1
|
Psychological distress and smoking behaviors of Chinese college students: mediating effects of the dimensions of learning burnout. BMC Psychol 2022; 10:125. [PMID: 35590430 PMCID: PMC9118698 DOI: 10.1186/s40359-022-00840-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/12/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Smokers or never smokers exposed to environmental tobacco use are usually associated with various diseases and cancers. In order to better help college students prevent the tobacco use and thus lower the incidence of avoidable diseases, this study explored the predictive power of different variables including demographic and psychological variables in relation to smoking behaviors. Methods Maslach Burnout Inventory-Student Survey and Kessler Psychological Distress Scale (K10) were used in this study. Results There were 1449 college students participating in the study with 1340 pieces of valid data left, the effective ratio was 92.48%. The valid data included 37.1% male and 62.9% female aged 18.83 on average with 1.55 standard deviation. The multivariate logistic regression indicated that college students who were male (versus female, OR = 9.55), majoring in medicine and sports (versus nursing, ORmedicine = 2.19, ORsports = 2.81), born in the non-singleton family (versus singleton family, OR = 0.63) with higher family income (versus lower family income, OR = 0.45), surrounded with smoking friends (versus without smoking friends, OR = 0.18), were more vulnerable to smoke. In addition, combined with the theory of planned behavior, the dimensions of learning burnout had full mediation effects between psychological distress and smoking behavior. Conclusions Psychological distress can only indirectly affect smoking behavior via learning efficacy, cynicism and emotional exhaustion. Adjustments from different dimensions of learning burnout such as avoiding cynicism about learning, enhancing learning efficacy and emotion exhaustion will help college students better prevent the tobacco use.
Collapse
|
2
|
Zhang S, Ding Q, Shen J, Qu H, Meng X. A 28-Day Challenge to Help Quit Smoking Using Telephone Follow-Ups Combined With the WeChat App: The Impact of the Humanistic Approach on Smoking Cessation. J Addict Nurs 2021; 32:211-215. [PMID: 34473451 PMCID: PMC8410085 DOI: 10.1097/jan.0000000000000420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The study aims to assess the effectiveness of telephone follow-ups combined with a smartphone app (e.g., WeChat [Tencent], which is one of the most widely used communication apps in China), as a smoking cessation intervention. Social volunteers were recruited on March 1, 2017, and randomized to supervision groups with five participants in each group. Every day, the specialists shared some information related to smoking cessation including the videos, songs, and scientific knowledge in WeChat groups and conducted telephone follow-ups on the third, fifth, seventh, ninth, 12th, 17th, 22nd, 27th, and 30th day in March and on April 1. Ultimately, a comparison was made of the self-reported smoking abstinence and self-reported average number of cigarettes smoked between the participants. One hundred ten volunteers participated in the study, with 105 who completed follow-up. Self-reported smoking abstinence in the past 7 days occurred in 65.7% of the participants (n = 69) compared with 34.3% (n = 36) in whom smoking abstinence did not occur. The mean age of those who failed was 40.15 years (range: 22–70 years), and 55.5% (n = 20) attributed their failure to personal reasons. However, the self-reported average number of cigarettes smoked every day was less than that before the study (on average, 10.34 ± 8.17 per day), and this difference was statistically significant (95% CI [8.312, 12.364], p < .01). It was effective to deliver a telephone follow-up combined with a smartphone app follow-up as an intervention for smoking cessation.
