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Zhang D, Chen WJ, Meng XX, Zhao X, Liu RH, Tian HY. Breaking down barriers: rationalisations and motivation to stop among Chinese male smokers under cigarette dependence. BMC Public Health 2024; 24:1812. [PMID: 38972984 PMCID: PMC11229221 DOI: 10.1186/s12889-024-19295-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/27/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND Smoking rationalisation beliefs are a huge barrier to quitting smoking. What types of rationalisations should be emphasised in smoking cessation interventions? Although past literature has confirmed the negative relationship between those beliefs and motivation to stop smoking, little is known regarding the importance and performance of those beliefs on motivation with varying cigarette dependence. The study aimed to ascertain rationalisations that are highly important for motivation yet perform poorly in different cigarette dependence groups. METHODS The cross-sectional study was conducted from November 19 to December 9, 2023 in Guiyang City, China. Adult male current smokers were enrolled. Partial least squares structural equation modelling was used to test the hypothesis. The multi-group analysis was used to determine the moderating effect of cigarette dependence, and the importance-performance map analysis was utilised to assess the importance and performance of rationalisations. RESULTS A total of 616 adult male current smokers were analysed, and they were divided into the low cigarette dependence group (n = 297) and the high cigarette dependence group (n = 319). Except for risk generalisation beliefs, smoking functional beliefs (H1: -β = 0.131, P < 0.01), social acceptability beliefs (H3: β = -0.258, P < 0.001), safe smoking beliefs (H4: β = -0.078, P < 0.05), self-exempting beliefs (H5: β = -0.244, P < 0.001), and quitting is harmful beliefs (H6: β = -0.148, P < 0.01) all had a significant positive influence on motivation. Cigarette dependence moderated the correlation between rationalisations and motivation. In the high-dependence group, the social acceptability beliefs and smoking functional beliefs were located in the "Concentrate Here" area. In the low-dependence group, the social acceptability beliefs were also situated in there. CONCLUSIONS Social acceptability beliefs and smoking functional beliefs showed great potential and value for improvement among high-dependence smokers, while only social acceptability beliefs had great potential and value for improvement among low-dependence smokers. Addressing these beliefs will be helpful for smoking cessation. The multi-group analysis and the importance-performance map analysis technique have practical implications and can be expanded to other domains of health education and intervention practice.
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Affiliation(s)
- Dan Zhang
- School of Medicine and Health Management, Guizhou Medical University, No. 6 Ankang Avenue, Guiyang City, 561113, China
- Guizhou Institute of Health Development, Guizhou Medical University, Guiyang, China
| | - Wen-Jiao Chen
- School of Medicine and Health Management, Guizhou Medical University, No. 6 Ankang Avenue, Guiyang City, 561113, China
- School of Sociology, Guizhou Minzu University, Guiyang, China
| | - Xiao-Xia Meng
- School of Medicine and Health Management, Guizhou Medical University, No. 6 Ankang Avenue, Guiyang City, 561113, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China
| | - Xiong Zhao
- School of Medicine and Health Management, Guizhou Medical University, No. 6 Ankang Avenue, Guiyang City, 561113, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China
| | - Run-Hua Liu
- School of Medicine and Health Management, Guizhou Medical University, No. 6 Ankang Avenue, Guiyang City, 561113, China.
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China.
| | - Hai-Yu Tian
- School of Medicine and Health Management, Guizhou Medical University, No. 6 Ankang Avenue, Guiyang City, 561113, China.
- One Health Institute, Guizhou Medical University, Guiyang, China.
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Zhang Z, Huang M, Chen T. Probability and predictors of long-term smoking relapse among Chinese adult smokers: A longitudinal study. Prev Med Rep 2023; 36:102482. [PMID: 37920593 PMCID: PMC10618515 DOI: 10.1016/j.pmedr.2023.102482] [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: 07/17/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
Numerous smokers attempt to quit smoking, but most cessation efforts prove unsuccessful. Scarce evidence exists regarding predictors of long-term relapse in China. This study aims to evaluate the probability of relapse and examine factors may contribute to relapse among Chinese adults. A dynamic cohort of 6,036 observations on 2,378 adult quitters was constructed from the China Family Panel Studies in 2010, 2012, 2014, 2016 and 2018. The life table method was employed to calculate the probability of relapse for long-term smoking abstinence. Multivariate complementary log-log survival models were developed to examine the predictors of smoking relapse. We found that the probability of relapse decreased as the duration of abstinence increased, with rates of 49.07 %, 20.05 %, 10.29 %, and 6.63 % at 2, 4, 6, and 8 years of abstinence, respectively. The cumulative probability of relapse within 8 years was 65.89 %. Age ≥65 years, higher educational attainment, respiratory disease, and a satisfying lifestyle were associated with a reduced likelihood of relapse. Conversely, higher occupational prestige, alcohol drinking, cohabitant smoking, and greater future confidence were associated with an increased risk of relapse. These findings demonstrated that the probability of relapse decreased progressively over time, with most relapses occurring in the initial two years following quit attempts. Predictors of Chinese quitters' relapse behavior in our study were similar to those in previous studies. Drinking and cohabitant smoking were identified as strong predictors of relapse in this population.
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Affiliation(s)
| | | | - Ting Chen
- School of Public Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
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Sun S, Yu H, Ling J, Yao D, Chen H, Liu G. The influence of health literacy and knowledge about smoking hazards on the intention to quit smoking and its intensity: an empirical study based on the data of China's health literacy investigation. BMC Public Health 2023; 23:2355. [PMID: 38017398 PMCID: PMC10685583 DOI: 10.1186/s12889-023-17292-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE This study explored the relationship between smokers' health literacy, knowledge of smoking hazards, and their intention to quit. METHODS Based on data from the 2019 Health Literacy and Tobacco Use Surveillance among residents of a city in Zhejiang Province, 1120 male smokers were screened. Differential tests were used to analyze whether smokers with varying levels of health literacy and knowledge about smoking hazards differed in their intention to quit smoking and the intensity of their intention. A multi-factor logistic regression model was constructed to explore the extent of these differences. RESULTS Only 24.8% of smokers had higher health literacy. Among smokers, those with an intention to quit had a higher health literacy level compared to those without such intention (32.7% vs. 17.0%, p < 0.001). Health literacy levels did not differ significantly between groups with different intensity of intention to quit (34.2% vs. 31.9% vs. 30.1%, p = 0.435). About 48.7% of the smokers a higher level of knowledge about smoking hazards. It was more prevalent in the intent to quit group compared to the no intent to quit group (54.0% vs. 43.4%, p < 0.001), and the low intent to quit group had lower knowledge compared to the moderate and high intent to quit groups (49.1% vs. 56.6% vs. 63.4%, p = 0.011). After adjusting for other influences, smokers with lower health literacy were less likely to have intention to quit (OR = 0.659, p = 0.016). And the association between knowledge about smoking hazards and whether smokers have the intention to quit is no longer significant, but it significantly affects the intensity of the intention to quit among smokers who already have the intention (OR = 0.623, p = 0.005). CONCLUSION General health literacy may play a role in facilitating smokers' progression from the stage of no intent to quit to one of intent to quit, but a more specific understanding of the harms of smoking may be needed to increase the strength of intent to quit.
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Affiliation(s)
- Siwen Sun
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huifang Yu
- Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang, China
| | - Jie Ling
- Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang, China
| | - Dingming Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Haixiao Chen
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
| | - Guilin Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Zhu L, Qiu Y, Zhong R, Xie J, Hu Y, Yu X, Chang X, Wang W, Zhang L, Chen O, Cao H, Zhu H, Zou Y. Baseline characteristics and the factors influencing successful smoking cessation: A comparison between a WeChat smoking cessation mini-program and an offline smoking cessation clinic. Tob Induc Dis 2023; 21:154. [PMID: 38026499 PMCID: PMC10664087 DOI: 10.18332/tid/174491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Smoking cessation (SC) clinics are a professional SC services in China. However, studies comparing the characteristics and SC rates of smoking populations in SC clinics with those using mobile SC programs are limited. We compared smokers' characteristics, 3-month SC rates, and the factors influencing 3-month SC success, between a large hospital SC clinic and a WeChat SC mini-program. METHODS Between January and November 2021, 384 participants voluntarily enrolled in either the hospital SC clinic (Group A: n=243) or the WeChat SC mini-program (Group B: n=141). Both groups underwent a 3-month SC intervention, and their SC status was monitored at 24 hours, 1 week, 1 month, and 3 months after quitting. SC rate was defined as the self-reported rate of continuous SC. RESULTS The 3-month SC rate was higher in Group A (42.4%) than in Group B (24.8%). Participants with middle school education had a lower likelihood of SC success than those with primary school or lower (p=0.014). Employees in the enterprise/business/services industries were more likely to have SC success than farmers (p=0.013). Participants with SC difficulty scores of 0-60 were more successful than those with scores >60 (p=0.001, p=0.000, respectively). Participants who quit smoking due to their illness, or other reasons, had a higher likelihood of SC success than those who quit due to concerns about their own and their family's health (p=0.006, p=0.098, respectively). While the likelihood of SC success was lower in those who quit because of the influence of their environment than in those who quit due to concerns about their own and their family's health (p=0.057). CONCLUSIONS Both SC clinics and WeChat SC mini-programs achieved satisfactory SC rates. The high accessibility of mobile SC platforms, which save time spent on transportation and medical visits, renders them worth promoting and publicizing as additional SC options for smokers, particularly young smokers.
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Affiliation(s)
- Lei Zhu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yanfang Qiu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Rui Zhong
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jianghua Xie
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Xiangya Hospital, Central South University, Changsha, China
| | - Yina Hu
- School of Nursing and Health Management, Wuhan Donghu University, Wuhan, China
| | - Xinhua Yu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiaochang Chang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Wei Wang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Lemeng Zhang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ouying Chen
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Hui Cao
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Haidong Zhu
- Hunan Yixuan Technology Co., LTD, Changsha, China
| | - Yanhui Zou
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Nguyen TNP, Love J, Hunsberger M, Tran TPT, Nguyen TL, Phan TH, Luong NK, Hoang VM, Ng N. Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study. BMC Public Health 2023; 23:1883. [PMID: 37770890 PMCID: PMC10540420 DOI: 10.1186/s12889-023-16781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Nearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam. METHODS We established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors. RESULTS At follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage. CONCLUSIONS Interventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers' beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers' intention to quit.
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Affiliation(s)
- Thi Ngoc Phuong Nguyen
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden.
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Jesper Love
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Monica Hunsberger
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Thi Phuong Thao Tran
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | | | | | | | - Van Minh Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nawi Ng
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umea University, Umea, Sweden
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Lin B, Nan Y, Xie X, Yang Y, Xie H, Yan Y, Zhang L, Xiao L, Xiong J. Assessing the Effectiveness of a Community-Based Smoking Cessation Intervention - Shenzhen City, Guangdong Province, China, 2022. China CDC Wkly 2023; 5:619-624. [PMID: 37520446 PMCID: PMC10372410 DOI: 10.46234/ccdcw2023.100] [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: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
What is already known about this topic? Research on community-based smoking cessation interventions in China is still in its early stages. Most existing studies have focused on a limited number of communities and have primarily examined interventions conducted by study teams rather than broader community initiatives. What is added by this report? The three-month continuous abstinence rate for the intervention group (21.61%) was significantly higher than that for the control group (8.98%). Comprehensive community-based smoking cessation interventions, administered by trained physicians at community health service centers and supported by community workers, have shown effectiveness in improving a variety of outcomes among community smokers. What are the implications for public health practice? The feasibility and effectiveness of comprehensive community-based smoking cessation interventions make them a valuable addition to existing cessation services in China. Wider implementation of these interventions should be pursued as a complementary approach to current efforts to reduce smoking rates in China.
