Motives for Smoking Cessation are Associated with Stage of Readiness to Quit Smoking and Sociodemographics among German Industrial Employees

Purpose.

To test the relationships among particular motives for smoking cessation, stage of readiness to quit (preparation or contemplation), and sociodemographic characteristics.

Design.

A cross-sectional study to examine attitudes toward and use of health promotion at the worksite, using a self-administered questionnaire.

Setting.

Two German metal companies.

Subjects.

Of 1641 responding employees (response rate 65% in company A and 44% in company B), 360 smokers who intended to quit immediately (n = 105) or in the near future (n = 255) were analyzed.

Measures.

The questionnaire comprised of sociodemographic characteristics, smoking behavior, smoking history, readiness to quit smoking, motives to quit, such as coworkers' complaints and health-related or financial concerns. Chi-squared tests and multiple logistic regression analyses were performed.

Results.

Health-related reasons (94%) predominated financial (27%) or image-related (14%) reasons for smoking cessation. Participants in the cessation preparation group were more likely to report an awareness of being addicted (79.6% vs. 58.2%; p < .001) and the negative public image (22.5% vs. 11.6%; p < .01) as reasons for quitting compared with those in the contemplation group. In multivariable regression models, the motives for smoking cessation, including reduced performance, family's and coworkers' complaints, pregnancy/children, and negative public image, but not health-related and financial concerns, differed significantly by gender, age, marital status, education, and occupational status.

Conclusions.

Motives for smoking cessation vary according to the individual's level of readiness to quit and sociodemographic background.

Analysis of the Paternalistic Justification of an Agenda Setting Public Health Policy: The Case of Tobacco Plain Packaging

This article analyses the paternalistic justification of the world's first mandatory tobacco plain packaging policy, which came into force in Australia in 2012. The policy is setting international precedence, with a range of developed and developing countries planning and implementing similar policies. Understanding the paternalistic dimension of the policy is therefore of imminent international importance. The policy meets important ethical benchmarks such as respect for citizens' self-interests and protection of others against harm. However, plain packaging faces a number of ethical challenges: the policy is a controversial type of paternalism; it runs partially against the harm principle; and it fails to meet key operational criteria.

Hardcore smokers in Norway 1996-2009

INTRODUCTION

The aim of this study was to investigate changes in the relative proportion of hardcore smokers (HCS) in Norway for the years 1996-2009.

METHODS

Data were derived from Statistics Norway's annually cross-sectional representative samples of the adult population. The total sample size of smokers each year was between 250 and 500. The outcome measure was HCS, defined by their intention not to quit smoking and absence of attempts to quit during the last 12 months. Logistic regression analysis was conducted to estimate the association between time (survey year) and the number of HCS.

RESULTS

We identified three groups of smokers: occasional smokers, daily non-HCS, and HCS. The relative proportion of HCS declined in the period 1996-2009, from 30% to 23%. A model adjusted for gender, age, educational level, and the use of snus (smokeless tobacco) showed the same downward trend.

CONCLUSIONS

Within this sample of Norwegian smokers, the relative share of HCS is not increasing. This knowledge is important for tobacco prevention policy. The result does not support a hardening hypothesis regarding changes in the size of the group of HCS. Further analysis is needed to investigate individual resistance to smoking cessation.

Prevalence and factors associated with difficulty and intention to quit smoking in Switzerland

BACKGROUND

Recent data indicate a slight decrease in the prevalence of smoking in Switzerland, but little is known regarding the intention and difficulty to quit smoking among current smokers. Hence, we aimed to quantify the difficulty and intention to quit smoking among current smokers in Switzerland.

METHODS

Cross-sectional study including 607 female and 658 male smokers. Difficulty, intention and motivation to quit smoking were assessed by questionnaire.

RESULTS

90% of women and 85% of men reported being "very difficult" or "difficult" to quit smoking. Almost three quarters of smokers (73% of women and 71% of men) intended to quit; however, less than 20% of them were in the preparation stage and 40% were in the precontemplation stage. On multivariate analysis, difficulty to quit was lower among men (Odds ratio and 95% [confidence interval]: 0.51 [0.35-0.74]) and increased with nicotine dependence and number of previous quitting attempts (OR=3.14 [1.75-5.63] for 6+ attempts compared to none). Intention to quit decreased with increasing age (OR=0.48 [0.30-0.75] for ≥65 years compared to <45 years) and increased with nicotine dependence, the number of previous quitting attempts (OR=4.35 [2.76-6.83] for 6+ attempts compared to none) and among non-cigarette smokers (OR=0.51 [0.28-0.92]). Motivation to quit was inversely associated with nicotine dependence and positively associated with the number of previous quitting attempts and personal history of lung disease.

CONCLUSION

Over two thirds of Swiss smokers want to quit. However, only a small fraction wishes to do so in the short term. Nicotine dependence, previous attempts to quit or previous history of lung disease are independently associated with difficulty and intention to quit.

Evolution of the association between parental and child smoking in Finland between 1977 and 2005

OBJECTIVES

To study changes in the family smoking profile and in the association between parental and child smoking from 1977 to 2005.

