaw Moges
- Department of Public Health, College of Health Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Berhanu Yazew
- Department of Environmental Health Science, College of Health Sciences, Haramaya University, Harar, Ethiopia
| | - Sibhatu Biadgilign
- Department of Epidemiology and Biostatistics, College of Medical and Health Sciences, Jimma University, Jimma, Ethiopia
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Abdullah AS, Hua F, Xia X, Hurlburt S, Ng P, MacLeod W, Siegel M, Griffiths S, Zhang Z. Second-hand smoke exposure and household smoking bans in Chinese families: a qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2012; 20:356-364. [PMID: 22029412 DOI: 10.1111/j.1365-2524.2011.01035.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
As workplace smoking restrictions spread, smoking in the home is becoming the predominant source of exposure to second-hand smoke (SHS) among children and other non-smokers in the household. This study explored issues around children's exposure to SHS. Focus group discussions (FGDs) and in-depth interviews (IDI) were conducted among 31 Chinese households in urban Shanghai, China. All FGDs/IDIs were audio recorded and analysed thematically. The findings suggest that there are gaps in knowledge of the health consequences of smoking and SHS among the participants. Although there was a lack of knowledge about the health risk of exposure to SHS, most were willing to protect their child from the SHS exposure. In 16/31 households, families had partial home-smoking restrictions; there were no complete restrictions in any of the smokers' homes. Many families do not openly discuss smoking or smoking restrictions at home. Barriers to adopting a smoke-free home included the social acceptability of smoking (22/31), hosting social gatherings at home, which would involve smoking (12/31), authoritative attitudes of the husband or father-in-law (10/31), and difficulties with visitors who smoke (7/31). Most (28/31) participants stated they would accept a counselling intervention to reduce SHS exposure to children and suggested various measures to implement it. The findings from this intervention have implications for designing intervention strategies to reduce SHS exposure at home among children in China.
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Affiliation(s)
- Abu S Abdullah
- School of Public Health, Guangxi Medical University, Nanning, China.
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26
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Mak KK, Ho SY, Day JR. Smoking of parents and best friend--independent and combined effects on adolescent smoking and intention to initiate and quit smoking. Nicotine Tob Res 2012; 14:1057-64. [PMID: 22345315 DOI: 10.1093/ntr/nts008] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study investigates the independent and combined effects of smoking of parents and best friend on smoking and the intention to initiate or quit smoking in adolescents. METHODS In this school-based survey, 6,553 Hong Kong students aged 13-18 reported their demographic characteristics, smoking status of themselves, parents, and best friend; and intention to smoke (initiation among never-smokers and reinitiation among ex-smokers) or quit smoking among current smokers. Logistic regression yielded adjusted odds ratios (AORs) of student smoking (current/ever) and intention to smoke or quit smoking for parental (paternal/maternal/both parents vs. none) and best friend (yes vs. no) smoking. RESULTS Parental smoking and having a smoking best friend were associated with adolescent current smoking, ever smoking, and intention to initiate smoking. Having a smoking best friend was also associated with reinitiating and quitting smoking. The AORs (95% CI) of current smoking for having a smoking best friend, in addition to smoking father, mother, or both were 19.14 (14.36-25.51), 20.38 (12.42-33.43), and 24.18 (15.89-36.77). The respective AORs of ever smoking were 8.30 (6.74-10.22), 8.92 (5.63-14.12), and 11.99 (8.05-17.87). CONCLUSIONS Parental smoking and best friend smoking have independent effects on adolescent smoking behaviors. Their combined effects on current and ever smoking were particularly large. Smoking prevention programs should pay special attention to adolescents with both best friend and parents who smoke.
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Affiliation(s)
- Kwok-Kei Mak
- School of Public Health, Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
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27
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Wong DCN, Chan SSC, Fong DYT, Leung AYM, Lam DOB, Lam TH. Quitting Trajectories of Chinese Youth Smokers Following Telephone Smoking Cessation Counseling: A Longitudinal Study. Nicotine Tob Res 2011; 13:848-59. [DOI: 10.1093/ntr/ntr086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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28
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Wong DCN, Chan SSC, Fong DYT, Leung AYM, Lam DOB, Lam TH. Patterns and Predictors of Quitting Among Youth Quitline Callers in Hong Kong. Nicotine Tob Res 2010; 13:7-14. [DOI: 10.1093/ntr/ntq192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Prevalence of Smoking and Other Smoking-Related Behaviours Among Students Aged 13 to 15 Years in Montenegro: Results from the Global Youth Tobacco Survey of 2008. Arh Hig Rada Toksikol 2010; 61:203-9. [DOI: 10.2478/10004-1254-61-2010-1987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Prevalence of Smoking and Other Smoking-Related Behaviours Among Students Aged 13 to 15 Years in Montenegro: Results from the Global Youth Tobacco Survey of 2008The Global Youth Tobacco Survey (GYTS) is an international study that provides data on youth tobacco use for development of tobacco control programs. It is a school-based survey that uses a standardised methodology for sampling, core questionnaire items, training protocol, field procedures, and data management.This article reports the findings from a GYTS conducted in Montenegro in 2008, which included 5723 adolescents. More than 30 % of students aged 13 to 15 tried smoking, 5.1 % smoked cigarettes, and 3.6 % of students used tobacco products other than cigarettes. Four in 10 ever smokers started to smoke before the age of 10. More than half the students reported secondary smoke exposure at home. Almost all (96.5 %) current smokers bought cigarettes in a store. Two in 10 students owned an artifact with a cigarette or tobacco brand logo on it.The GYTS study has shown that there is an urgent need to introduce effective child-oriented smoking prevention programmes in early elementary school classes. These should be accompanied by public awareness campaigns on smoke-free homes.