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Affiliation(s)
- Bingliang Lin
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Nan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoyun Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Yang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiyu Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yongfu Yan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luge Zhang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jingfan Xiong
- Shenzhen Center for Chronic Disease Control, Shenzhen City, Guangdong Province, China
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Lin B, Xie L, Xie X, Yan Y, Zhang L, Xiao L. Predictors for quitting smoking in smoking cessation clinics among female smokers in China. Tob Induc Dis 2023; 21:26. [PMID: 36819959 PMCID: PMC9936604 DOI: 10.18332/tid/159132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/26/2022] [Accepted: 01/09/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION The number of cessation clinics in China have been increasing ever since the Chinese government supported the establishment of smoking cessation clinics (SCCs) in each province in 2014. Many studies have examined smoking cessation behaviors among male smokers, but few of female smokers. This study aimed to understand female smokers' quitting behaviors in SCCs and identify predictors of successful cessation. METHODS This study used data of the SCCs Platform in China from 2018 to 2020. The self-reported 7-day point prevalence of abstinence rate (PPAR) at 1 month and at 3 months follow-up and the continuous abstinence rate (CAR) at 3 months follow-up are reported based on smokers' characteristics and intention to treat analysis. A multiple logistic regression model was used to identify predictors of continuous abstinence at 3 months follow-up. RESULTS The 7-day PPAR of female outpatients in SCCs was 29.20% at 1 month follow-up and 28.36% at 3 months follow-up. The CAR at 3 months follow-up was 19.88%. Female smokers who were prepared to quit within 7 days (AOR=2.86; 95% CI: 1.53-5.32), today (AOR=4.01; 95% CI: 2.35-6.85), had started to quit (AOR=7.11; 95% CI: 4.12-12.27), and used a combination of counseling and drugs (AOR=2.41; 95% CI: 1.73-3.35) were more likely to quit smoking. Associated with lower quitting rates were: living in the central region of China (AOR=0.47; 95% CI: 0.31-0.73) and the west region (AOR=0.48; 95% CI: 0.31-0.73); being aged 30-39 years (AOR=0.39; 95% CI: 0.23-0.64), and 40-49 years (AOR=0.41; 95% CI:0.24-0.69); being unemployed (AOR=0.64; 95% CI: 0.45-0.91); having a fair perceived health status at the first visit (AOR=0.65; 95% CI: 0.47-0.91) and a poor one (AOR=0.37; 95% CI: 0.21-0.64); having a moderate nicotine dependence (AOR=0.64; 95% CI: 0.44-0.92) and a severe one (AOR=0.50; 95% CI: 0.34-0.72). CONCLUSIONS In our study, the region of residence, age, employment, perceived health status, Fagerström test for nicotine dependence (FTND), readiness to quit, and intervention model were independent predictors of quitting for female smokers. Improving the motivation to quit, providing intensive psychological interventions and equipping SCCs with cessation medication would assist female smokers to quit.
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Affiliation(s)
- Bingliang Lin
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Li Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Xiaoyun Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Yongfu Yan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Luge Zhang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
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Xie JH, Qiu YF, Zhu L, Hu Y, Chang X, Wang W, Zhang LM, Chen OY, Zhong X, Yu X, Zou Y, Zhong R. Evaluation of the smoking cessation effects of QuitAction, a smartphone WeChat platform. Tob Induc Dis 2023; 21:49. [PMID: 37057059 PMCID: PMC10088363 DOI: 10.18332/tid/161257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/06/2023] [Accepted: 02/14/2023] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION Many smokers in China desire to quit, though the success rate among adults is low. This study evaluated the effects of QuitAction, a WeChat smoking cessation platform, summarized the intervention experience of the smoking cessation platform, identified aspects of the platform that necessitated improvement, and provided references for further optimization of the smoking cessation platform. METHODS This single-arm study was conducted in Hunan, China, from September 2020 to October 2021. Regular smokers, who were aged ≥15 years and willing to quit smoking using QuitAction, were recruited. An in-application questionnaire evaluated participants' baseline smoking status and intention to quit smoking. The QuitAction program included questionnaires regarding the participants' ongoing smoking cessation status at 24 hours, one week, one month and three months after quitting. The smoking cessation procedure was discontinued if the participant had no intention of continuing. The smoking cessation rate, influencing success factors, frequency of use satisfaction, and helpfulness of QuitAction were recorded. RESULTS A total of 303 participants registered and logged into the QuitAction program, including 59 with incomplete information and 64 with no intention of quitting. The study finally included 180 participants. The smoking cessation rate was 33.9% at 24 hours, 27.2% at one week, 26.1% at one month, and 25.0% at three months. QuitAction was reported as helpful by 94.9% of participants and 95.7% were satisfied with the program. Participants with a quitting difficulty score of 80-100 were less likely to quit smoking than participants with a difficulty score of 0-60 (OR=0.28; 95% CI: 0.10-0.78; p=0.015). Participants using the platform ≥5 times were more likely to quit smoking than those who used the platform <5 times (OR=3.59; 95% CI: 1.51-8.52; p=0.004). CONCLUSIONS The QuitAction platform provides smoking cessation services that can improve smokers' success rate and improve user experience satisfaction.
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Affiliation(s)
- Jianghua H. Xie
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
- School of Nursing, Hunan University of Chinese Medicine, China
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, China
| | - Yanfang F. Qiu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Lei Zhu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
- School of Nursing, Hunan University of Chinese Medicine, China
| | - Yina Hu
- School of Nursing and Health Management, Wuhan Donghu University, Wuhan, China
| | - Xiaochang Chang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Wei Wang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Lemeng M. Zhang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Ouying Y. Chen
- School of Nursing, Hunan University of Chinese Medicine, China
| | - Xianmin Zhong
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Xinhua Yu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Yanhui Zou
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Rui Zhong
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
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Hasan SI, Kaai SC, Amer Nordin AS, Mohd Hairi F, Danaee M, Yee A, Ahmad Tajuddin NA, Kamaludin IS, Grey M, Yan M, Driezen P, Thompson ME, Quah ACK, Fong GT. Who Are More Likely to Have Quit Intentions among Malaysian Adult Smokers? Findings from the 2020 ITC Malaysia Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3035. [PMID: 35270727 PMCID: PMC8910535 DOI: 10.3390/ijerph19053035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022]
Abstract
Increasing quitting among smokers is essential to reduce the population burden of smoking-related diseases. Smokers' intentions to quit smoking are among the strongest predictors of future quit attempts. It is therefore important to understand factors associated with intentions to quit, and this is particularly important in low- and middle-income countries, where there have been few studies on quit intentions. The present study was conducted to identify factors associated with quit intentions among smokers in Malaysia. Data came from the 2020 International Tobacco Control (ITC) Malaysia Survey, a self-administered online survey of 1047 adult (18+) Malaysian smokers. Smokers who reported that they planned to quit smoking in the next month, within the next six months, or sometime beyond six months were classified as having intentions to quit smoking. Factors associated with quit intentions were examined by using multivariable logistic regression. Most smokers (85.2%) intended to quit smoking. Smokers were more likely to have quit intentions if they were of Malay ethnicity vs. other ethnicities (adjusted odds ratio (AOR) = 1.82, 95% confidence interval (CI) = 1.03-3.20), of moderate (AOR = 2.11, 95% CI = 1.12-3.99) or high level of education vs. low level of education (AOR = 1.97, 95% CI = 1.04-3.75), if they had ever tried to quit smoking vs. no quit attempt (AOR = 8.81, 95% CI = 5.09-15.27), if they received advice to quit from a healthcare provider vs. not receiving any quit advice (AOR = 3.78, 95% CI = 1.62-8.83), and if they reported worrying about future health because of smoking (AOR = 3.11, 95% CI = 1.35-7.15 (a little worried/moderately worried vs. not worried); AOR = 7.35, 95% CI = 2.47-21.83 (very worried vs. not worried)). The factors associated with intentions to quit smoking among Malaysian smokers were consistent with those identified in other countries. A better understanding of the factors influencing intentions to quit can strengthen existing cessation programs and guide the development of more effective smoking-cessation programs in Malaysia.
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Affiliation(s)
- Siti Idayu Hasan
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
| | - Susan C. Kaai
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Mahmoud Danaee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Anne Yee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Ina Sharyn Kamaludin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Matt Grey
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
| | - Mi Yan
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
| | - Pete Driezen
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada;
| | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada
- Ontario Institute for Cancer Research, 661 University Ave., Suite 510, Toronto, ON M5G 0A3, Canada
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Xie J, Zhong R, Zhu L, Chang X, Chen J, Wang W, Zhang L, Chen O, Yu X, Zou Y, Li Y. Smoking cessation rate and factors affecting the success of quitting in a smoking cessation clinic using telephone follow-up. Tob Induc Dis 2022; 19:99. [PMID: 35002594 PMCID: PMC8686120 DOI: 10.18332/tid/143375] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION China has the largest number of smokers in the world. The great majority of China’s smokers desire to quit smoking (QS); however, the success rate of self-quitting is low. This study investigated the effects of smoking cessation (SC) clinics in a cancer hospital in Hunan province and determined the influencing factors of successful SC. METHODS Smokers were recruited to QS by healthcare workers in the SC clinic from February 2015 to February 2019. SC counseling was provided and telephone follow-up was conducted at 1 week, and at 1, 3 and 6 months. Patients who continued SC during the follow-up period were considered to have QS. RESULTS Of the 344 patients included in this study, 16.3% QS at one week, 26.5% at one month, 27.6% at three months, and 31.7% at six months. Age ≥60 years, previous SC attempts, immediate quit dates, and telephone follow-up times (3–4 calls) were predictive factors for smokers to SC at six months. CONCLUSIONS Age, previous attempts to QS, immediate quit dates and telephone follow-up times were independent predictors of SC success at six months. SC clinics and frequent telephone follow-up improve the success rate of SC, especially in patients who have previously tried to QS or in those who set immediate quit dates.
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Affiliation(s)
- Jianghua Xie
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China.,School of Nursing, Hunan University of Chinese Medicine, Changsha City, China
| | - Rui Zhong
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Lei Zhu
- School of Nursing, Hunan University of Chinese Medicine, Changsha City, China
| | - Xiaochang Chang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Jianhua Chen
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Wei Wang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Lemeng Zhang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Ouying Chen
- School of Nursing, Hunan University of Chinese Medicine, Changsha City, China
| | - Xinhua Yu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Yanhui Zou
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Yanqun Li
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha City, China
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11
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Lin H, Chen M, Yun Q, Zhang L, Chang C. Tobacco dependence affects determinants related to quitting intention and behaviour. Sci Rep 2021; 11:20202. [PMID: 34642382 PMCID: PMC8511040 DOI: 10.1038/s41598-021-99766-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022] Open
Abstract
This study uses protection motivation theory (PMT) to examine the quitting intentions and behaviours of smokers who have varying levels of nicotine dependence. Our goals are to identify the psychological factors that influence smoking cessation and to provide valuable evidence to promote theory-guided interventions. This is a cross-sectional study that was conducted from July to August 2020. Participants were randomly selected on the streets of 26 provinces on mainland China. Data were collected via face-to-face interviews. Our analysis was conducted in three steps. First, we employed descriptive statistics to present the overall characteristics of our sample. Second, we analysed the association between PMT constructs and quitting intentions stratified by nicotine dependence. Third, we tested how quitting intentions were associated with quitting behaviours in each subgroup using logistic regression models. For intention, almost all the PMT constructs were significantly associated with quitting intention in the low-dependence group. For the moderate- and high-dependence groups, only perceived vulnerability (coefficient = 0.35, P = 0.04) was positively associated with quitting intention. For behaviour, we found a stronger association between quitting intention and behaviour in the low-dependence group (Coef. = 1.67, P = 0.00) than for the other groups. We found a significant association between e-cigarette use and quitting behaviour only in the low-dependence group (Coef. = 1.34, P = 0.00). Coefficients for the moderate- and high-dependence groups were not statistically significant. Smokers at various levels of nicotine dependence have different psychological factors that influence their intentions to stop smoking. Quitting intention was more significantly associated with quitting behaviour for the low nicotine-dependence group than for the other groups. More convincing research is necessary to determine how e-cigarette use affects quitting behaviour in the long term.
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Affiliation(s)
- Haoxiang Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Meijun Chen
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Qingping Yun
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Lanchao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China.