Collapse
|
3
|
Qiu D, Chen T, Liu T, Song F. Smoking cessation and related factors in middle-aged and older Chinese adults: Evidence from a longitudinal study. PLoS One 2020; 15:e0240806. [PMID: 33057395 PMCID: PMC7561122 DOI: 10.1371/journal.pone.0240806] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 10/02/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES There are more than 300 million smokers in China. This study aimed to evaluate the rate of smoking cessation, smoking relapse and related factors in middle-aged and older smokers in China. METHODS We performed a secondary analysis of data from China Health and Retirement Longitudinal Study (CHARLS) that recruited a nationally representative sample of adults aged 45 and older. Participants were 3708 smokers in 2011 who completed two waves of follow-up interviews in 2013 and 2015. Self-reported quit and relapse rates at follow-ups were estimated. Multiple logistic regressions were conducted to identify factors associated with smoking cessation and relapse. RESULTS The overall quit rate was 8.5% (95% CI 7.7% - 9.5%) at the 2-year follow-up in 2013, and 16.6% (95% CI 15.5% - 17.9%) at the 4-year follow up. Smoking cessation in 2013 was associated with not living in the northeast region (p = 0.003), fewer cigarettes smoked daily (p <0.001), and longer time to the first cigarette in the morning (p<0.001). Smoking cessation in 2015 was associated with older age (p = 0.049), smoking initiation at age ≥20 years (p<0.001), longer time to the first cigarette in the morning (p<0.001), and self-perceived poor health (p<0.001). Of the 317 participants who stopped smoking in 2013, 13.3% (95% CI 9.9% - 17.5%) relapsed by 2015. Smoking relapse was associated with younger age (p = 0.025), shorter time to the first cigarette in the morning (p = 0.003), and self-perception of not poor health (p = 0.018). CONCLUSION The overall quit rate was 8.5% at the 2-year follow up, and 16.6% at the 4-year follow up in the middle-aged and older smokers, but 13% of quitters returned to smoking in two years. Successful smoking cessation was associated with older age, lower nicotine dependence, and self-perceived poor health.
Collapse
Affiliation(s)
- Dechao Qiu
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
| | - Ting Chen
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
| | - Taiyi Liu
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
| | - Fujian Song
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom
| |
Collapse
|
4
|
Xia H, Du X, Yin G, Zhang Y, Li X, Cai J, Huang X, Ning Y, Soares JC, Wu F, Zhang XY. Effects of smoking on cognition and BDNF levels in a male Chinese population: relationship with BDNF Val66Met polymorphism. Sci Rep 2019; 9:217. [PMID: 30659208 PMCID: PMC6338731 DOI: 10.1038/s41598-018-36419-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/14/2018] [Indexed: 01/17/2023] Open
Abstract
Recent studies demonstrate that brain-derived neurotrophic factor (BDNF) might be associated with nicotine addiction, and circulating BDNF is a biomarker of memory and general cognitive function. Moreover, studies suggest that a functional polymorphism of the BDNF Val66Met may mediate hippocampal-dependent cognitive functions. We aimed to explore the relationships between smoking, cognitive performance and BDNF in a normal Chinese Han population. We recruited 628 male healthy subjects, inducing 322 smokers and 306 nonsmokers, and genotyped them the BDNF Val66Met polymorphism. Of these, we assessed 114 smokers and 98 nonsmokers on the repeatable battery for the assessment of neuropsychological status (RBANS), and 103 smokers and 89 nonsmokers on serum BDNF levels. Smokers scored lower than the nonsmokers on RBANS total score (p = 0.002), immediate memory (p = 0.003) and delayed memory (p = 0.021). BDNF levels among the smokers who were Val allele carriers were correlated with the degree of cognitive impairments, especially attention, as well as with the carbon monoxide concentrations. Our findings suggest that smoking is associated with cognitive impairment in a male Chinese Han population. The association between higher BDNF levels and cognitive impairment, mainly attention in smokers appears to be dependent on the BDNF Val66Met polymorphism.
Collapse
Affiliation(s)
- Haisen Xia
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Guangzhong Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Yingyang Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Xiaosi Li
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Junyi Cai
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xingbing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
| | - Xiang Yang Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
5
|
Peng P, Li M, Liu H, Tian YR, Chu SL, Van Halm-Lutterodt N, Jing B, Jiang T. Brain Structure Alterations in Respect to Tobacco Consumption and Nicotine Dependence: A Comparative Voxel-Based Morphometry Study. Front Neuroanat 2018; 12:43. [PMID: 29881337 PMCID: PMC5978277 DOI: 10.3389/fnana.2018.00043] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/08/2018] [Indexed: 01/02/2023] Open
Abstract
The main purpose of this study is to examine the lifetime tobacco consumption and the degree of nicotine dependence related gray matter (GM) and white matter (WM) volume alterations in young adult-male smokers. Fifty-three long-term male smokers and 53 well-matched male healthy non-smokers participated in the study, and the smokers were respectively categorized into light and heavy tobacco consumption subgroups by pack-years and into moderate and severe nicotine dependence subgroups using the Fagerström Test for Nicotine Dependence (FTND). Voxel-based morphometry analysis was then performed, and ANCOVA analysis combined with subsequent post hoc test were used to explore the between-group brain volume abnormalities related to the smoking amount and nicotine dependence. Light and heavy smokers displayed smaller GM and WM volumes than non-smokers, while heavy smokers were found with more significant brain atrophy than light smokers in GM areas of precuneus, inferior and middle frontal gyrus, superior temporal gyrus, cerebellum anterior lobe and insula, and in WM areas of cerebellum anterior lobe. However, the contrary trend was observed regarding alterations associated with severity of nicotine dependence. Severe nicotine dependence smokers rather demonstrated less atrophy levels compared to moderate nicotine dependence smokers, especially in GM areas of precuneus, superior and middle temporal gyrus, middle occipital gyrus, posterior cingulate and insula, and in WM areas of precuneus, posterior cingulate, cerebellum anterior lobe and midbrain. The results reveal that the nicotine dependence displays a dissimilar effect on the brain volume in comparison to the cigarette consumption. Our study could provide new evidences to understand the adverse effects of smoking on the brain structure, which is helpful for further treatment of smokers.