METHODS

Data was based on biennial surveys using nationally-representative samples of 14-18-year-old Finns (n=58,279). Response rate ranged between 88% (1977) and 65% (2005). Parental smoking categories were: two smoking parents, smoking father, smoking mother, both currently non-smokers but one or both ex-smokers, and two never-smoking parents. Child smoking categories were: experimental, daily, and never. Associations between parental and child smoking were examined using multinomial logistic regression models.

RESULTS

Over the study period, the proportion of never-smoking families (child and parents never-smokers) increased (9% vs. 18%). Age, sex, family structure, and survey decade adjusted odds ratios for child's daily smoking were 6.9 (95% CI: 6.4, 7.5) when both parents smoked, 4.7 (95% CI: 4.3, 5.2) when mother smoked, 3.8 (95% CI: 3.5, 4.1) when father smoked, and 2.8 (95% CI: 2.6, 2.9) when one/both were ex-smokers compared with children of never-smoking parents. Only a few non-systematic interactions between parental smoking and survey decade were found.

CONCLUSIONS

The proportion of totally smoke-free families increased substantially. Association between parental and child smoking persisted strong and mainly similar over time.

Key health promotion factors among male members of staff at a higher educational institution: a cross-sectional postal survey

Background

Men's lifestyles are generally less healthy than women's. This study identifies associations between health-related behaviour in different groups of men working in a Higher Education (HE) institution. In addition, men were asked whether they regarded their health-related behaviours as a concern. This article highlights smoking, consumption of alcohol and physical activity as most common men's health-related lifestyle behaviours.

Methods

A descriptive cross-sectional survey was conducted among all male staff employed by a Higher Education institute in Scotland using a postal self-completed questionnaire. A total of 1,335 questionnaires were distributed and 501 were returned completed (38% return rate). The data were analysed using SPSS 13.0 for Windows.

Results

Less than 10% currently smoked and almost 44% of these smokers were light smokers. Marital status, job title, consumption of alcohol and physical activity level were the major factors associated with smoking behaviour. Men in manual jobs were far more likely to smoke. Nearly all (90%) consumed alcohol, and almost 37% had more than recommended eight units of alcohol per day at least once a week and 16% had more than 21 units weekly. Younger men reported higher amount of units of alcohol on their heaviest day and per week. Approximately 80% were physically active, but less than 40% met the current Government guidelines for moderate physical activity. Most men wanted to increase their activity level.

Conclusion

There are areas of health-related behaviour, which should be addressed in populations of this kind. Needs assessment could indicate which public health interventions would be most appropriately aimed at this target group. However, the low response rate calls for some caution in interpreting our findings.

Linkage of nicotine dependence and smoking behavior on 10q, 7q and 11p in twins with homogeneous genetic background

The significant worldwide health burden introduced by tobacco smoking highlights the importance of studying the genetic determinants of smoking behavior and the key factor sustaining compulsive smoking, that is, nicotine dependence (ND). We have here addressed the genetic background of smoking in a special study sample of twins, harmonized for early life events and specifically ascertained for smoking from the nationwide twin cohort of the genetically unique population of Finland. The twins and their families were carefully examined for extensive phenotype profiles and a genome-wide scan was performed to identify loci behind the smoking status, ND and the comorbid phenotype of ND and alcohol use in 505 individuals from 153 families. We replicated previous linkage findings on 10q (max logarithm of the odds (LOD) 3.12) for a smoker phenotype, and on 7q and 11p (max LOD 2.50, and 2.25, respectively) for the ND phenotype. The loci linked for ND also showed evidence for linkage for the comorbid phenotype. Our study provides confirmatory evidence for the involvement of these genome regions in the genetic etiology of smoking behavior and ND and for the first time associates drinking and smoking to a shared locus on 10q.

Nicotine dependence, quit attempts, and quitting among smokers in a regional population sample from a country with a high prevalence of tobacco smoking

BACKGROUND

Nicotine dependence might function as a barrier to smoking cessation. Therefore, the goal was to determine whether single symptoms of nicotine dependence are related to the number of quit attempts and smoking status.

METHODS

In a random population sample of 4075 women and men aged 18-64, drawn from 47 German communities, data about nicotine dependence according to the US Diagnostic and Statistical Manual of Mental Disorders and according to the Fagerström Test for Nicotine Dependence (FTND), and data on quit attempts and quitting were collected at baseline with an interview and 30 months later with a questionnaire.

RESULTS

Nicotine dependence, in particular withdrawal, was related to a high number of quit attempts and to remaining a current smoker. The urgent need for tobacco, craving for nicotine, smoking to avoid withdrawal, and the expectation of increased appetite or weight gain correctly classified smoking status in 72.1% of individuals through logistic regression analysis.

CONCLUSIONS

Nicotine dependence is a strong factor that may partly explain the failure of a subpopulation of smokers to live abstinent. Population-based interventions should include measures of tobacco control and brief interventions carried out, for example, by experts in health care.