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12
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Weng X, Wu Y, Luk TT, Li WHC, Cheung DYT, Tong HSC, Lai V, Lam TH, Wang MP. Active referral plus a small financial incentive upon cessation services use on smoking abstinence: a community-based, cluster-randomised controlled trial. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 13:100189. [PMID: 34527982 PMCID: PMC8358160 DOI: 10.1016/j.lanwpc.2021.100189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Many smokers do not use existing free or low-cost smoking cessation services, cost-effective interventions to increase use are needed. METHODS We did a 2-armed cluster randomised controlled trial (cRCT) in Hong Kong, China, to evaluate the effectiveness of active referral plus a small financial incentive on abstinence. Chinese adult smokers who smoked at least 1 cigarette per day were proactively recruited from 70 community sites (clusters). Random allocation was concealed until the recruitment started. The intervention group received an offer of active referral to cessation services at baseline plus an incentive (HK$300/US$38) after using any cessation services within 3 months. The control group received general brief cessation advice. The primary outcomes were biochemically validated abstinence at 3 and 6 months. Operating costs in real-world implementation was calculated. Trial Registry: ClinicalTrials.gov NCT03565796. FINDINGS Between June and September 2018, 1093 participants were randomly assigned to the intervention (n=563) and control (n=530) groups. By intention-to-treat, the intervention group showed higher validated abstinence than the control group at 3 months (8.4% vs. 4.5%, risk ratio [RR] 1.88, 95% CI 1.01-3.51, P=0.046) and 6 months (7.5% vs. 4.5%, RR 1.72, 95% CI 1.01-2.93, P=0.046). Average cost per validated abstinence was lower in the intervention (US$ 421) than control (US$ 548) group. INTERPRETATION This cRCT has first shown that a simple, brief, and low-cost intervention with active referral plus a small monetary incentive was effective in increasing smoking abstinence and smoking cessation service use in community smokers. FUNDING Hong Kong Council on Smoking and Health.
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Affiliation(s)
- Xue Weng
- School of Nursing, the University of Hong Kong, Hong Kong SAR, China
| | - Yongda Wu
- School of Nursing, the University of Hong Kong, Hong Kong SAR, China
| | - Tzu Tsun Luk
- School of Nursing, the University of Hong Kong, Hong Kong SAR, China
| | | | | | | | - Vienna Lai
- Hong Kong Council on Smoking and Health, Hong Kong SAR, China
| | - Tai Hing Lam
- School of Public Health, the University of Hong Kong, Hong Kong SAR, China
| | - Man Ping Wang
- School of Nursing, the University of Hong Kong, Hong Kong SAR, China
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13
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Abstract
OBJECTIVES The time to first cigarette (TTFC) of the day has been identified as the best single-item indicator of nicotine dependence. However, TTFC has not been extensively used in clinical settings and is not a criterion for tobacco use disorder, perhaps due to a lack of information about TTFC's predictive value. This review provides a synthesis of the accumulating literature on TTFC's relationships with nicotine dependence, identify gaps, and inform future clinical and epidemiologic research of potential uses of TTFC. METHODS A systematic review of the literature was conducted using PubMed, Google Scholar, and Web of Science ISI databases. We identified 16 articles examining the relation between TTFC and negative outcomes associated with high levels of nicotine addiction and Tobacco Use Disorders (eg, high levels of nicotine and toxicant exposure, progressive use over time, failed cessation, head-and-neck cancers). RESULTS Earlier TTFC was consistently associated with greater likelihood of cessation failure and relapse, and higher levels of biomarkers of tobacco exposure. Several of these associations were found among both adult and adolescent smokers, and remained even after accounting for smoking behaviors (eg, cigarettes/day). CONCLUSIONS Earlier TTFC is a key indicator of greater nicotine dependence. Knowledge of a smoker's TTFC may allow clinicians to accurately inform smokers of health risks and assign greater resources during cessation attempts. Smokers may be able to use TTFC to self-select cessation aids and accurately assess their unique smoking-related health risks. TTFC may be a better item than cigarettes/day for accurately quantifying dependence and risk in epidemiologic studies.
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14
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Fong GT, Yuan J, Craig LV, Xu SS, Meng G, Quah AC, Seo HG, Lee S, Yoshimi I, Katanoda K, Tabuchi T. Achieving the Goals of Healthy China 2030 Depends on Increasing Smoking Cessation in China: Comparative Findings from the ITC Project in China, Japan, and the Republic of Korea. China CDC Wkly 2021; 3:463-467. [PMID: 34594914 PMCID: PMC8393109 DOI: 10.46234/ccdcw2021.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/22/2021] [Indexed: 12/18/2022] Open
Abstract
Tobacco smoking is the number one preventable cause of disease and death in China as it is globally. Indeed, the toll of smoking in China is much greater than its status as the world's most populous country. There is a persistent and continuing need for China to implement the measures specified in the global tobacco control treaty, the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), which China ratified in 2005. The theme for the 2021 WHO World No Tobacco Day focuses on the need to support smoking cessation. This article presents findings from the International Tobacco Control (ITC) Policy Evaluation Project cohort surveys in China, in comparison to ITC cohort surveys in two neighboring countries: Japan and the Republic of Korea. These findings demonstrate that smokers in China very much want to quit, but these intentions are not being translated into quit attempts, relative to smokers in Japan and the Republic of Korea. Additionally, about 80% of Chinese smokers want the Chinese government to do more to control smoking. These findings reaffirm the need for China to implement strong, evidence-based measures to reduce smoking. The objective of Healthy China 2030 to reduce deaths from non-communicable diseases by 30% can be achieved by reducing smoking prevalence from its current 26.6% to 20%, and this reduction can be achieved through strong implementation of FCTC measures.
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Affiliation(s)
- Geoffrey T. Fong
- University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Jiang Yuan
- Tobacco Control Office, China CDC, Beijing, China
| | | | | | - Gang Meng
- University of Waterloo, Waterloo, Ontario, Canada
| | | | - Hong-Gwan Seo
- Korea National Cancer Center, Seoul, Republic of Korea
| | - Sungkyu Lee
- Korea Center for Tobacco Research and Education, Seoul, Republic of Korea
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15
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Hu Y, Xie J, Chang X, Chen J, Wang W, Zhang L, Zhong R, Chen O, Yu X, Zou Y. Characteristics and Predictors of Abstinence Among Smokers of a Smoking Cessation Clinic in Hunan China. Front Public Health 2021; 9:615817. [PMID: 33816416 PMCID: PMC8017299 DOI: 10.3389/fpubh.2021.615817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background: More than 300 million smokers make China the largest cigarette consumer globally, which is a huge economic burden. Smoking cessation (SC) clinics can offer counseling and follow-up services. The operational experience of SC clinics in China needs to be summarized and improved based on research evidence. Purpose: The objectives of this study were to describe quit rates among attendees of SC clinics in Hunan and assess predictors of successful SC. Methods: The participants in this study were smokers who visited the SC clinic of Hunan Cancer Hospital from February 1, 2015 to September 30, 2018. Individuals who received individual counseling and assessment from the SC clinic staff and were willing to quit smoking were eligible for inclusion. Those with critical illness or cancer were excluded. Application of smoking cessation clinic registration form (unified by Chinese Center for Disease Control and Prevention) was used to assess participants at the consultation. Follow-ups and counseling were performed over telephone at 1 week, 1 month, and 3 months after the initial cessation consultation or in times of need. Successful SC was checked for at 3 months after the start of SC. Results: A total of 328 smokers (mean age 45.67 ± 12.38 years) had participated. The abstinence rate at 3 months was 28.4%. Binary regression analysis revealed significant independent predictors to be the total numbers of SC follow up sessions, previous SC attempts, and participants' decision on when to quit smoking (The relative to quit immediately group, quit within 30 days, quit after 30 days, and undecided quit were less likely to succeed in quitting. while quit within seven days had no statistical significance. Conclusion: SC clinics can achieve a desirably high quit rate. Participant's previous attempts at quitting, three or more follow-ups, and the decision to quit immediately or within seven days were factors helpful in predicting the success of SC.
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Affiliation(s)
- Yina Hu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jianghua Xie
- Hunan University of Chinese Medicine, Changsha, China
| | - Xiaochang Chang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jianhua Chen
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Wei Wang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Lemeng Zhang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Rui Zhong
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ouying Chen
- Hunan University of Chinese Medicine, Changsha, China
| | - Xinhua Yu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yanhui Zou
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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16
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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.
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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
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Weng X, Luk TT, Suen YN, Wu Y, Li HCW, Cheung YTD, Kwong ACS, Lai VWY, Chan SSC, Lam TH, Wang MP. Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster-randomized clinical trial. Addiction 2020; 115:1902-1912. [PMID: 32149425 DOI: 10.1111/add.15029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/06/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Proactive brief cessation advice by a lay counsellor combined with a referral to a smoking cessation service (active referral) is effective in increasing service use and quitting in community smokers. We compared the effect of two modified approaches to referrals on the cessation outcomes in community smokers. DESIGN Three-arm cluster-randomized trial. SETTING General community in Hong Kong. PARTICIPANTS Daily cigarette smokers (n = 1163; 77.7% male). INTERVENTIONS Participants were randomized to receive on-site active referral (OSR, n = 395), where lay counsellors helped participants make appointments with a smoking cessation service of their choice plus tailored reminders; mobile text messaging referral (TMR, n = 385), where participants were encouraged to use a smoking cessation service via text messages; or brief cessation advice only (control, n = 383). MEASUREMENTS The primary outcome was a self-reported 7-day point-prevalence abstinence at 6 months post-treatment initiation. Secondary outcomes included 7-day point-prevalence abstinence at 3 and 18 months, biochemically validated abstinence, smoking reduction and the use of cessation services at 3, 6 and 18 months. FINDINGS Using intention-to-treat analysis, the OSR (17.7%) and TMR (17.1%) groups had significantly higher self-reported abstinence than the control (12.0%) group at 6 months [odds ratio (OR) for OSR versus control = 1.58, 95% confidence interval (CI) = 1.06-2.36; OR for TMR versus control = 1.52, 95% CI = 1.01-2.28; both P < 0.05]. The corresponding validated abstinence rates at 6 months were 7.6, 7.8 and 3.9% (OR for TMR versus control = 2.02, 95% CI = 1.07-3.81; OR for TMR versus control = 2.07, 95% CI = 1.10-3.92; both P < 0.05). Self-reported and validated abstinence were similar at 18 months. OSR groups had higher rates of smoking cessation service use than the control group at all follow-ups (all P < 0.001). The smoking reduction rates were similar in continuing smokers. CONCLUSIONS Simple active referrals (in person or via text messaging) to smoking cessation services increased abstinence rates among smokers in Hong Kong compared with general brief cessation advice. On-site active referral increased the use of smoking cessation services compared with general brief cessation advice.
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Affiliation(s)
- Xue Weng
- School of Nursing, the University of Hong Kong, Pokfulam, Hong Kong
| | - Tzu Tsun Luk
- School of Nursing, the University of Hong Kong, Pokfulam, Hong Kong
| | - Yi Nam Suen
- Department of Psychiatry, the University of Hong Kong, Pokfulam, Hong Kong
| | - Yongda Wu
- School of Nursing, the University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | | | | | - Tai-Hing Lam
- School of Public Health, the University of Hong Kong, Pokfulam, Hong Kong
| | - Man Ping Wang
- School of Nursing, the University of Hong Kong, Pokfulam, Hong Kong
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Girvalaki C, Filippidis FT, Kyriakos CN, Driezen P, Herbeć A, Mons U, Papadakis S, Mechili EA, Katsaounou PA, Przewoźniak K, Fernández E, Trofor AC, Demjén T, Fong GT, Vardavas CI. Perceptions, Predictors of and Motivation for Quitting among Smokers from Six European Countries from 2016 to 2018: Findings from EUREST-PLUS ITC Europe Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6263. [PMID: 32872132 PMCID: PMC7504326 DOI: 10.3390/ijerph17176263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/23/2022]
Abstract
The European Tobacco Products Directive (TPD) was introduced in 2016 in an effort to decrease prevalence of smoking and increase cessation in the European Union (EU). This study aimed to explore quitting behaviours, motivation, reasons and perceptions about quitting, as well as predictors (reported before the TPD implementation) associated with post-TPD quit status. A cohort study was conducted involving adult smokers from six EU countries (n = 3195). Data collection occurred pre-(Wave 1; 2016) and post-(Wave 2; 2018) TPD implementation. Bivariate and logistic regression analyses of weighted data were conducted. Within this cohort sample, 415 (13.0%) respondents reported quitting at Wave 2. Predictors of quitting were moderate or high education, fewer cigarettes smoked per day at baseline, a past quit attempt, lower level of perceived addiction, plans for quitting and the presence of a smoking-related comorbidity. Health concerns, price of cigarettes and being a good example for children were among the most important reasons that predicted being a quitter at Wave 2. Our findings show that the factors influencing decisions about quitting may be shared among European countries. European policy and the revised version of TPD could emphasise these factors through health warnings and/or campaigns and other policies.
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Affiliation(s)
- Charis Girvalaki
- Medical School, University of Crete, Heraklion, 71003 Crete, Greece; (C.N.K.); (S.P.); (E.A.M.); (C.I.V.)