Collapse
Affiliation(s)
- Peng Peng
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Min Li
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Han Liu
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Ya-Ru Tian
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Shui-Lian Chu
- Clinical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Nicholas Van Halm-Lutterodt
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Orthopaedics and Neurosurgery, Keck Medical Center of USC, University of Southern California, Los Angeles, CA, United States
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Tao Jiang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Wang Q, Shen JJ, Sotero M, Li CA, Hou Z. Income, occupation and education: Are they related to smoking behaviors in China? PLoS One 2018; 13:e0192571. [PMID: 29420649 PMCID: PMC5805321 DOI: 10.1371/journal.pone.0192571] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 01/25/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association between socioeconomic status (SES) and smoking behaviors may differ across countries. This study aimed to estimate the association between socioeconomic status (income, occupation and education) and multiple measures of smoking behaviors among the Chinese elderly population. METHODS Using data from the China Health and Retirement Longitudinal Study in 2013, we examined the relationship between socioeconomic status and smoking behaviors through multivariate regression analysis. Sample selection models were applied to correct for sample selection bias. Smoking behaviors were measured by four indicators: smoking status, cigarette consumption, health risks related to smoking, and smoking dependence. Analyses were stratified by gender and urban-rural residence. RESULTS Among Chinese people aged 45 years or older, smokers accounted for 40% of the population in 2013, smoking 19 cigarettes per day. It was also found that 79% of smokers were at an increased health risk. Overall, although the influence of income on smoking behaviors was small and even insignificant, occupation and education levels were significantly associated with smoking behaviors. Managers or professionals were more likely to smoke, however there was no significant relationship with smoking dependence. Individuals with higher educational attainment were less likely to be associated with smoking behaviors. In addition, gender and urban-rural differences existed in the relationship between SES and smoking behaviors. CONCLUSIONS Smoking disparities among diverse levels of socioeconomic status existed but varied greatly by SES indicators and population characteristics. Tobacco control policies in China should be increasingly focused on populations with low socioeconomic status in order to break the link between socioeconomic disadvantage and smoking behaviors. Further actions should mitigate inequalities in education, improve the social culture of cigarette use, and tailor interventions based on characteristics of the population.
Collapse
Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin, Liaoning, China
| | - Jay J. Shen
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Michelle Sotero
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Casey A. Li
- Green Valley High School, Henderson, Nevada, United States of America
| | - Zhiyuan Hou
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
- National Key Laboratory of Health Technology Assessment (Health and Family Planning Commission), Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| |
Collapse
|
7
|
Perceived stress and smoking across 41 countries: A global perspective across Europe, Africa, Asia and the Americas. Sci Rep 2017; 7:7597. [PMID: 28790418 PMCID: PMC5548752 DOI: 10.1038/s41598-017-07579-w] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/11/2017] [Indexed: 12/13/2022] Open
Abstract
Within recent years, there has been a seismic shift in smoking rates from high-income to low- and middle-income countries (LMICs). Evidence indicates that perceived stress may comprise a barrier for smoking cessation, but little is known about the association of perceived stress and smoking in LMICs. We conducted a cross-sectional, community-based study comprising 217,561 people [mean age 38.5 (SD = 16.1) years, 49.4% males]. A perceived stress score [range 2 (lowest-stress) 10 (highest-stress)] was computed from the Perceived Stress Scale. Multivariable logistic regression analyses were conducted. In the overall sample, a one-unit increase in perceived-stress resulted in a 5% increased odds of smoking (OR = 1.05; 95%CI = 1.03–1.06). Increased stress was associated with smoking in Africa (OR = 1.06; 95%CI = 1.04–1.09), Americas (OR = 1.03; 95%CI = 1.01–1.05), and Asia (OR = 1.06; 95%CI = 1.04–1.08), but not Europe (OR = 0.99; 95%CI = 0.95–1.02). Increasing levels of perceived stress were significantly associated with heavy smoking (≥30 cigarettes per day) among daily smokers (OR = 1.08; 95%CI = 1.02–1.15). A country-wide meta-analysis showed that perceived stress is associated with daily smoking in most countries. Prospective studies are warranted to confirm/refute this relationship, which may have meaningful public health implications.
