Assessment of successful smoking cessation by psychological factors using the Bayesian network approach

Nicotine dependence, perceived stress, and self-efficacy among primary health care professionals during the times of Covid-19 pandemic – A cross-sectional descriptive study

Background:

Nicotine dependency would have increased during the times of COVID-19 among the primary health professionals, which would can be attributed to perceived stress and can also be influenced by self-efficacy; hence, the aim of the present study was to determine the relationship between nicotine dependence with perceived stress, self-efficacy among primary health care professionals during the times of covid-19 pandemic.

Materials and Methods:

The present study was a cross-sectional descriptive questionnaire study. The study was conducted among primary health workers of Ajmer district; stratified random sampling technique was used to collect data. A questionnaire was prepared that consists of demographic details, questions on perceived stress, self-efficacy, and nicotine dependence.

Results:

Perceived stress and nicotine dependence was high among study participants. Self-efficacy was low. There was significant (P ≤ 0.05) association between high nicotine dependence and high perceived stress. It was also reported that majority of study participants {58 (30.4%)} with high self-efficacy significantly (P ≤ 0.05) was associated with low nicotine dependence.

Conclusion:

High nicotine dependence was significantly associated with high perceived stress, while low nicotine dependence was significantly lower among primary health care workers’ low perceived stress. Low nicotine dependence was significantly associated among study participants with high self-efficacy.

Relationships among smoking abstinence self-efficacy, trait coping style and nicotine dependence of smokers in Beijing

INTRODUCTION

Psychological, physiological and social factors play an important role in the initiation, persistence, dependence and relapse of smoking behaviors, and coping style and smoking abstinence self-efficacy can all affect nicotine dependence.

METHODS

A cross-sectional sample of 568 quitters from 19 communities in Beijing in 2019 was surveyed. Demographic information and psychological characteristics of smokers were collected by an interview questionnaire, and psychological traits scales including the Smoking Abstinence Self-Efficacy (SASE) and the Trait Coping Style Questionnaire (TCSQ). We compared differences in psychological traits across demographic information and explored the relationship between nicotine dependence and coping styles and self-efficacy in refusing to smoke.

RESULTS

Significant differences were identified in self-efficacy in refusing to smoke and across dimensions among quitters by gender, job type, education level, and monthly income level (all p<0.05). Males had lower self-efficacy in the habitual/addictive context than females; retirees had better overall self-efficacy and self-efficacy in the negative/emotional context than business service workers and professionals; and high-educated, high-income quitters had lower self-efficacy in the negative/emotional context. There are significant differences in positive coping styles among quitters of different ages, levels of education, and types of work (all p<0.05). The results further showed that the underage population, highly educated population, and practitioners other than those in retirement, are less likely to use positive coping styles. Interventional effects analysis showed that a higher sense of self-efficacy in addictive contexts can counteract some of the negative coping styles that induce smoking.

CONCLUSIONS

Self-efficacy played an indirect mediating role between negative coping style and nicotine dependence; individuals who used more negative coping styles were more likely to engage in smoking and therefore were more nicotine dependent. Hence, it is necessary to reduce the use of negative coping strategies and improve the self-efficacy of smoking abstinence in the face of addiction.

Exposure to tobacco smoke and stillbirth: a national prospective cohort study in rural China

INTRODUCTION

Parental exposure to tobacco smoke has been associated with an increased risk of stillbirth, while only a few studies took the overall parental tobacco exposure status into consideration. We aim to explore the relationship of parental smoking and passive smoking before and during pregnancy with stillbirth in a large Chinese rural cohort.

DESIGN

248 501 couples were enrolled in a national prospective cohort study conducted in rural China. Parental exposure to tobacco smoke before and during pregnancy, along with other risk factors, was ascertained by questionnaires. Pregnancy outcomes were recorded by physicians.

RESULTS

The ORs (Odds Ratios) of maternal active smoking, maternal passive smoking, paternal active smoking and paternal passive smoking were 2.07 (95% CI 1.25 to 3.41), 1.22 (95% CI 1.01 to 1.47), 1.36 (95% CI 1.13 to 1.63) and 1.10 (95% CI 0.87 to 1.39), respectively. The rates of stillbirth increased from 0.31% for the maternal non-smoking group to 0.43% for the smoking cessation during pregnancy group, to 0.64% for the decreased smoking group and 1.28% for the continuing smoking group. A similar pattern was found in the change in paternal smoking status and stillbirth. Stratified by maternal passive smoking, the OR of paternal smoking was 1.35 (95% CI 1.13 to 1.61) in the maternal non-smoking group and 1.67 (95% CI 1.09 to 2.56) in the maternal passive smoking group.