- European Network for Smoking and Tobacco Prevention, 1050 Brussels, Belgium
| | - Filippos T. Filippidis
- Department of Primary Care and Public Health, Imperial College, London W6 8RP, UK;
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, 10561 Athens, Greece;
| | - Christina N. Kyriakos
- Medical School, University of Crete, Heraklion, 71003 Crete, Greece; (C.N.K.); (S.P.); (E.A.M.); (C.I.V.)
- European Network for Smoking and Tobacco Prevention, 1050 Brussels, Belgium
| | - Pete Driezen
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Aleksandra Herbeć
- Health Promotion Foundation, 00 764 Warsaw, Poland; (A.H.); (K.P.); (G.T.F.)
- Centre for Behaviour Change, Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
- Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50923 Cologne, Germany
| | - Sophia Papadakis
- Medical School, University of Crete, Heraklion, 71003 Crete, Greece; (C.N.K.); (S.P.); (E.A.M.); (C.I.V.)
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, and Faculty of Medicine, University of Ottawa, Ottawa, ON K1Y 4W7, Canada
| | - Enkeleint A. Mechili
- Medical School, University of Crete, Heraklion, 71003 Crete, Greece; (C.N.K.); (S.P.); (E.A.M.); (C.I.V.)
- European Network for Smoking and Tobacco Prevention, 1050 Brussels, Belgium
- Department of Health Care, Faculty of Public Health, University of Vlora, 9401 Vlora, Albania
| | - Paraskevi A. Katsaounou
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, 10561 Athens, Greece;
- First ICU Evaggelismos Hospital Athens, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Krzysztof Przewoźniak
- Health Promotion Foundation, 00 764 Warsaw, Poland; (A.H.); (K.P.); (G.T.F.)
- Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Collegium Civitas, 00-901 Warsaw, Poland
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), 08908 L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain;
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Catalonia, Spain
- School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, 08908 L’Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER of Respiratory Diseases, CIBERES), 28029 Madrid, Spain
| | - Antigona C. Trofor
- University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, 700115 Iasi, Romania;
- Aer Pur Romania, 052034 Bucharest, Romania
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation, 1044 Budapest, Hungary;
| | - Geoffrey T. Fong
- Health Promotion Foundation, 00 764 Warsaw, Poland; (A.H.); (K.P.); (G.T.F.)
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
| | - Constantine I. Vardavas
- Medical School, University of Crete, Heraklion, 71003 Crete, Greece; (C.N.K.); (S.P.); (E.A.M.); (C.I.V.)
- European Network for Smoking and Tobacco Prevention, 1050 Brussels, Belgium
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Yong HH, Karmakar C, Borland R, Kusmakar S, Fuller-Tyszkiewicz M, Yearwood J. Identifying smoker subgroups with high versus low smoking cessation attempt probability: A decision tree analysis approach. Addict Behav 2020; 103:106258. [PMID: 31884376 DOI: 10.1016/j.addbeh.2019.106258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/28/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Regression-based research has successfully identified independent predictors of smoking cessation, both its initiation and maintenance. However, it is unclear how these various independent predictors interact with each other and conjointly influence smoking behaviour. As a proof-of-concept, this study used decision tree analysis (DTA) to identify the characteristics of smoker subgroups with high versus low smoking cessation initiation probability based on the conjoint effects of four predictor variables, and determine any variations by socio-economic status (SES). METHODS Data come from the Australian arm of the ITC project, a longitudinal cohort study of adult smokers followed up approximately annually. Reported wanting to quit smoking, worries about smoking negative health impact, quitting self-efficacy and quit intentions assessed in 2005 were used as predictors and reported quit attempts at the 2006 follow-up survey were used as the outcome for the initial model calibration and validation analyses (n = 1475), and further cross-validated using the 2012-2013 data (n = 787). RESULTS DTA revealed that while all four predictor variables conjointly contributed to the identification of subgroups with high versus low smoking cessation initiation probability, quit intention was the most important predictor common across all SES strata. The relative importance of the other predictors showed differences by SES. CONCLUSIONS Modifiable characteristics of smoker subgroups associated with making a quit attempt and any variations by SES can be successfully identified using a decision tree analysis approach, to provide insights as to who might benefit from targeted intervention, thus, underscoring the value of this approach to complement the conventional regression-based approach.
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20
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Towards a Tobacco Free Ireland—scaling up and strengthening quit smoking behaviour at population level. Ir J Med Sci 2020; 189:3-10. [DOI: 10.1007/s11845-019-02083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022]
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Casado L, Thrasher JF, Perez C, Santos Thuler LC, Fong GT. Factors associated with quit attempts and smoking cessation in Brazil: findings from the International Tobacco Control Brazil Survey. Public Health 2019; 174:127-133. [PMID: 31362178 DOI: 10.1016/j.puhe.2019.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to identify factors associated with attempting to quit and successful smoking cessation in a population-based sample of Brazilian smokers. STUDY DESIGN This is a prospective cohort study. METHODS Data came from the first two waves of the International Tobacco Control Brazil Survey, conducted in 2009 and 2012/2013 in three cities: Rio de Janeiro, São Paulo, and Porto Alegre. Data were collected from 488 adults (aged ≥18 years) who smoked at Wave 1 and who were resurveyed at Wave 2. Crude and adjusted relative risks for two outcomes (making a quit attempt between Wave 1 and Wave 2 and successfully quitting by Wave 2) were estimated. Multivariable multilevel logistic regression models were used, whereby variables were added to the models in a series of blocks. RESULTS Nearly two-thirds (65.6%) of smokers attempted to quit between waves, and 23.4% had quit at Wave 2. Intention to quit smoking at Wave 1 was the only variable associated with attempt to quit by Wave 2 (odds ratio [OR] = 2.85; 95% confidence interval [CI] 1.64-4.94; P < 0.001). Smokers of higher socio-economic status (OR high versus low = 1.80; 95% CI 1.05-3.10; P = 0.03) and lower nicotine dependence (OR low Heaviness of Smoking Index [HSI] versus high HSI = 1.94; 95% CI 1.10-3.43; P = 0.02) were more likely to successfully quit. The presence of another adult smoker at home was negatively related to successful quitting (OR = 0.50; 95% CI 0.26-0.94; P = 0.03). CONCLUSIONS These results are generally consistent with prior research and have potential to inform governmental interventions to promote tobacco cessation, particularly among disadvantaged groups.
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Affiliation(s)
- L Casado
- Coordenação de Ensino, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
| | - J F Thrasher
- Department of Health Promotion, Education & Behavior, University of South Carolina, Columbia, USA
| | - C Perez
- Fundação do Câncer, Rio de Janeiro, Brazil
| | - L C Santos Thuler
- Divisão de Pesquisa Clínica, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - G T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Wang R, Jiang Y, Yao C, Zhu M, Zhao Q, Huang L, Wang G, Guan Y, Michael E, Zhao G. Prevalence of tobacco related chronic diseases and its role in smoking cessation among smokers in a rural area of Shanghai, China: a cross sectional study. BMC Public Health 2019; 19:753. [PMID: 31196049 PMCID: PMC6567455 DOI: 10.1186/s12889-019-7110-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 06/05/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Tobacco smoking is a recognized risk factor for many chronic diseases and previous study evidences have indicated that smokers receive smoking cessation service after the diagnosis of chronic diseases increases successful rate in quitting. But the prevalence of tobacco related chronic diseases (TCD) among smokers, as well as the role of TCD diagnosis in smoking cessation is still unclear in China. METHODS From June 2016 to December 2017, we sampled 36, 698 residents aged over 18 years by a three stage sampling in Songjiang district, Shanghai. We conducted a cross-sectional study to understand the prevalence of TCD among smokers, and the role of TCD diagnosis in smoking cessation among ex-smokers as well as the smoking cessation attempt among current smokers. RESULTS Over all, the prevalence of current smoking is 19.78% (48.36% for male and 0.22% for female). 15.93% of smokers have stopped smoking successfully (1, 376/8, 636). The prevalence of ten selected TCDs among smokers range from 0.63% (Chronic Obstructive Pulmonary Disease, COPD) to 36.31% (hypertension). All of 1, 376 ex-smokers had at least one kind of TCD, and 52.33% of them stop smoking after the diagnosis of TCD, the time interval between TCD diagnosis and smoking cessation ranges from 0 to 65 years, with a median of 9 years. Smokers with TCD had higher prevalence of quit smoking, and current smokers with TCD had higher smoking cessation attempt proportion. CONCLUSIONS The prevalence of current smoking is still very high among male residents in rural area of Shanghai, and the occurrence of TCD even non-lethal one could provide an opportunity for doctors to assist the smoking cessation among smokers.
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Affiliation(s)
- Ruiping Wang
- YueYang Hospital, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai, 200437 China
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Yonggen Jiang
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Chunxia Yao
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Meiying Zhu
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Qi Zhao
- School of Public Health, Fudan University, Shanghai, China
| | - Limei Huang
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Guimin Wang
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Ying Guan
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | | | - Genming Zhao
- School of Public Health, Fudan University, Shanghai, China
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Huang X, Fu W, Zhang H, Li H, Li X, Yang Y, Wang F, Gao J, Zheng P, Fu H, Chapman S, Ding D. Why are male Chinese smokers unwilling to quit? A multicentre cross-sectional study on smoking rationalisation and intention to quit. BMJ Open 2019; 9:e025285. [PMID: 30782929 PMCID: PMC6368028 DOI: 10.1136/bmjopen-2018-025285] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/29/2018] [Accepted: 12/13/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We aimed to describe the rationalisation beliefs endorsed by Chinese male smokers and to examine the association between rationalisation and the intention to quit. SETTING Questionnaires were conducted among male smokers in three cities (Shanghai, Nanning and Mudanjiang) which represent different geographical locations, economic development levels and legislative status of tobacco control in China. DESIGN AND PARTICIPANTS It was a multicentre cross-sectional survey involved a total of 3710 male smokers over 18 years. OUTCOME MEASURES Primary outcomes were intention to quit, smoking rationalisation scores and sub scores in six dimensions. Smoking rationalisation was assessed using a newly developed Chinese rationalisation scale. Multivariable logistic regression was performed to examine the relationship between rationalisation and intention to quit. RESULTS On average, smokers scored 3.3 out of 5 on the smoking rationalisation scale. With a one point increase in total rationalisation scale, the odds for intention to quit in the next 6 months decreased by 48% (OR=0.52, 95% CI: 0.44 to 0.61; p<0.001). Separate logistic regressions for six subscales of rationalisation shown consistent inverse associations with intention to quit (all p values <0.001). Believing that smoking was socially acceptable was the strongest predictor (OR=0.62, 95% CI: 0.55 to 0.71; p<0.001). CONCLUSIONS Rationalisation beliefs could be important barriers to smoking cessation. Some beliefs have stronger association with quit intention than others. Eroding rationalisation beliefs endorsed by smokers is a potential strategy for smoking cessation intervention.
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Affiliation(s)
- Xinyuan Huang
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Wenjie Fu
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Haiying Zhang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Hong Li
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Xiaoxia Li
- School of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Yong Yang
- School of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Fan Wang
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Junling Gao
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Simon Chapman
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ding Ding
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Jackson SE, Beard E, Michie S, Shahab L, Raupach T, West R, Brown J. Are smokers who are regularly exposed to e-cigarette use by others more or less motivated to stop or to make a quit attempt? A cross-sectional and longitudinal survey. BMC Med 2018; 16:206. [PMID: 30424771 PMCID: PMC6234626 DOI: 10.1186/s12916-018-1195-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/18/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Concerns have been raised that observing other people using e-cigarettes may undermine motivation to quit by renormalising smoking. This study aimed to explore associations between regular exposure to other people's e-cigarette use and motivation to stop smoking and quit attempts in smokers. METHODS Data were from 12,787 smokers in England who participated in the Smoking Toolkit Study between November 2014 and May 2018. At baseline, respondents were asked whether anyone other than themselves regularly used an e-cigarette in their presence, whether they had made a quit attempt in the past year and how motivated they were to stop. Data at 6-month follow-up were available for 1580 respondents, who reported on whether they had attempted to quit in the past 6 months. RESULTS Smokers who reported regular exposure to e-cigarette use by others were more likely than those who did not to have tried to stop smoking in the past year (32.3% vs. 26.8%; unadjusted RR 1.21, 95% CI 1.11-1.31) and have high motivation to quit (16.6% vs. 14.2%; unadjusted RR 1.17, 95% CI 1.05-1.30) but were not significantly more or less likely to make a quit attempt over the subsequent 6 months (34.4% vs. 31.3%; unadjusted RR 1.10, 95% CI 0.88-1.38). In models that adjusted for participants' own current e-cigarette use and unadjusted and adjusted models excluding current e-cigarette users from the sample, there were no significant associations between exposure to e-cigarette use by others and past quit attempts (RR 0.97-1.00), high current motivation to quit (RR 0.97-1.00) or prospective quit attempts (RR 0.94-1.12). In contrast, exposure to use of cigarettes was associated with low motivation to quit even after adjustment (RR 0.89) but not with quit attempts. Participants' own use of e-cigarette was strongly associated with high motivation to quit (RR 1.95) and past quit attempts (RR 2.14) and appeared to account for the bivariate associations with reported exposure to e-cigarettes. CONCLUSION Smokers who report regular exposure to other people using e-cigarettes are more likely to report past quit attempts and high current motivation to quit, but there does not appear to be an independent association with motivation or quit attempts after adjustment for their own current use of e-cigarettes. In contrast, reported exposure to other people using cigarettes was independently and negatively associated with high motivation.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK.