Collapse
|
8
|
Yang L, Liu Y, Wang J, Jia C. Prevalence and risk factors associated with hardcore smoking among rural daily male smokers. Am J Addict 2016; 25:628-633. [PMID: 27706867 DOI: 10.1111/ajad.12455] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The existence of smokers who are resistant to smoking cessation interventions has attracted considerable interest in recent years. Given the paucity of data on that topic in rural China, we aimed to assess the prevalence and risk factors of hardcore smoking in rural China. METHODS A cross-sectional study was conducted in 14 villages in Shandong, China. A total of 1,287 male daily smokers were face-to-face interviewed. A multiple logistic regression model was used to explore the associations of demographics, environment, knowledge and attitudes about smoking, and smoking behavior characteristics with hardcore smoking among daily male smokers. A general dominance analysis model was used to access the relative contribution of the determinants that were identified in the multiple logistic regression. RESULTS Hardcore smokers constituted 32.9% (n = 423) of daily male smokers. Five determinants for hardcore smoking were identified in the multiple logistic regression. Dominance analysis showed higher level of smoking intensity was the most important determinant of hardcore smoking, followed by being a farmer, starting to smoke daily under the age of 20, younger age, having fewer smokers around. DISCUSSION AND CONCLUSIONS This study suggests that hardcore smokers account for a substantial proportion of daily male smokers and are distinct from other groups of daily smokers. SCIENTIFIC SIGNIFICANCE Specifically tailored tobacco-control efforts should be made to address the issues incurred by hardcore smokers. (Am J Addict 2016;25:628-633).
Collapse
Affiliation(s)
- Lei Yang
- Department of Epidemiology, Shandong University, Jinan, Shandong, China
| | - Yanxun Liu
- Department of Biostatistics, Shandong University, Jinan, Shandong, China
| | - Jian Wang
- Center for Health Management and Policy, Shandong University, Jinan, Shandong, China
| | - Chongqi Jia
- Department of Epidemiology, Shandong University, Jinan, Shandong, China
| |
Collapse
|
9
|
Associations of cytochrome P450 oxidoreductase genetic polymorphisms with smoking cessation in a Chinese population. Hum Genet 2016; 135:1389-1397. [DOI: 10.1007/s00439-016-1728-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 09/11/2016] [Indexed: 12/28/2022]
|
10
|
Xu Y, Chen X. Protection motivation theory and cigarette smoking among vocational high school students in China: a cusp catastrophe modeling analysis. Glob Health Res Policy 2016; 1:3. [PMID: 29202053 PMCID: PMC5675066 DOI: 10.1186/s41256-016-0004-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 05/21/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Tobacco use is one of the greatest public health problems worldwide and the hazards of cigarette smoking to public health call for better recognition of cigarette smoking behaviors to guide evidence-based policy. Protection motivation theory (PMT) provides a conceptual framework to investigate tobacco use. Evidence from diverse sources implies that the dynamics of smoking behavior may be quantum in nature, consisting of an intuition and an analytical process, challenging the traditional linear continuous analytical approach. In this study, we used cusp catastrophe, a nonlinear analytical approach to test the dual-process hypothesis of cigarette smoking. METHODS Data were collected from a random sample of vocational high school students in China (n = 528). The multivariate stochastic cusp modeling was used and executed with the Cusp Package in R. The PMT-based Threat Appraisal and Coping Appraisal were used as the two control variables and the frequency of cigarette smoking (daily, weekly, occasional, and never) in the past month was used as the outcome variable. RESULTS Consistent with PMT, the Threat Appraisal (asymmetry, α1 = 0.1987, p < 0.001) and Coping Appraisal (bifurcation, β2 = 0.1760, p < 0.05) significantly predicted the smoking behavior after controlling for covariates. Furthermore, the cusp model performed better than the alternative linear and logistic regression models with regard to higher R2 (0.82 for cusp, but 0.21 for linear and 0.25 for logistic) and smaller AIC and BIC. CONCLUSION Study findings support the conclusion that cigarette smoking in adolescents is a quantum process and PMT is relevant to guide studies to understand smoking behavior for smoking prevention and cessation.