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30
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Wong DCN, Chan SSC, Ho SY, Fong DYT, Lam TH. Predictors of intention to quit smoking in Hong Kong secondary school children. J Public Health (Oxf) 2009; 32:360-71. [PMID: 20038546 DOI: 10.1093/pubmed/fdp125] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Behavioral theories suggest that a past quit attempt influences psycho-social determinants to predict smokers' intention to quit, although no study has tested the hypothesis among youth smokers. METHODS A sample of 1561 Chinese secondary students, who were current smokers, were collected in a cross-sectional school-based survey in Hong Kong. RESULTS For the 943 students with past quit attempts, those with lower daily cigarette consumption; who perceived smoking would not elicit positive social responses from others; who had one parent/teacher who prohibited them to smoke; who were aware of the health hazards of smoking and being male smokers, were more likely to have an intention to quit smoking. For the 618 students without a past quit attempt, those who did not perceive any benefit from smoking; who had parents and teachers to prohibit them to smoke and who received social support to quit, were more likely to have an intention to quit smoking. CONCLUSION Strengthening the prohibition of smoking and providing social support may help initiate the intention to quit among youth smokers without a past quit attempt, while de-normalizing social images of smoking, providing information about the health hazards of smoking and relieving nicotine addiction may sustain quitting intentions among youth smokers with past quit attempts.
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Affiliation(s)
- David C N Wong
- Department of Nursing Studies, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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31
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Chan SSC, Wong DCN, Fong DYT, Leung AYM, Mak YW, Lam DOB, Lam TH. Short-term impact of new smoke-free legislation on the utilization of a quitline in Hong Kong. Nicotine Tob Res 2009; 11:356-61. [PMID: 19366984 DOI: 10.1093/ntr/ntp025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION New smoke-free legislation implemented in Hong Kong on 1 January 2007, prohibited smoking in the vast majority of indoor workplaces and public places. Experiences of western countries indicated that the need for smoking cessation services would increase after enactment of the smoke-free legislation, but no systematic study of this issue has been undertaken in Southeast Asia. The present study aimed to examine the impact of smoke-free legislation in promoting smoking cessation through a local quitline. METHODS The present study reports the results of a telephone survey using interrupted time-series analysis. We operated a toll-free smoking cessation hotline (quitline) for the general public from August 2005 to September 2007. The present study measured the percent change in the number of telephone calls received and handled before and after the smoke-free legislation. RESULTS We evaluated the quitline for 9-month periods before (January-September 2006) and after (January-September 2007) the smoke-free legislation was implemented. The call rate in the initial period was 27.6 per month compared with 34.9 per month after enactment of the legislation, a 26% increase. Based on interrupted time-series models, the initial impact of the smoke-free legislation was to increase the number of telephone calls received and handled per week (p < .001), but the impact was temporal and deteriorated within 6 months. DISCUSSION Implementation of the new smoke-free legislation had a short-term effect in promoting the utilization of a smoking cessation quitline in Hong Kong. A systematic and long-term tobacco control campaign should be combined with smoke-free legislation to promote and sustain smokers' interests in smoking cessation.
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Affiliation(s)
- Sophia S C Chan
- Department of Nursing Studies, University of Hong Kong, 4/F M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
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Rachiotis G, Muula AS, Rudatsikira E, Siziya S, Kyrlesi A, Gourgoulianis K, Hadjichristodoulou C. Factors associated with adolescent cigarette smoking in Greece: results from a cross sectional study (GYTS Study). BMC Public Health 2008; 8:313. [PMID: 18793389 PMCID: PMC2561036 DOI: 10.1186/1471-2458-8-313] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 09/15/2008] [Indexed: 11/28/2022] Open
Abstract
Background Data about the predictors of smoking among adolescents in Greece are sparse. We tried to identify factors associated with current cigarette smoking among in-school adolescents in Greece in the context of GYTS study. Methods A secondary analysis of data from a questionnaire study using the Global Youth Tobacco Survey methodology was conducted to identify factors associated with smoking among adolescents in Greece. Data were collected in 2004–2005. The outcome variable was cigarette smoking within the past 30 days preceding the survey while independent variables included age, gender, parental educational status, parental smoking, perception of harmfulness of smoking, and the amount of pocket money at the adolescent's disposal. Results 6141 adolescents (51.5% males and 48.5% females) participated in the study. In multivariate analysis, cigarette smoking was associated with male gender (OR: 1.62; 95% CI: 1, 08–3.08), parental smoking (OR: 2.59; 95% CI: 1.45–5.89), and having pocket money ≥ 16 Euros (OR: 2.64; 95% CI: 1.19–5.98). Conclusion Male gender, parental smoking, and having pocket-money ≥ 16 Euros were independently associated with current smoking among Greek students. These findings could be taken into account in order to formulate a comprehensive anti-smoking strategy in Greece.
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Affiliation(s)
- George Rachiotis
- Department of Hygiene and Epidemiology, School of Medicine, University of Thessaly, Greece.
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