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Cheraghi L, Niknam M, Masihay-Akbar H, Azizi F, Amiri P. How Do Active and Passive Cigarette Smokers in Iran Evaluate Their Health? A Sex-Specific Analysis on the Full-Spectrum of Quality of Life. Nicotine Tob Res 2024; 26:913-921. [PMID: 37651684 DOI: 10.1093/ntr/ntad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/18/2023] [Accepted: 08/30/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION This study aimed to determine the sex-specific effects of active and passive cigarette smoking on the full spectrum of health-related quality of life (HRQoL) among a sizeable adult population. METHODS This study was conducted within the Tehran Lipid and Glucose Study (TLGS) framework. Participants included 7478 adults in the last examination of the TLGS. We used a quantile regression model to compare sex-specific HRQoL distributions among non-, current, and passive smokers. Two-step cluster analysis was used to consider the synergic effects of confounder variables. RESULTS In men, current smoking was negatively associated with only mental HRQoL in all percentiles of its distribution with a decrease in absolute estimation values from the lowest (5th: β = -6.59, p < .001) to the highest (90th: β=-0.93, p = .027). Also, passive smoking was negatively associated with men's physical HRQoL in the upper percentiles of its distribution (75th: β = -1.12, p = .010; 90th: β = -1.26, p = .016). In women, the current (β = -4.17 to -4.45 for 25th to 90th percentiles) and passive smokers (β = -2.05 to -4.25 for 10th to 90th percentiles) had lower mental HRQoL in the mentioned percentiles. Also, the current smoking had a negative association with the 5th percentile (β = -2.04, p = .008), and a positive association with the 50th (β = 1.94, p < .008) and 75th percentile of physical HRQoL (β = 2.25, p = .004). CONCLUSIONS The present study showed the harmful effect of smoking on mental HRQol in all participants. In contrast, the physical effect of smoking was only observed in female active smokers and at the extreme levels of the physical HRQoL spectrum. IMPLICATIONS According to the harmful effect of smoking on HRQoL, understanding active and passive smokers' perceptions of how smoking impacts their health is critical for tobacco control programs. Since most previous studies of smoking and HRQoL have mainly focused on the extreme parts or central values of the HRQoL distribution, the use of a multiple regression approach enables the evaluation of other parts of the conditional distribution of the outcome variable. This study demonstrated the prominent effect of smoking on the mental HRQoL as well as the more serious public health burden of passive smoking in women.
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Affiliation(s)
- Leila Cheraghi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hasti Masihay-Akbar
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Su X, Zhang Y, Zhou H, Ma F, Jin X, Bai Y, Wei W, Zhang X, Zhou M. Perceived Determinants of Health-Related Behaviors Among Patients with Coronary Heart Disease After Percutaneous Coronary Intervention: A Longitudinal Qualitative Study. Patient Prefer Adherence 2024; 18:591-606. [PMID: 38463399 PMCID: PMC10924927 DOI: 10.2147/ppa.s452943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/24/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose Studies had reported some influencing factors of health behavior among patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI). However, considering that human perceptions are complex, unrestricted and dynamically changing. A longitudinal qualitative study was conducted to explore the determinants of health-related behaviors of patients after PCI and dynamic changes of these determinants at the 1st, 3rd, and 6th months. Patients and Methods Using purposive sampling, 18 patients undergoing PCI were interviewed. The conventional content analysis method was used to identify categories and subcategories. Semi-structured, face-to-face or telephone in-depth interviews were conducted at the cardiology unit of a tertiary referral hospital in Yunnan Province, China from March 2022 to January 2023. Results Seven categories with some subcategories were constructed from the data, categorized into three domains. Firstly, individual factors include (i) Personal coping with healthy lifestyle requirements (tried but failed; I can do it), (ii) individual perception and feeling toward disease (knowing about the disease; belief of cure; fears of relapse), and (iii) personal benefits (improved health; meaning of life). Secondly, social factors include (i) social facilitators (family resources; healthcare support), (ii) social barriers (inconvenient medical care service; conflicting information). Finally, cultural factors include (i) way of living (dietary habits; key roles of yan (cigarette) and jiu (alcohol) in Chinese society), (ii) way of thinking (fatalism and Confucian familism). Conclusion The determinants of health-related behaviors of patients after PCI are multifaceted and dynamic. Different interventions should be formulated to promote patients' adherence to health behaviors. Moreover, priority should be given to the impact of traditional Chinese philosophy on the health behaviors of patients after PCI, and the health promotion program for these patients should be culturally sensitive. In addition, future research should further explore the determinants of health behaviors among diverse ethnic minorities after PCI, which has not been fully inquired in this study.
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Affiliation(s)
- Xu Su
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Yimei Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Huilin Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Xiaorong Jin
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Wei Wei
- Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Xiong Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Min Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
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Lee YH, Kong D, Hu CM, Chang YC. Participation in mahjong and the associated smoking and alcohol consumption behaviors among Chinese older adults. J Ethn Subst Abuse 2023:1-14. [PMID: 38109064 DOI: 10.1080/15332640.2023.2293942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This study examined the relationship of playing mahjong with smoking and alcohol consumption behaviors among Chinese older adults. We used a large and nationally representative dataset, the 8th wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Older adults who were 65 years old or above were included in the final analysis sample (n = 10,954). Multivariable logistic regressions were used to examine the associations of playing mahjong with current and former smoking/alcohol consumption status. Additionally, we used negative binomial and multiple linear regressions to investigate the number of cigarettes smoked per day and the amount of alcohol consumed per day. Compared with older adults who did not play mahjong, those who played mahjong at least once per month were more likely to report both current and prior smoking/alcohol consumption habits (all p < 0.05). The sub-analysis revealed that older adults who played mahjong at least once per week tended to smoke more cigarettes per day (all p < 0.05) than those who did not play mahjong at all. When public health practitioners advocate for the health benefits of playing mahjong, they should also consider its associations with smoking/alcohol consumption behaviors among Chinese older adults.