Collapse
Affiliation(s)
- Yunan Xu
- University of Florida, Gainesville, Florida USA
| | - Xinguang Chen
- University of Florida, Gainesville, Florida USA
- Wuhan University Global Health Institute, Wuhan, China
- Wuhan Center for Disease Prevention and Control, Wuhan, China
| |
Collapse
|
11
|
Wu L, He Y, Jiang B, Zuo F, Liu Q, Zhang L, Zhou C, Liu M, Chen H, Cheng KK, Chan SSC, Lam TH. Effectiveness of additional follow-up telephone counseling in a smoking cessation clinic in Beijing and predictors of quitting among Chinese male smokers. BMC Public Health 2016; 16:63. [PMID: 26801402 PMCID: PMC4722719 DOI: 10.1186/s12889-016-2718-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 01/08/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND No previous studies have investigated whether additional telephone follow-up counseling sessions after face-to-face counseling can increase quitting in China, and whether this strategy is feasible and effective for promoting smoking cessation is still unclear. METHODS A non-randomized controlled study was conducted in Beijing. We compared the quit rates of one group which received face-to-face counseling (FC) alone (one session of 40 min) to another group which received the same face-to-face counseling plus four follow-up sessions of brief telephone counseling (15-20 min each) at 1 week, 1, 3 and 6 month follow-up (FCF). No smoking cessation medication was provided. From October 2008 to August 2013, Chinese male smokers who sought treatment in a part-time regular smoking cessation clinic of a large general hospital in Beijing were invited to participate in the present study. Eligible male smokers (n = 547) were divided into two groups: FC (n = 149) and FCF (n = 398). Main outcomes were self-reported 7-day point prevalence and 6 month continuous quit rates at 12 month follow-up. RESULTS By intention to treat, at 12 month follow-up, the 7-day point prevalence and 6 month continuous quit rates of FC and FCF were 14.8 % and 26.4 %, and 10.7 % and 19.6 % respectively. The adjusted odds ratios (95 % confidence intervals) of quitting in FCF compared to FC was 2.34 (1.34-4.10) (P = 0.003) and 2.41 (1.28-4.52) (P = 0.006), respectively. Stepwise logistic regression showed that FCF, being married, unemployed and a lower Fagerström score were significant independent predictors of 6 month continuous quitting at 12 month follow-up. CONCLUSIONS Using systematically collected data from real-world practice, our smoking cessation clinic has shown that the additional telephone follow-up counseling sessions doubled the quit rate.