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | - Tobias Raupach
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Department for Cardiology and Pneumology, Göttingen University Medical Centre, Göttingen, Germany
| | - Robert West
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Cho MH, Kim SM, Lee K, Park SM, Chang J, Choi S, Kim K, Koo HY, Jun JH. Factors associated with continued smoking after the diagnosis of type 2 diabetes: a retrospective study in the Korean cohort. BMJ Open 2018; 8:e020160. [PMID: 29961006 PMCID: PMC6042621 DOI: 10.1136/bmjopen-2017-020160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To investigate the factors associated with continued smoking in patients newly diagnosed with type 2 diabetes. DESIGN Retrospective study using the Korean National Health Insurance Service-National Health Screening Cohort (2002-2013) database. PARTICIPANTS Male patients newly diagnosed with type 2 diabetes between 1 January 2004 and 31 December 2011. MEASUREMENT Change in smoking behaviour after the diabetes diagnosis was assessed using a self-reported questionnaire, which was administered before and after the diagnosis. To identify the factors associated with continued smoking after diabetes diagnosis, a multivariate-adjusted logistic regression was conducted using only the variables with statistical significance from the univariate analyses. RESULTS Younger age, lower economic status, heavier smoking habit, lower Charlson Comorbidity Index and comorbid hypertension were identified as factors associated with continued smoking after the diagnosis of type 2 diabetes. Older patients (adjusted OR (aOR) 0.71, 95% CI 0.63 to 0.79) and patients with longer diabetic duration (1-2 years OR 0.88, 95% CI 0.80 to 0.98, ≥3 years OR 0.63, 95% CI 0.55 to 0.73) were more likely to quit smoking. Contrastingly, smokers in the lower economic status (aOR 1.29, 95% CI 1.18 to 1.42) and heavier smoking habit (moderate: aOR 1.53, 95% CI 1.35 to 1.72; heavy: aOR 1.90, 95% CI 1.67 to 2.17) categories were more likely to continue smoking after the diagnosis. CONCLUSIONS It is important to identify the factors associated with smoking behaviour in patients with type 2 diabetes. Recognising the factors that contribute to the vulnerability of patients to continued smoking will be helpful in developing policies and intervention strategies in future. Vulnerable patients may require intensive education and encouragement to quit smoking. We recommend physicians to take a more proactive approach, such as encouraging frequent clinical sessions for behavioural counselling and even early pharmacological interventions, when they encounter patients with the factors outlined in this study.
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Affiliation(s)
- Mi Hee Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Kiheon Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
- Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Hye-Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Ji-Hye Jun
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
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Zhang Q, Yu B, Chen X, Varma DS, Li J, Zhao J, Ruan Y, Han X, Min X, Liu Z. Patterns of smoking initiation during adolescence and young adulthood in South-West China: findings of the National Nutrition and Health Survey (2010-2012). BMJ Open 2018; 8:e019424. [PMID: 29858407 PMCID: PMC5988072 DOI: 10.1136/bmjopen-2017-019424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study aims to understand the age patterns of smoking initiation during adolescence and young adulthood in South-West China, where the prevalence of tobacco use is reported as the highest in the country. DESIGN A cross-sectional study. SETTING The data were derived from the China National Nutrition and Health Survey in Yunnan Province, South-West China (2010-2012). PARTICIPANTS A total of 4801 participants aged 15-65 years were included. PRIMARY OUTCOME MEASURES A survival model was used to estimate the hazard of smoking initiation by age and log-rank test was used to compare the hazard curves across subgroups (men/women, urban/rural, Han Chinese/ethnic minority). RESULTS The prevalence of current smoking among men and women were 60.4% (95% CI 58.2% to 62.6%) and 5.1% (95% CI 4.3% to 5.9%), respectively. Smoking was more prevalent among men and women of lower education and less income, as well as rural and ethnic minority women. Among the current smokers, cigarette (80.7%) was the most commonly used tobacco product, followed by waterpipe (10.8%) and pipe tobacco (8.5%). The hazards of smoking initiation were low for both men and women before the age of 15 years (1% for men and 0.05% for women); and the hazards increased quickly from age 15 years and peaked at 19years (21.5% for men and 1.0% for women). Rural and ethnic minority women were at higher risk of smoking initiation than their counterparts between 15 years and 19 years of age (χ2=44.8, p<0.01; χ2=165.2, p<0.01) and no such difference was found in men. CONCLUSIONS Findings of this study underscore the importance to implement tobacco prevention interventions among older teens and young adults in South-West China, especially for rural and ethnic minority women.
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Affiliation(s)
- Qiang Zhang
- Department of Nutrition and Food Hygiene, Yunnan center for disease control and prevention, Kunming, China
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Bin Yu
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Deepthi S Varma
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Juanjuan Li
- Department of Nutrition and Food Hygiene, Yunnan center for disease control and prevention, Kunming, China
| | - Jiang Zhao
- Department of Nutrition and Food Hygiene, Yunnan center for disease control and prevention, Kunming, China
| | - Yuan Ruan
- Department of Nutrition and Food Hygiene, Yunnan center for disease control and prevention, Kunming, China
| | - Xingmeng Han
- School of Public Health, Kunming Medical University, Kunming, China
| | - Xiangdong Min
- Department of Nutrition and Food Hygiene, Yunnan center for disease control and prevention, Kunming, China
| | - Zhitao Liu
- Department of Nutrition and Food Hygiene, Yunnan center for disease control and prevention, Kunming, China
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Taniguchi C, Tanaka H, Saka H, Oze I, Tachibana K, Nozaki Y, Suzuki Y, Sakakibara H. Changes in self-efficacy associated with success in quitting smoking in participants in Japanese smoking cessation therapy. Int J Nurs Pract 2018; 24:e12647. [DOI: 10.1111/ijn.12647] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 01/22/2018] [Accepted: 02/16/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Chie Taniguchi
- Department of Nursing, Japan and Visiting Scholar, Nagoya Medical Center, Clinical Research Center; Sugiyama Jogakuen University; Nagoya Japan
| | - Hideo Tanaka
- Kishiwada Public Health Center of Osaka Prefecture, Japan and Visiting Scholar, Division of Epidemiology and Prevention; Aichi Cancer Center Research Institute; Nagoya Japan
| | - Hideo Saka
- Department of Respiratory Medicine and Medical Oncology; National Hospital Organization Nagoya Medical Center; Nagoya Japan
| | - Isao Oze
- Division of Molecular & Clinical Epidemiology; Aichi Cancer Center Research Institute; Nagoya Japan
| | - Kazunobu Tachibana
- Department of Education and Training, Department of Respiratory Medicine; National Hospital Organization Kinki-Chuo Chest Medical Center; Sakai Japan
| | - Yasuhiro Nozaki
- Department of Respiratory Medicine; Japan Community Healthcare Organization Chukyo Hospital; Osaka Japan
| | - Yukio Suzuki
- Department of Respiratory Medicine; Kitasato University Kitasato Institute Hospital; Tokyo Japan
| | - Hisataka Sakakibara
- Department of Nursing; Nagoya University Graduate School of Medicine; Nagoya Japan
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28
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Borland R, Li L, Balmford J. The association between the nature of the goal committed to and quitting smoking. HEALTH EDUCATION RESEARCH 2017; 32:546-554. [PMID: 29112754 DOI: 10.1093/her/cyx066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/25/2017] [Indexed: 06/07/2023]
Abstract
Commitments to goals are theorized to affect behavior change outcomes, but competing theories argue for hard to achieve goals and strategic sub-goals as optimum strategies for success. This study aimed to explore whether the nature of the goal affects smoking cessation outcomes. A total of 1043 participants in a randomized controlled trial of variations to an automated computer generated cessation advice program, who had made a quit attempt were asked at 1 month post quit about the initial goal they had set at the time of making the attempt. They were also followed up at 6 months post quit. Compared with those reporting 'seeing how it will go', those who reported the goal of 'taking it a cigarette at a time' were less likely to be quit at 1 month, while those with the most ambitious goal, to 'never smoke again', were more likely to be quit, and were more likely to maintain abstinence for 6 months. Indeed, 'taking it a cigarette at a time' was associated with greater short-term relapse. There is likely to be a benefit in encouraging smokers to set ambitious long-term goals rather than setting intermediate or non-specific goals.
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Affiliation(s)
- Ron Borland
- Nigel Gray Fellowship Group, Cancer Council Victoria, 615 St Kilda Rd, Melbourne 3004, Australia
| | - Lin Li
- Nigel Gray Fellowship Group, Cancer Council Victoria, 615 St Kilda Rd, Melbourne 3004, Australia
| | - James Balmford
- Nigel Gray Fellowship Group, Cancer Council Victoria, 615 St Kilda Rd, Melbourne 3004, Australia
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Ubhi HK, Kotz D, Michie S, van Schayck OCP, West R. A comparison of the characteristics of iOS and Android users of a smoking cessation app. Transl Behav Med 2017; 7:166-171. [PMID: 28168609 PMCID: PMC5526810 DOI: 10.1007/s13142-016-0455-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
iOS and Android smartphone users may differ in ways that affect their use and likelihood of success when using a smoking cessation application (app). If so, it may be necessary to take the device type (iOS and Android) into account when designing smoking cessation apps and in studies evaluating app effectiveness. How do socio-demographic and smoking characteristics, potentially relevant to engagement and cessation outcomes, of the SF28 app users differ between those using the iOS version and those using the Android version? Data were collected between October 2013 and April 2015. The variables measured were age, gender, social grade, time since the most recent quit attempt, choice of medication use (nicotine replacement therapy or varenicline), weekly expenditure on cigarettes, cigarettes smoked per day, reason for using the app and quit date set. The alpha was set to p < 0.006 to adjust for multiple comparisons. A total of 1368 users were included in the analysis. iOS and Android device users were similar in terms of age, social grade, weekly expenditure on cigarettes and cigarettes smoked per day. Compared with Android users, iOS users were more likely to have downloaded the app for a serious quit attempt (74.3 versus 69.6%, p = 0.001), made a quit attempt within the last 12 months (59.6 versus 45.9%, p < 0.001) and set their quit date on the day of registration (61 versus 46.2%, p < 0.001). They were less likely to have used stop-smoking medication to support their quit attempt (31.5 versus 48.6%, p < 0.001). Differences between smokers using the iOS version of smoking cessation apps and those using the Android version may influence quit success.
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Affiliation(s)
- Harveen Kaur Ubhi
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Daniel Kotz
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Susan Michie
- Department of Clinical Effectiveness and Health Psychology, Centre for Outcome Research and Effectiveness, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Onno C P van Schayck
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
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Skov-Ettrup LS, Egan KK, Dalum P, Tolstrup JS. Stress-related expectations about smoking cessation and future quit attempts and abstinence - a prospective study in daily smokers who wish to quit. Prev Med Rep 2017; 6:187-190. [PMID: 28367399 PMCID: PMC5369866 DOI: 10.1016/j.pmedr.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 03/13/2017] [Indexed: 11/23/2022] Open
Abstract
Smokers who wish to quit may refrain from doing so if they expect to experience more stress after haven given up. We test if stress-related expectations about smoking cessation are associated with quit attempts and abstinence among smokers who are motivated to quit. The study included 1809 daily smokers in Denmark in 2011–2013. Stress-related expectations (do you think you will be more, less or equally stressed as a non-smoker?) were measured at baseline. Quit attempts, 30-day point prevalence abstinence and prolonged abstinence (defined as having been abstinent since baseline), were measured after 3, 8 and 14 months. We found that the association between expecting to be more stressed if giving up smoking differed between participants who had previously attempted to quit and those who had not: In participants who previously attempted to quit (47%), expecting to be more stressed was associated with significantly lower odds of abstinence compared to smokers who expected the same or a lower level of stress (odds ratios were 0.49 (95% CI: 0.31–0.79) for 30-day abstinence and was 0.28 (95% CI: 0.08–0.99) for prolonged abstinence). In participants who had not previously attempted to quit, expectations about stress were not associated with abstinence. Results indicate that expectations about stress in relation to smoking cessation are an important determinant of cessation in smokers who previously attempted to quit. Addressing stress and how to handle stressful situations may increase the likelihood of a successful quit attempt.