CONCLUSIONS

Parental exposure to tobacco smoke increased the risk of stillbirth, especially for those continuing smoking during pregnancy. Paternal smoking is an independent risk factor for stillbirth despite maternal passive smoking status.

Risk factors of stillbirth in rural China: A national cohort study

People living in rural China are more frequently exposed to some specific risk factors which made stillbirth rate higher than urban areas. National Free Preconception Health Examination Project was launched to investigate these risk factors and collected a representative sample of 248501 participants from 31 provinces in China from 2010 to 2013. Parental risk factors were ascertained twice before and during pregnancy respectively by questionnaires. Stillbirth or live birth were recorded by trained physicians. In the analysis, nested case-control study was conducted, and propensity score matching method was used to adjust the confounding. Multi-level logistic regression was used to fit for multi-level sampling. The overall stillbirth rate was 0.35% in rural China, it was higher in North (0.42%) and West (0.64%) areas. Maternal exposure to pesticide (OR (95%CI 1.06, 3.39)), hypertension (OR = 1.58 (95%CI 1.07, 2.34)), lack of appetite for vegetables (OR = 1.99 (95%CI 1.00, 3.93)), stress (compared with no pressure, OR of a little pressure was 1.34(95% CI 1.02, 1.76)); paternal exposure to smoking (OR = 1.22 (95% CI 1.02, 1.46)), organic solvents (OR = 1.64 (95% CI 1.01, 2.69)) were found independent risk factors of stillbirth. Folacin intake 3 months before pregnancy (OR = 0.72 (95%) CI 0.59, 0.89), folacin intake 1-2 months before pregnancy (OR = 0.71 (95% CI 0.55, 0.92)), folacin intake after pregnancy (OR = 0.81 (95% CI 0.65, 1.02) for) were protect factors of stillbirth. Maternal pesticide exposure, lack of vegetables, stress, paternal smoking and exposure to organic solvents were risk factors of stillbirth. Folic acid intake was protective factor of stillbirth, no matter when the intake began.

The Influence of Recognition and Social Support on European Health Professionals' Occupational Stress: A Demands-Control-Social Support-Recognition Bayesian Network Model

Healthcare professionals undergo high levels of occupational stress as a result of their working conditions. Thus, the aim of this study is to develop a model that focuses on healthcare professionals so as to analyze the influence that job demands, control, social support, and recognition have on the likelihood that a worker will experience stress. The data collected correspond to 2,211 healthcare workers from 35 countries, as reported in the sixth European Working Condition Survey (EWCS). The results obtained from this study allow us to infer stress under several working condition scenarios and to identify the more relevant variables in order to reduce this stress in healthcare professionals, which is of paramount importance to managing the stress of workers in this sector. The Bayesian network proposed indicates that emotional demands have a greater influence on raising the likelihood of stress due to workload than do family demands. The results show that the support of colleagues, in general, has less effect on reducing stress than social support from superiors. Furthermore, the sensitivity analysis shows that, in high-demand and low-control situations, recognition clearly impacts stress, drastically reducing it.

Evaluation of smoking cessation intervention in patients with chronic diseases in smoking cessation clinics

This study aimed to evaluate the effects of psychological intervention and psychological plus drug intervention on smoking cessation among male smokers with single chronic diseases.A total of 509 male smokers were divided into psychological group (n = 290) and psychological plus drugs (n = 219) groups according to their will. The physicians provided free individual counseling and follow-up interviews with brief counseling for all the subjects. In addition to mental intervention, patients in psychological plus drug group also received bupropion hydrochloride or varenicline tartrate to quit smoking. Outcomes were self-reported, regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1-, 3-, and 6-month follow-up period. Data analyses were performed using intention-to-treat analysis and per protocol analysis.With regards to the 3 follow-up time points, 7-day point-prevalence abstinence rate in psychological plus drugs group was all higher than that in the psychological intervention group. Additionally, the 3-month continuous abstinence rate (21.4%) of the 6-month follow-up in the psychological group was not significantly higher than that (26.9%) in the psychological plus drugs group (P >.05 for all). Fagerström test score, stage of quitting smoking, perceived confidence or difficulty in quitting, and chronic disease types were independently correlated with 3-month continuous abstinence in the 6-month follow up (P <.05 for all). The results were similar between intentional analysis and protocol analysis.The psychological intervention and psychological plus drugs intervention exerted good effects on smoking cessation in a short time (1 month). Nevertheless, the advantages did not appear during long-time (6 months) follow-up.