Collapse
Affiliation(s)
- Lei Wu
- Department of Epidemiology, Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Institute of Geriatrics, 28 Fuxing Road, Beijing, 100853 China
| | - Yao He
- Department of Epidemiology, Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Institute of Geriatrics, 28 Fuxing Road, Beijing, 100853 China
- State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Bin Jiang
- Nanlou Faculty of Clinical Medicine, Department of Acupuncture, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Fang Zuo
- Nanlou Faculty of Clinical Medicine, Department of Acupuncture, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Qinghui Liu
- Nanlou Faculty of Clinical Medicine, Department of Respiration, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Li Zhang
- Nanlou Faculty of Clinical Medicine, Department of Rehabilitation, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Changxi Zhou
- Nanlou Faculty of Clinical Medicine, Department of Respiration, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Miao Liu
- Department of Epidemiology, Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Institute of Geriatrics, 28 Fuxing Road, Beijing, 100853 China
| | - Hongyan Chen
- Department of Epidemiology, Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Institute of Geriatrics, 28 Fuxing Road, Beijing, 100853 China
| | - KK Cheng
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | | | - Tai Hing Lam
- Department of Community Medicine and School of Public Health, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
12
|
Wang Y, Chen X, Gong J, Yan Y. Relationships Between Stress, Negative Emotions, Resilience, and Smoking: Testing a Moderated Mediation Model. Subst Use Misuse 2016; 51:427-38. [PMID: 26894428 PMCID: PMC4855524 DOI: 10.3109/10826084.2015.1110176] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE More effective tobacco prevention and cessation programs require in-depth understanding of the mechanism by which multiple factors interact with each other to affect smoking behaviors. Stress has long been recognized as a risk factor for smoking. However, the underlying mediation and moderation mechanisms are far from clear. The purpose of this study was to examine the role of negative emotions in mediating the link between stress and smoking and whether this indirect link was modified by resilience. METHODS Survey data were collected using audio computer-assisted self-interview (ACASI) from a large random sample of urban residents (n = 1249, mean age = 35.1, 45.3% male) in Wuhan, China. Perceived stress, negative emotions (anxiety, depression), resilience were measured with reliable instruments also validated in China. Self-reported smoking was validated with exhaled carbon monoxide. RESULTS Mediation analysis indicated that two negative emotions fully mediated the link between stress and intensity of smoking (assessed by number of cigarettes smoked per day, effect =.082 for anxiety and.083 for depression) and nicotine dependence (assessed by DSM-IV standard, effect =.134 for anxiety and.207 for depression). Moderated mediation analysis demonstrated that the mediation effects of negative emotions were negatively associated with resilience. CONCLUSIONS Results suggest resilience interacts with stress and negative emotions to affect the risk of tobacco use and nicotine dependence among Chinese adults. Further research with longitudinal data is needed to verify the findings of this study and to estimate the effect size of resilience in tobacco intervention and cessation programs.
Collapse
Affiliation(s)
- Yan Wang
- a Department of Epidemiology , University of Florida , Gainesville , Florida , USA
| | - Xinguang Chen
- a Department of Epidemiology , University of Florida , Gainesville , Florida , USA
| | | | | |
Collapse
|
13
|
Cai L, Cui W, You D, He J, Zhao K. Socioeconomic variations in nicotine dependence in rural southwest China. BMC Public Health 2015; 15:1158. [PMID: 26597724 PMCID: PMC4657195 DOI: 10.1186/s12889-015-2492-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/16/2015] [Indexed: 11/16/2022] Open
Abstract
Background This study examines how nicotine dependence is distributed across socioeconomic gradients in rural Yunnan province, which has the most ethnic minorities in one province in southwest China. Methods A cross-sectional survey was conducted in four rural areas of Yunnan province among 17,158 consenting individuals aged ≥18 years in 2011. Information on demographic characteristics and smoking habits was obtained using a standard questionnaire. The Fagerstrom Test for Nicotine Dependence (FTND) was applied to assess nicotine dependence. Multilevel logistic regression was used to model the variation in prevalence of nicotine dependence. Results In the study population, the overall prevalence of current smokers and nicotine dependence was 32.4 % and 31.6 %, respectively. Females were much less likely to have nicotine addiction than males: odds ratio (OR) of 0.01 (95 % CI: 0.008 – 0.012). Higher annual household income was associated with a greater risk of nicotine dependence (OR 1.09, 95 % CI: 1.01 – 1.17). Adults who grew tobacco were more likely to have nicotine addiction (OR 1.22, 95 % CI 1.07 – 1.41). Individual educational level was inversely associated with the probability of nicotine dependence (OR 0.63, 95 % CI 0.55 – 0.72), lower community educational level was also associated with an increased risk of nicotine dependence (OR 0.94, 95 % CI 0.92 – 0.98). Conclusions Nicotine dependence showed significant variations across different indicators of both contextual and individual socioeconomic status in rural southwest China. Future interventions on tobacco cessation should give increased attention to men, tobacco farmers, less educated or poorer persons, and lower educational level communities.