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Affiliation(s)
| | - Kia Kejlskov Egan
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Peter Dalum
- Department of Cancer Prevention and Information, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Janne Schurmann Tolstrup
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, 1353 Copenhagen, Denmark
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Taniguchi C, Tanaka H, Saka H, Oze I, Tachibana K, Nozaki Y, Suzuki Y, Sakakibara H. Cognitive, behavioural and psychosocial factors associated with successful and maintained quit smoking status among patients who received smoking cessation intervention with nurses’ counselling. J Adv Nurs 2017; 73:1681-1695. [DOI: 10.1111/jan.13258] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Chie Taniguchi
- Department of Nursing; Sugiyama Jogakuen University; Nagoya Japan
- Department of Nursing; Nagoya University Graduate School of Medicine; Nagoya Japan
- Nagoya Medical Center; Clinical Research Center; Nagoya Japan
| | - Hideo Tanaka
- Division of Epidemiology and Prevention; Aichi Cancer Center Research Institute; Nagoya Japan
- Department of Epidemiology; Nagoya University Graduate School of Medicine; Japan
| | - Hideo Saka
- Department of Respiratory Medicine and Medical Oncology; National Hospital Organization Nagoya Medical Center; Nagoya Japan
| | - Isao Oze
- Division of Epidemiology and Prevention; Aichi Cancer Center Research Institute; Nagoya Japan
| | - Kazunobu Tachibana
- Department of Education and Training; Department of Respiratory Medicine; National Hospital Organization Kinki-Chuo Chest Medical Center; Sakai Japan
| | - Yasuhiro Nozaki
- Department of Respiratory Medicine; Japan Community Healthcare Organization Chukyo Hospital; Nagoya Japan
| | - Yukio Suzuki
- Department of Respiratory Medicine; Kitasato University Kitasato Institute Hospital; Tokyo Japan
| | - Hisataka Sakakibara
- Department of Nursing; Nagoya University Graduate School of Medicine; Nagoya Japan
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32
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Prevalence of Tobacco Smoking and Determinants of Success in Quitting Smoking among Patients with Chronic Diseases: A Cross-Sectional Study in Rural Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020167. [PMID: 28208782 PMCID: PMC5334721 DOI: 10.3390/ijerph14020167] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
Tobacco use is one of the behavioral risk factors for chronic diseases. The aim of the study was to investigate smoking prevalence in chronically ill residents and their smoking behavior in western rural China, to identify factors associated with success in quitting smoking, and to provide appropriate intervention strategies for tobacco control. Cross-sectional survey data from patients with chronic diseases from rural western China were analyzed. Among the 906 chronically ill patients, the current smoking prevalence was 26.2%. About 64.3% of smokers with chronic diseases attempted to quit smoking, 21.0% of which successfully quitted. The odds ratio (OR) of smokers with only one chronic disease to quit smoking successfully was higher than that of those who have other diseases (OR = 2.037, 95% confidence interval (CI) = 1.060-3.912; p < 0.05). The smokers who were always restricted to smoking in public places were more likely to quit smoking successfully than those who were free to smoke (OR = 2.188, 95% CI = 1.116-4.291; p < 0.05). This study suggests that health literacy, comorbidity of diseases, and psychological counseling should be considered when developing targeted tobacco prevention strategies. Strengthening tobacco control measures in public places such as rural medical institutions will be effective.
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Dagvadorj A, Ota E, Shahrook S, Baljinnyam Olkhanud P, Takehara K, Hikita N, Bavuusuren B, Mori R, Nakayama T. Hospitalization risk factors for children's lower respiratory tract infection: A population-based, cross-sectional study in Mongolia. Sci Rep 2016; 6:24615. [PMID: 27090182 PMCID: PMC4835771 DOI: 10.1038/srep24615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 03/31/2016] [Indexed: 11/29/2022] Open
Abstract
This study aimed to assess the potential risk factors for lower respiratory tract infection (LRTI)-related hospital admissions in Mongolian children. A population-based cross-sectional study was conducted in rural Mongolia in 2013, and 1,013 mother–child pairs were included. Of the participating children, 38.9% were admitted to hospital with LRTIs. Home smoking, low birthweight, being a male child, exclusive breastfeeding and healthcare-seeking behaviour showed substantial association with LRTI-related hospital admissions. Number of cigarettes smoked by family members showed a dose-response relationship and increased hospital admissions. Strategies to prevent second-hand-smoke exposure from adult smokers, especially inside the home, are crucial to preventing LRTI-related hospital admissions for children in Mongolia. Improving rates of exclusive breastfeeding and increasing birthweight have great potential to decrease the likelihood of children acquiring a LRTI. Educational initiatives are also necessary for women who are less likely to seek out care for their children’s symptoms.
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Affiliation(s)
- Amarjargal Dagvadorj
- Department of Health Informatics, Kyoto University, Yoshida Konoe-cho, Syakyo-ku, Kyoto, 606-8501, Japan.,Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Erika Ota
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Sadequa Shahrook
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Purevdorj Baljinnyam Olkhanud
- Department of Environmental Health Sciences, Mongolian National University of Medical Sciences, Zorig street, Ulaanbaatar-14210, Mongolia
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Naoko Hikita
- Department of Midwifery and Women's Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Bayasgalantai Bavuusuren
- Department of Pediatrics, Mongolian National University of Medical Sciences, Zorig street, Ulaanbaatar-14210, Mongolia
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University, Yoshida Konoe-cho, Syakyo-ku, Kyoto, 606-8501, Japan
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Cook JW, Collins LM, Fiore MC, Smith SS, Fraser D, Bolt DM, Baker TB, Piper ME, Schlam TR, Jorenby D, Loh WY, Mermelstein R. Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit: a factorial screening experiment. Addiction 2016; 111:117-28. [PMID: 26582140 PMCID: PMC4681585 DOI: 10.1111/add.13161] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 09/03/2015] [Accepted: 09/08/2015] [Indexed: 11/28/2022]
Abstract
AIMS To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. DESIGN A balanced, four-factor, randomized factorial experiment. SETTING Eleven primary care clinics in southern Wisconsin, USA. PARTICIPANTS A total of 517 adult smokers (63.4% women, 91.1% white) recruited during primary care visits who were willing to reduce their smoking but not quit. INTERVENTIONS Four factors contrasted intervention components designed to reduce smoking and promote abstinence: (1) nicotine patch versus none; (2) nicotine gum versus none; (3) motivational interviewing (MI) versus none; and (4) behavioral reduction counseling (BR) versus none. Participants could request cessation treatment at any point during the study. MEASUREMENTS The primary outcome was percentage change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percentage change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. FINDINGS There were few main effects, but a significant four-way interaction at 26 weeks post-study enrollment (P = 0.01, β = 0.12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (P = 0.04), and nicotine gum, when used without MI, increased 26-week abstinence after a subsequent aided quit attempt (P = 0.01). CONCLUSIONS Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit.
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Affiliation(s)
- Jessica W. Cook
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705,William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705
| | - Linda M. Collins
- The Pennsylvania State University, The Methodology Center and Department of Human Development & Family Studies, 404 Health and Human Development Building, University Park, PA 16802
| | - Michael C. Fiore
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - Stevens S. Smith
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - David Fraser
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - Daniel M. Bolt
- University of Wisconsin, Department of Educational Psychology, 1025 W. Johnson St., Madison, WI 53706
| | - Timothy B. Baker
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - Megan E. Piper
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - Tanya R. Schlam
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - Douglas Jorenby
- University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711,University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705
| | - Wei-Yin Loh
- University of Wisconsin, Department of Statistics, 1220 Medical Sciences Center, 1300 University Ave., Madison, WI 53706
| | - Robin Mermelstein
- University of Illinois at Chicago, Institute for Health Research and Policy, 544 Westside Research Office Bldg., 1747 West Roosevelt Rd., Chicago, IL 60608
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35
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Factors influencing quit attempts among male daily smokers in China. Prev Med 2015; 81:361-6. [PMID: 26441296 PMCID: PMC4679468 DOI: 10.1016/j.ypmed.2015.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/24/2015] [Accepted: 09/26/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. METHODS The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation analyses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking-related variables affected making a quit attempt. RESULTS An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15-24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. CONCLUSION Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers.
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36
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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.
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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
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37
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Kale D, Gilbert HM, Sutton S. Are predictors of making a quit attempt the same as predictors of 3-month abstinence from smoking? Findings from a sample of smokers recruited for a study of computer-tailored smoking cessation advice in primary care. Addiction 2015; 110:1653-64. [PMID: 25939254 DOI: 10.1111/add.12972] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/19/2014] [Accepted: 04/28/2015] [Indexed: 11/30/2022]
Abstract
AIMS To identify predictors of quit attempts and of 3-month abstinence from cigarette smoking. DESIGN Secondary analysis of data gathered for a two-armed randomized controlled trial with 6-month follow-up. SETTING A total of 123 general practices across the United Kingdom. PARTICIPANTS A total of 4397 participants who completed the 6-month follow-up. Participants were categorized on self-reported smoking behaviour at 6-month follow-up as non-attempters (n = 2664), attempted quitters (n = 1548) and successful quitters (n = 185). MEASURES Demographic characteristics, smoking history and nicotine dependence, cognitive and social-environmental factors measured at baseline were examined as potential predictors of quit attempts and 3-month abstinence. FINDINGS Univariate predictors of quit attempts included commitment [odds ratio (OR) = 11.64, 95% confidence interval (CI) = 8.30-16.32], motivation (OR = 2.10, 95% CI = 1.98-2.22) and determination to quit (OR = 1.94, 95% CI = 1.83-2.05). Successful quitting was associated with being married (OR = 1.51, 95% CI = 1.11-2.05), lower social deprivation (OR = 0.47, 95% CI = 0.30-0.74), higher reading level (OR = 1.62, 95% CI = 1.19-2.21) and lower nicotine dependence (OR = 0.42, 95% CI = 0.29-0.62). Health problems related to smoking and previous quit attempts for 3 months or longer predicted both. In the multivariate analysis, the significant predictors of making a quit attempt were; later stage of readiness to quit (OR = 5.38, 95% CI = 3.67-7.89), motivation (OR = 1.48, 95% CI = 1.34-1.62) and determination to quit (OR = 1.16, 95% CI = 1.05-1.29) and health problems related to smoking (OR = 1.44, 95% CI = 1.18-1.75). For 3-month abstinence, the only significant predictor was not having health problems related to smoking (OR = 0.50, 95% CI = 0.29-0.83). CONCLUSIONS While high motivation and determination to quit is necessary to prompt an attempt to quit smoking, demographic factors and level of nicotine dependence are more important for maintaining abstinence.
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Affiliation(s)
- Dimitra Kale
- Research Department of Primary Care and Population Health, University College Medical School, Royal Free Campus, London, UK
| | - Hazel M Gilbert
- Research Department of Primary Care and Population Health, University College Medical School, Royal Free Campus, London, UK
| | - Stephen Sutton
- Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge, UK
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38
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Niu L, Luo D, Silenzio VMB, Xiao S, Tian Y. Are Informing Knowledge and Supportive Attitude Enough for Tobacco Control? A Latent Class Analysis of Cigarette Smoking Patterns among Medical Teachers in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12030-42. [PMID: 26404331 PMCID: PMC4626953 DOI: 10.3390/ijerph121012030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 08/31/2015] [Accepted: 09/18/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study is one part of a five-year tobacco-control project in China, which aimed to gain insight into the smoking behavior, knowledge, and attitudes among medical teachers in China. METHODS In May 2010, a cross-sectional survey was conducted among medical teachers of Xiangya Medical School, Central South University, China. RESULTS A total number of 682 medical teachers completed the surveys. Latent class analysis indicated the sample of smoking patterns was best represented by three latent subgroups of smoking consumption severity levels. Most respondents were informed of smoking related knowledge, but lack of knowledge on smoking cessation. Most of them held a supportive attitude towards their responsibilities among tobacco control, as well as the social significance of smoking. However, both smoking related knowledge and attitude were not correlated with severity of smoking consumption among medical teachers. CONCLUSION The smoking prevalence among medical teachers in China remains high. Programs on smoking cessation training are required. Future study should also develop targeted interventions for subgroups of smokers based on smoking consumption. Persistent and effective anti-tobacco efforts are needed to achieve the goals of creating smoke-free campuses and hospitals.