Collapse
Affiliation(s)
- Le Cai
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.
| | - Wenlong Cui
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| | - Dingyun You
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| | - Jianhui He
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| | - Keying Zhao
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| |
Collapse
|
14
|
Taylor G, McNeill A, Aveyard P. Does deterioration in mental health after smoking cessation predict relapse to smoking? BMC Public Health 2015; 15:1150. [PMID: 26589146 PMCID: PMC4654809 DOI: 10.1186/s12889-015-2473-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is possible that some people who quit smoking experience improved mental health after cessation and therefore remain abstinent, whereas other people who quit may experience worse mental health after cessation and therefore be more likely to relapse to smoking. Thus, in this study we aimed to examine the association between an enduring change in mental health following the cessation period and future risk of relapse. METHODS A secondary analysis of prospective data pooled from five placebo-controlled randomised trials for smoking reduction conducted in Europe, USA and Australia. Change in mental health (SF-36, scored 0-100) was measured from baseline to four months for those who were biologically-validated as point-prevalence abstainers at four month follow-up. Thereafter we assessed whether relapse to smoking by 12 months was more likely in those whose mental health had worsened between baseline and four months compared with those who saw no change or an improvement. RESULTS After adjustment for baseline mental health and other major covariates, there was no greater tendency to relapse at 12 months for those whose mental health worsened after cessation compared with those who had no change or an improvement. The odds ratio and 95% confidence interval was 1.01 (0.97 to 1.05). CONCLUSIONS People whose mental health worsens after smoking cessation are at no greater risk of subsequent relapse to smoking than those whose mental health stays the same or improves.
Collapse
Affiliation(s)
- Gemma Taylor
- UK Centre for Tobacco and Alcohol Studies, School of Health and Population, Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, King's College London, London, SE5 8AF, UK.
| | - Paul Aveyard
- UK Centre for Tobacco and Alcohol Studies, Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, OX1 2ET, UK.
| |
Collapse
|
15
|
The impact of regional economic reliance on the tobacco industry on current smoking in China. Health Place 2015; 33:159-71. [DOI: 10.1016/j.healthplace.2014.12.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/18/2014] [Accepted: 12/24/2014] [Indexed: 11/23/2022]
|
16
|
The Relationship between Nicotine Dependence and Age among Current Smokers. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:495-500. [PMID: 26056668 PMCID: PMC4441962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/25/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND A recent study indicates that the incidence of smoking cessation varies with age. Although nicotine dependence (ND) has been regarded as one of the most significant barriers of successful smoking cessation, few researches have focused on the relationship between nicotine dependence and age. METHODS A cross-sectional study (conducted in 2013) with 596 Chinese rural male current smokers was performed to study the relationship between ND and age. The ND level was assessed using the Fagerström Test for Nicotine Dependence (FTND) scale. The univariate two-degree fractional polynomials (FPs) regression was used to explore the relation of ND to age. RESULTS The mean of FTND scores in the middle-aged group (45-64 yr old) was higher than that in the younger (<45 yr old) and older groups (≥65 yr old). The FPs regression showed an inverse U-shaped relationship between ND and age. CONCLUSION The middle-aged current smokers had higher degree of ND than the younger and the older groups, which showed an inverse U-shaped relationship between ND and age. This finding needs to be confirmed by further researches.
Collapse
|
17
|
Lin W, Sloan F. Risk perceptions and smoking decisions of adult Chinese men. JOURNAL OF HEALTH ECONOMICS 2015; 39:60-73. [PMID: 25485692 DOI: 10.1016/j.jhealeco.2014.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/13/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
This study analyzes effects of changes in risk perceptions of smoking's health harms on actual and attempted quits and quitting intentions of male smokers in China. Our survey of 5000+ male smokers was conducted two years after their neighbor's lung cancer diagnosis. We use proximity to a lung cancer neighbor as an exogenous determinant of individual's smoking risk perception. We show that learning of a neighbor's lung cancer diagnosis substantially affects smokers' subjective beliefs about smoking's harms, which in turn affects decisions about continued smoking and intentions to quit. Our study findings offer important public policy implications in indicating the importance of designing health-warning messages that fit smokers' personal circumstances as opposed to warnings solely based on edicts from scientific experts and/or epidemiological evidence.