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Affiliation(s)
- Lu Niu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, Hunan, China.
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, NY 14642, USA.
| | - Dan Luo
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, Hunan, China.
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, NY 14642, USA.
| | - Vincent M B Silenzio
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, NY 14642, USA.
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, Hunan, China.
| | - Yongquan Tian
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, Hunan, China.
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Li L, Borland R, Fong GT, Jiang Y, Yang Y, Wang L, Partos TR, Thrasher JF. Smoking-related thoughts and microbehaviours, and their predictive power for quitting. Tob Control 2015; 24:354-61. [PMID: 24570098 PMCID: PMC4532545 DOI: 10.1136/tobaccocontrol-2013-051384] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/29/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Negative attitudes to smoking are well-established predictors of intentions to quit and quit behaviours, but less attention has been given to whether quitting is influenced by smoking-related thoughts and microbehaviours that reflect a concern about smoking. OBJECTIVES This paper aimed to describe the occurrence of smoking-related thoughts and microbehaviours among Chinese smokers, and to examine their predictive power for making quit attempts and sustained abstinence. METHODS The data came from the first three waves of the International Tobacco Control China Survey. Four measures of recent thoughts about smoking and two microbehaviour measures (collectively referred to as microindicators) were examined. RESULTS Most smokers (around three-quarters) reported thinking about harms of smoking to themselves or to others at least occasionally, and an increasing minority reported the two microbehaviours of prematurely butting out cigarettes and forgoing them. All microindicators were positively related to subsequent quit attempts in individual predictor analyses, but only serious thoughts about quitting and butting out cigarettes had independent relationships. Overall, there was no clear relationship between these microindicators and sustained abstinence. CONCLUSIONS There was a moderately high level of occurrence of recent smoking-related thoughts and microbehaviours among the Chinese adult smokers in the six cities studied. Like in the West, microindicators of concern about smoking were positively associated with subsequent quit attempts, but unlike in the West, they were largely unrelated to sustained abstinence.
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Affiliation(s)
- Lin Li
- Research Division, Cancer Council Victoria, Melbourne, Australia
| | - Ron Borland
- Research Division, Cancer Council Victoria, Melbourne, Australia
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Yuan Jiang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Yang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lili Wang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Timea R. Partos
- Research Division, Cancer Council Victoria, Melbourne, Australia
| | - James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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Cooperman NA, Richter KP, Bernstein SL, Steinberg ML, Williams JM. Determining Smoking Cessation Related Information, Motivation, and Behavioral Skills among Opiate Dependent Smokers in Methadone Treatment. Subst Use Misuse 2015; 50:566-81. [PMID: 25559697 PMCID: PMC4646090 DOI: 10.3109/10826084.2014.991405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Over 80% of people in methadone treatment smoke cigarettes, and existing smoking cessation interventions have been minimally effective. OBJECTIVE To develop an Information-Motivation-Behavioral Skills (IMB) Model of behavior change based smoking cessation intervention for methadone maintained smokers, we examined smoking cessation related IMB factors in this population. METHODS Current or former smokers in methadone treatment (n = 35) participated in focus groups. Ten methadone clinic counselors participated in an individual interview. A content analysis was conducted using deductive and inductive approaches. RESULTS Commonly known IMB factors related to smoking cessation were described. These factors included: the health effects of smoking and treatment options for quitting (information); pregnancy and cost of cigarettes (motivators); and coping with emotions, finding social support, and pharmacotherapy adherence (behavioral skills). IMB factors specific to methadone maintained smokers were also described. These factors included: the relationship between quitting smoking and drug relapse (information), the belief that smoking is the same as using drugs (motivator); and coping with methadone clinic culture and applying skills used to quit drugs to quitting smoking (behavioral skills). IMB strengths and deficits varied by individual. CONCLUSIONS Methadone maintained smokers could benefit from research on an IMB Model based smoking cessation intervention that is individualized, addresses IMB factors common among all smokers, and also addresses IMB factors unique to this population.
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Affiliation(s)
- Nina A Cooperman
- 1Rutgers Robert Wood Johnson Medical School, Division of Addiction Psychiatry , New Brunswick, New Jersey , United States
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Li L, Borland R, Yong HH, Fong GT, Jiang Y, Li Q, Hammond D, Quah ACK. Reported exposures to anti-smoking messages and their impact on Chinese smoker's subsequent quit attempts. Int J Behav Med 2014; 21:667-76. [PMID: 24078490 DOI: 10.1007/s12529-013-9349-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND It is important to monitor whether anti-smoking messages (if any) are noticed by the public in China and whether they have any impact on smokers’ quitting behaviours over time. PURPOSE This study aimed to examine Chinese smokers' exposure to anti-smoking messages in a range of channels and to determine if exposure was associated with subsequent quit attempts. METHOD A prospective cohort design was employed. Participants were 6,509 adult smokers who completed at least one of the first three waves (2006-2009) of the International Tobacco Control (ITC) China Survey sampled from six Chinese cities. The main measures were reported exposure to anti-smoking messages in a range of channels and smokers' subsequent quit attempts. Generalized Estimating Equations (GEE) modelling was used to combine respondents from all three waves while accounting for inherent within-person correlation. RESULTS The overall exposure levels to anti-smoking messages were low and varied between cities and from one channel to another. Television was the medium with the greatest overall exposure (over 50% in almost all the cities across all the waves). After controlling for a range of covariates, higher level of combined exposure were positively related to higher subsequent quit attempts (adjusted odds ratio=1.03, 95% CI 1.02~1.05, p <.001); among the individual channels, exposures in newspapers and on posters were significant in their own right. CONCLUSION The findings suggest that anti-smoking warning messages have the potential to stimulate Chinese smokers to make quit attempts, but they also indicate that the levels and strength of warning messages in China need to be increased. China should consider adopting proven international practices, including mandating pictorial health warnings on cigarette packages, adopting prominent point-of-sale warnings, and carrying out strong and ongoing mass media campaigns.
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Branstetter SA, Mercincavage M, Muscat JE. Time to first cigarette predicts 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in adolescent regular and intermittent smokers, National Health and Nutrition and Examination Survey (NHANES) 2007-10. Addiction 2014; 109:1005-12. [PMID: 24521204 PMCID: PMC4013259 DOI: 10.1111/add.12515] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/07/2013] [Accepted: 01/30/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS The time to first cigarette (TTFC) of the day is an indicator of nicotine intake in adults and adolescents. However, the relation between TTFC and biological markers of nicotine addiction and health risk in youths has not been well described. The current study examined whether an earlier TTFC predicts higher levels of a tobacco-specific carcinogen, 4-(methylnitrosamino)-1-(3-pyridal)-1 (NNAL), in regular and intermittent adolescent smokers and if this relation is mediated by nicotine intake (measured by cotinine) or cigarettes per day (CPD). DESIGN A cross-sectional analysis of a nationally representative subsample of adolescents. SETTING A general community sample from the 2007-08 and 2009-10 National Health and Nutrition and Examination Survey. PARTICIPANTS A total of 215 adolescents in the United States between the ages of 12 and 19 years who reported smoking at least once in the 5 days prior to data collection. MEASUREMENTS The primary outcome measure was urinary levels of NNAL. FINDINGS In both regular and intermittent smokers, earlier TTFC was associated dose-dependently with higher levels of NNAL (P < 0.03 in both cases). TTFC had an indirect effect on NNAL, mediated by nicotine intake (cotinine) in both regular [β = -0.08, standard error (SE) = 0.03, 95% confidence interval (CI) = -0.15, -0.03] and intermittent (β = -0.02, SE = 0.01, 95% CI = -0.05, -0.002) smokers. CPD was not found to be an important mediator of the relation between TTFC and NNAL. CONCLUSIONS Time between waking and the first cigarette of the day is correlated in daily and non-daily adolescent smokers with overall nicotine and therefore carcinogen intake.
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Affiliation(s)
- Steven A. Branstetter
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA
| | - Melissa Mercincavage
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA
| | - Joshua E. Muscat
- The Pennsylvania State University, Penn State College of Medicine, Hershey, PA
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Caviness CM, Hagerty CE, Anderson BJ, de Dios MA, Hayaki J, Herman D, Stein MD. Self-efficacy and motivation to quit marijuana use among young women. Am J Addict 2014; 22:373-80. [PMID: 23795877 DOI: 10.1111/j.1521-0391.2013.12030.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 11/17/2011] [Accepted: 12/16/2011] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Assessing motivation to quit substance use is recommended as part of brief interventions. The purpose of this study was to determine correlates of desire to quit marijuana use among young adult women enrolled in a brief motivational intervention trial. METHODS Participants were 332 female marijuana users, aged 18-24, who rated their current desire to quit using a single item change ladder. We hypothesized self-efficacy and prior quit attempts will interact in this population to increase motivation to quit. RESULTS Participants had a mean age of 20.5 years, 67.7% were non-Hispanic Caucasian, and 60% had some desire to quit marijuana use. Using multivariate linear regression, quit desire was significantly lower among Caucasians (b = -.256; 95% CI -.489; -.037) and more frequent marijuana users (b = -.268; 95% CI -.372; -.166), and higher among those with previous quit attempts (b = .454; 95% CI .235; .671), and greater marijuana problem severity (b = .408; 95% CI .302; .514). Greater refusal self-efficacy was associated with greater quit desire among participants with previous quit attempts, but not among those without prior quit attempts (b = .241; 95% CI .050; .440). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Understanding the factors relating to quit desire among marijuana users may allow clinicians to tailor counseling so as to increase readiness to quit and decrease use and its associated consequences.
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Pacek LR, Latkin C, Crum RM, Stuart EA, Knowlton AR. Interest in quitting and lifetime quit attempts among smokers living with HIV infection. Drug Alcohol Depend 2014; 138:220-4. [PMID: 24602364 PMCID: PMC4015183 DOI: 10.1016/j.drugalcdep.2014.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/31/2014] [Accepted: 02/02/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Cigarette smoking is highly prevalent among people living with HIV, and is associated with many negative health outcomes, including death. There is little research on smoking behaviors such as interest in quitting and lifetime quit attempts among smokers living with HIV. Existing research has focused on individual-level characteristics, to the neglect of social environmental characteristics. We explored individual- and social-level characteristics associated with interest in quitting and lifetime nicotine replacement (NRT) or medication use for smoking cessation. METHODS Data are from a study of participants recruited from clinic and community venues originally designed to examine social environmental influences on current/former drug users' HIV medication adherence and health outcomes. This analysis comprised 267 current smokers living with HIV. Chi-square tests were used to describe the sample; logistic regression was used to explore associations between covariates and outcomes. RESULTS In adjusted analyses, older age (age 54-65: aOR=4.64, 95% CI=1.59-13.47) and lifetime use of NRT/medications (aOR=2.02, 95% CI=1.08-3.80) were associated with an interest in quitting smoking. Additionally, older age (age 45-49: aOR=3.38, 95% CI=1.57-7.26; age 54-65: aOR=2.70 95% CI=1.20-6.11), White race (aOR=3.56, 95% CI=1.20-10.62), and having a Supporter who had used NRT/medications for cessation (aOR=2.13, 95% CI=1.05-4.29) were associated with lifetime NRT/medications use. CONCLUSIONS Findings corroborate prior research concerning individual-level characteristics, and indicate the importance of social-level characteristics in association with prior use of NRT/medications for cessation. Findings have implications for the implementation of cessation interventions for smokers living with HIV.