Collapse
Affiliation(s)
- Wanchuan Lin
- Department of Applied Economics, Guanghua School of Management, Peking University, Hall 2, Beijing 100871, China.
| | - Frank Sloan
- Department of Economics, Duke University and National Bureau of Economic Research, 213 Social Sciences Building, Campus Box 90097, Durham, NC 27708, United States.
| |
Collapse
|
18
|
Bernstein MH, Colby SM, Bidwell LC, Kahler CW, Leventhal AM. Hostility and cigarette use: a comparison between smokers and nonsmokers in a matched sample of adolescents. Nicotine Tob Res 2014; 16:1085-93. [PMID: 24692670 DOI: 10.1093/ntr/ntu033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION We examined the association between hostility-a personality trait reflective of negativity and cynicism toward others-and smoking in adolescents by measuring (a) several subcomponents of hostility, and (b) facial emotion processing ability, which has been previously linked to hostility. METHODS Participants (N = 241 aged 14-19) were 95 smokers and 95 demographically matched nonsmokers as well as 51 nonmatched smokers. All participants completed the Cook-Medley (C-M) hostility scale, which provides a general hostility score and 3 component scores (cynicism, hypersensitivity, and aggressive responding), and a facial emotion processing task. This task, designed to assess emotion recognition, requires quickly identifying the emotion of faces that gradually morph from neutral to high-intensity happy, angry, or fearful. RESULTS Independent sample t tests indicated that matched smokers scored significantly higher in cynicism and aggressive responding than nonsmokers. Among smokers, age of smoking onset was negatively correlated with general hostility and aggressive responding. All hostility scales were positively correlated with the intensity needed to recognize happy faces. Counterintuitively, smokers required a greater intensity to recognize angry faces than nonsmokers. No other relations between hostility/smoking status and facial emotion processing were observed. CONCLUSIONS Aspects of hostility, particularly aggressive responding, may be a risk factor for early onset smoking. Although hostile participants exhibited a deficiency in their ability to recognize happiness in facial pictures, these results did not translate to differences in smoking status. This study elucidates some of the complex interrelations between hostility, emotion processing, and adolescent smoking, which may have implications for teen smoking prevention.
Collapse
Affiliation(s)
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI
| | - L Cinnamon Bidwell
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, and Department of Behavioral and Social Sciences, Brown University, Providence, RI
| | - Adam M Leventhal
- Department of Preventive Medicine and Department of Psychology, University of Southern California, Los Angeles, CA
| |
Collapse
|
19
|
Zhu C, Cai Y, Ma J, Li N, Zhu J, He Y, Redmon P, Qiao Y. Predictors of intention to smoke among junior high school students in Shanghai, China: an empirical test of the information-motivation-behavioral skills (IMB) model. PLoS One 2013; 8:e80482. [PMID: 24244690 PMCID: PMC3828279 DOI: 10.1371/journal.pone.0080482] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/12/2013] [Indexed: 11/30/2022] Open
Abstract
Background Adolescent smoking is a worldwide problem that is particularly severe in low- and middle-income countries. Many endogenous and environmental factors affect the intention to smoke, so a comprehensive model is needed to understand the significance and relationship of predictors. The study aimed to test the associations among information-motivation-behavioral skills (IMB) model constructs as predictors of intention to smoke in junior high school students in Shanghai, China. Methods We conducted a cross-sectional study of 16,500 junior high school students in Shanghai, China. Data on tobacco-related information, motivation, behavioral skills, and behaviors were collected from students. Structural equation model (SEM) was used to assess the IMB model. Results The mean age of participants was 13.8 years old (standard deviation = 1.02; range 11–17). The experimental smoking rate among junior high school students was 6.6% and 8.7% of the participants expected that they would be smokers in 5 years. The IMB model provided acceptable fit to the data (comparative fit index = 0.984, root mean square error of approximation = 0.04). Intention to smoke was predicted by behavioral skills (β= 0.670, P < 0.001) and motivation (β= 0.095, P<0.001) among junior high school students. Conclusion The IMB model provides a good understanding of the predictors of intention to smoke and it suggests future interventions among junior high school students should focus on improving motivation and behavioral skills.
Collapse
Affiliation(s)
- Chendi Zhu
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Yong Cai
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
- * E-mail: (YC); (JM)
| | - Jin Ma
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
- * E-mail: (YC); (JM)
| | - Na Li
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Jingfen Zhu
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Yaping He
- School of Public Health, Shanghai JiaoTong University, Shanghai, PR China
| | - Pamela Redmon
- Global Health Institute, Emory University, Atlanta, Georgia, United States of America
| | - Yun Qiao
- Pudong Institute for Health Development, Shanghai, PR China
| |
Collapse
|