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Affiliation(s)
- Lauren R. Pacek
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland 21205,Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, Maryland 21205,Address correspondence to: Lauren R. Pacek. Address: 5510 Nathan Shock Drive, Suite 1708, Baltimore, MD 21224. Phone: 410-550-1975, Fax: 410-550-0030,
| | - Carl Latkin
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior & Society, Baltimore, Maryland 21205,Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland 21205
| | - Rosa M. Crum
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland 21205,Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, Maryland 21205,Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland 21205
| | - Elizabeth A. Stuart
- Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, Maryland 21205,Johns Hopkins University Bloomberg School of Public Health, Department of Biostatistics, Baltimore, Maryland 21205
| | - Amy R. Knowlton
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior & Society, Baltimore, Maryland 21205
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BinDhim NF, McGeechan K, Trevena L. Who Uses Smoking Cessation Apps? A Feasibility Study Across Three Countries via Smartphones. JMIR Mhealth Uhealth 2014; 2:e4. [PMID: 25098439 PMCID: PMC4114511 DOI: 10.2196/mhealth.2841] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/24/2013] [Accepted: 12/05/2013] [Indexed: 12/17/2022] Open
Abstract
Background Smartphone use is growing worldwide. While hundreds of smoking cessation apps are currently available in the app stores, there is no information about who uses them. Smartphones also offer potential as a research tool, but this has not previously been explored. Objective This study aims to measure and compare the uptake of a smoking cessation app over one year in Australia, the United Kingdom, and the United States. It also assesses the feasibility of conducting research via an app, describing respondents’ characteristics (demographics, smoking status, and other health related app use), and examining differences across countries. Methods This is a cross-sectional exploratory study of adults 18 years and older, passively recruited over one year in 2012, who downloaded this study app (Quit Advisor) via the two largest app stores (Apple and Android). Results The total number of app downloads after one year was 1751, 72.98% (1278/1751) of them were Apple operation system users. Of these 1751 participants, 47.68% (835/1751) were from the United States, 29.18% (511/1751) were from the United Kingdom, and 16.68% (292/1751) were from Australia. There were 602 participants, 36.75% (602/1638) that completed a questionnaire within the app. Of these 602 participants, 58.8% (354/602) were female and the mean age was 32 years. There were no significant differences between countries in terms of age, operation system used, number of quitting attempts, and language spoken at home. However, there were significant differences between countries in terms of gender and stage of change. There were 77.2% (465/602) of the respondents that were ready to quit in the next 30 days and the majority of these had never sought professional help (eg, “Quitline”). More than half had downloaded smoking cessation apps in the past and of these, three-quarters had made quitting attempts (lasted at least 24 hours) using an app before. Respondents who had attempted to quit three times or more in the previous year were more likely to have tried smoking cessation apps (OR 3.3, 95% CI 2.1-5.2). There were 50.2% (302/602) of the respondents that had used other health related apps before. Of these, 89.4% (270/302) were using health related apps at least once a week, but 77.5% (234/302) never checked the credibility of the health app publishers before downloading. Conclusions A smartphone app was able to reach smokers across three countries that were not seeking professional help, but were ready to quit within the next 30 days. Respondents were relatively young and almost demographically similar across all three countries. They also frequently used other health related apps, mostly without checking the credibility of their publishers.
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Affiliation(s)
- Nasser F BinDhim
- Sydney Medical School, Department of Public Health, University of Sydney, Sydney, Australia.
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Goldhaber-Fiebert JD, Brandeau ML. Modeling and calibration for exposure to time-varying, modifiable risk factors: the example of smoking behavior in India. Med Decis Making 2014; 35:196-210. [PMID: 24477078 DOI: 10.1177/0272989x13518272] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Risk factors increase the incidence and severity of chronic disease. To examine future trends and develop policies addressing chronic diseases, it is important to capture the relationship between exposure and disease development, which is challenging given limited data. OBJECTIVE To develop parsimonious risk factor models embeddable in chronic disease models, which are useful when longitudinal data are unavailable. DESIGN The model structures encode relevant features of risk factors (e.g., time-varying, modifiable) and can be embedded in chronic disease models. Calibration captures time-varying exposures for the risk factor models using available cross-sectional data. We illustrate feasibility with the policy-relevant example of smoking in India. METHODS The model is calibrated to the prevalence of male smoking in 12 Indian regions estimated from the 2009-2010 Indian Global Adult Tobacco Survey. Nelder-Mead searches (250,000 starting locations) identify distributions of starting, quitting, and restarting rates that minimize the difference between modeled and observed age-specific prevalence. We compare modeled life expectancies to estimates in the absence of time-varying risk exposures and consider gains from hypothetical smoking cessation programs delivered for 1 to 30 years. RESULTS Calibration achieves concordance between modeled and observed outcomes. Probabilities of starting to smoke rise and fall with age, while quitting and restarting probabilities fall with age. Accounting for time-varying smoking exposures is important, as not doing so produces smaller estimates of life expectancy losses. Estimated impacts of smoking cessation programs delivered for different periods depend on the fact that people who have been induced to abstain from smoking longer are less likely to restart. CONCLUSIONS The approach described is feasible for important risk factors for numerous chronic diseases. Incorporating exposure-change rates can improve modeled estimates of chronic disease outcomes and of the long-term effects of interventions targeting risk factors.
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Affiliation(s)
- Jeremy D Goldhaber-Fiebert
- Stanford Health Policy, Centers for Health Policy and Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA (JDG-F)
| | - Margaret L Brandeau
- Department of Management Science and Engineering, Stanford University, Stanford, CA, USA (MLB)
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Shin SS, Moreno PG, Rao S, Garfein RS, Novotny TE, Strathdee SA. Cigarette smoking and quit attempts among injection drug users in Tijuana, Mexico. Nicotine Tob Res 2013; 15:2060-8. [PMID: 23873979 DOI: 10.1093/ntr/ntt099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Injection drug use and cigarette smoking are major global health concerns. Limited data exist regarding cigarette smoking behavior and quit attempts among injection drug users (IDUs) in low- and middle-income countries to inform the development of cigarette smoking interventions. We conducted a cross-sectional study to describe cigarette smoking behavior and quit attempts among IDUs in Tijuana, Mexico. METHODS IDUs were recruited through community outreach and administered in-person interviews. Multivariable Poisson regression models were constructed to determine prevalence ratios (PRs) for quit attempts. RESULTS Of the 670 participants interviewed, 601 (89.7%) were current smokers. Of these, median number of cigarettes smoked daily was 10; 190 (31.6%) contemplated quitting smoking in the next 6 months; 132 (22.0%) had previously quit for ≥1 year; and 124 (20.6%) had made a recent quit attempt (lasting ≥1 day during the previous 6 months). In multivariable analysis, recent quit attempts were positively associated with average monthly income (≥3,500 pesos [US$280] vs. <1,500 pesos [US$120]; PR = 2.30; 95% CI = 1.57-3.36), smoking marijuana (PR = 1.38; 95% CI = 1.01-2.90), and smoking heroin (PR = 1.85; 95% CI = 1.23-2.78), and they were negatively associated with number of cigarettes smoked daily (PR = 0.96; 95% CI = 0.94-0.98). CONCLUSIONS One out of 5 IDUs attempted to quit cigarette smoking during the previous 6 months. Additional research is needed to improve the understanding of the association between drug use patterns and cigarette smoking quit attempts, including the higher rate of quit attempts observed among IDUs who smoke marijuana or heroin compared with IDUs who do not smoke these substances.
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Affiliation(s)
- Sanghyuk S Shin
- Joint Doctoral Program in Public Health (Global Health), San Diego State University/University of California San Diego, San Diego, CA
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Beard E, Aveyard P, Brown J, West R. Assessing the association between the use of NRT for smoking reduction and attempts to quit smoking using propensity score matching. Drug Alcohol Depend 2012; 126:354-61. [PMID: 22748518 DOI: 10.1016/j.drugalcdep.2012.05.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 05/31/2012] [Accepted: 05/31/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Smokers who use nicotine replacement therapy (NRT) to aid smoking reduction (SR) are more likely to quit smoking than those who try to reduce without NRT. This could be because NRT enhances the likelihood of quitting or because those who are motivated to quit choose to use NRT (i.e., selection bias). METHODS 'Propensity score matching' was used to assess whether the increased likelihood of a quit attempt in those using NRT for SR would remain in a subsample of smokers paired on variables indicative of the likelihood of making a quit attempt and using NRT (i.e., when selection bias is reduced). Measures were obtained on a range of smoking and socio-demographic variables at baseline, then after 3 and 6 months. Fifty-eight smokers who were attempting SR at 3 months were matched on baseline measures to 58 smokers not using NRT for SR. The odds of their going on to make a quit attempt in the following 3 months were then compared. RESULTS In smokers matched on motivational and other variables for their propensity to use NRT to aid smoking reduction, those using NRT for SR had three times greater odds of reporting a quit attempt than those not using NRT (OR 3.23; CI 1.49-7.01; p<0.01). CONCLUSION The increased likelihood of subsequently trying to stop smoking among smokers who use NRT to aid SR versus those who try to reduce without NRT, remains following the matching of participants on motivational and other potentially relevant variables.
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Affiliation(s)
- Emma Beard
- Cancer Research UK Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK.
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Yong HH, Siahpush M, Borland R, Li L, O'Connor RJ, Yang J, Fong GT, Yuan J. Urban Chinese smokers from lower socioeconomic backgrounds face more barriers to quitting: results from the international tobacco control-China survey. Nicotine Tob Res 2012; 15:1044-51. [PMID: 23125438 DOI: 10.1093/ntr/nts234] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Research findings on social disparities in barriers to quitting faced by smokers from mainly Western English-language countries may or may not generalize to smokers in China. This paper sought to determine whether nicotine dependence, quitting self-efficacy, quitting interest differ by socio-economic status (SES), and whether they mediate the relationship between SES and quitting behavior of urban Chinese smokers. METHODS Data come from 7,309 adult smokers who participated in the first 3 waves of the International Tobacco Control-China survey conducted in 7 cities across China. The association of socio-economic indicators with nicotine dependence, quitting self-efficacy, quitting interest, and behavior was evaluated using generalized estimating equations models along with a formal test of mediational effects. RESULTS The SES index indicated that those from lower SES were significantly more addicted (p < .001), less confident (p < .001), and less interested in quitting (p < .05). This finding was replicated by education and employment status, but it was not clearly related to income. Mediational analyses revealed that the effects of SES on making quit attempts and quit success among those who tried were indirect. For quit attempts, self-efficacy, interest to quit, and heaviness of smoking index (HSI) were all significant mediators of the SES effect (p < .001), but for maintenance, only HSI was a significant mediator (p < .001). CONCLUSIONS Urban Chinese smokers from lower socio- economic backgrounds experience greater levels of psychological and behavioral barriers to quitting than their counterparts from higher socio-economic backgrounds and as such, they need more help to quit and do so successfully.
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Affiliation(s)
- Hua-Hie Yong
- VicHealth Centre for Tobacco Control, The Cancer Council Victoria, Carlton, VIC, Australia.
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Cai L, Wu X, Goyal A, Han Y, Cui W, Xiao X, He J, Zhao K, Song Y, Jiao F. Patterns and socioeconomic influences of tobacco exposure in tobacco cultivating rural areas of Yunnan Province, China. BMC Public Health 2012; 12:842. [PMID: 23035644 PMCID: PMC3515419 DOI: 10.1186/1471-2458-12-842] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 10/02/2012] [Indexed: 01/20/2023] Open
Abstract
Background This study describes the patterns and socioeconomic influences of tobacco use among adults in tobacco-cultivating regions of rural southwest China. Methods A cross-sectional survey was conducted in 8681 adults aged ≥18 years in rural areas of Yunnan Province, China from 2010 to 2011. A standardized questionnaire was administered to obtain data about participants’ demographic characteristics, individual socioeconomic status, ethnicity, self-reported smoking habits, and exposure to secondhand smoke (SHS). The socioeconomic predictors of current smoking, nicotine addiction, and SHS exposure were analyzed using multivariate logistic regression. Results The prevalence rates of tobacco use were much higher in men compared with women (current smoking 68.5% vs. 1.3%; and nicotine dependence 85.2% vs. 72.7%). However, the rate of SHS exposure was higher in women compared with men (76.6% vs. 70.5%). Tobacco farmers had higher prevalence rates of current smoking, nicotine dependence, and SHS exposure compared with participants not engaged in tobacco farming (P<0.01). Most tobacco users (84.5%) reported initiating smoking during adolescence. A total of 81.1% of smokers smoked in public places, and 77.6% smoked in workplaces. Individuals belonging to an ethnic minority had a lower probability of SHS exposure and nicotine dependence. Individual educational level was found to be inversely associated with the prevalence of current smoking, exposure to SHS, and nicotine dependence. Higher annual household income was associated with a greater risk of nicotine dependence. Conclusions This study suggests that tobacco control efforts in rural southwest China must be tailored to address tobacco-cultivating status and socioeconomic factors.
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Affiliation(s)
- Le Cai
- Cheng Gong New City, School of Public Health, Kunming Medical University, Kunming, China.
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