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Affiliation(s)
- Yen-Han Lee
- University of Central Florida, Orlando, Florida
| | - Dexia Kong
- The Chinese University of Hong Kong, Shatin, Hong Kong
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Zhao B, Chen H. Effects of Smoking Social Cues on Inhibitory Control in Smokers: An Event-Related Potential Study. Int J Clin Health Psychol 2023; 23:100387. [PMID: 37214345 PMCID: PMC10199225 DOI: 10.1016/j.ijchp.2023.100387] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023] Open
Abstract
Objective Reduced inhibitory control is a general characteristic of smokers and becomes increasingly pronounced in smoking-related contexts. However, research has rarely considered differences in the effects of various smoking-related cues. To fill this research gap, this study compared the effects of smoking object-related and smoking social-related cues on inhibitory control in smokers. Methods We used a visual Go/NoGo paradigm with three types of long-lasting backgrounds (neutral, smoking object, and smoking social background) to record the error rates, reaction times, and amplitudes of the N2 and P3 event-related potentials (ERPs) by 25 smokers and 25 non-smokers. Results (1) Smokers displayed smaller NoGo-N2 amplitudes than controls under the neutral background; (2) smokers displayed smaller NoGo-N2 amplitudes under the smoking social background and smoking object background than they did under the neutral background; (3) relative to neutral and smoking object backgrounds, smokers displayed higher commission error rates, shorter reaction times, and larger NoGo-P3 amplitudes under smoking social background. Conclusion Smoking-related stimuli impair inhibitory control in smokers, especially when these stimuli are socially related.
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Affiliation(s)
- Boqiang Zhao
- Department of Psychology, Renmin University of China, No.59 Zhongguancun Avenue, Haidian District, Beijing 100872, China
| | - Haide Chen
- School of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua 321004, China
- Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Zhejiang Normal University, 688 Yingbin Road, Jinhua 321004, China
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Tang J, Yang J, Liu Y, Liu X, Li L, Sun Y, Jin J, Fang Y, Zhou Z, Wang Y, Liu Y, Chen W, McNeill A, Kelly BC, Cohen JE, Liao Y. Efficacy of WeChat-based online smoking cessation intervention ('WeChat WeQuit') in China: a randomised controlled trial. EClinicalMedicine 2023; 60:102009. [PMID: 37251625 PMCID: PMC10209122 DOI: 10.1016/j.eclinm.2023.102009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background China has approximately 300 million current smokers, and smoking cessation services are limited. This study aimed to assess the efficacy of a Cognitive Behavioral Theory-based smoking cessation intervention ('WeChat WeQuit') via the most popular social media platform in China, WeChat. Methods A parallel, single-blind, two-arm randomised controlled trial was conducted via WeChat between March 19, 2020 and November 16, 2022. Chinese-speaking adult smokers (n = 2000) willing to quit within one month were recruited and randomised in a 1:1 ratio. The intervention group (n = 1005) received the 'WeChat WeQuit' program and the control group (n = 955) received control messages for 14 weeks (2-week prequit and 12-week postquit). Participants were followed up to 26 weeks after the quit date. The primary outcome was self-reported continuous smoking abstinence rate, biochemically validated at 26 weeks. The secondary outcomes were self-reported 7-day and continuous abstinence rates at 6 months. All analyses were by intention to treat. The trial is registered at ClinicalTrials.gov (NCT03169686). Findings By intention-to-treat analysis, the biochemically verified 26-week continuous abstinence rate was 11.94% in the intervention group and 2.81% in the control group (OR = 4.68, 95% CI: 3.07-7.13, p < 0.0001). The self-reported 7-day abstinence rates ranged from 39.70% at week 1-32.04% at week 26 for the intervention group and 14.17%-11.86% in the control group for weeks 1 and 26, respectively; the self-reported continuous abstinence rates at weeks 1 and 26 ranged from 34.33% to 24.28% and 9.65% to 6.13% in the intervention group and the control group respectively (all p < 0.0001). Participants with low nicotine dependence or previous quit attempts were more likely to successfully quit smoking. Interpretation The 'WeChat WeQuit' intervention significantly increased smoking abstinence rates at 6 months and should be considered for treatment-seeking smokers in China. Funding The research is supported by the Natural Science Foundation of Hunan Province (2020JJ4794, YLiao), the K.C. Wong Postdoctoral Fellowship for YLiao to study at King's College London, and China Medical Board (CMB) Open Competition Program (grant no. 15-226, 22-485, YLiao).
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Affiliation(s)
- Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Jie Yang
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Yi Liu
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Xiaocong Liu
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Ling Li
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Yunkai Sun
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Jieyin Jin
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Yehong Fang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Zitang Zhou
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Yunfei Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China
| | - Yueheng Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Brian C. Kelly
- Department of Sociology & Center for Research on Young People’s Health (CRYPH), Purdue University, 700 W State Street, West Lafayette, IN 47907, USA
| | - Joanna E. Cohen
- Institute for Global Tobacco Control (IGTC), Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St., Fourth Floor, Baltimore, MD 21205, USA
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
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Zhang YY, Tang WT, Zhang H, Wang J, Bai XX, Liao YH, Robinson N, Liu JP. Barriers and Facilitators for Smoking Cessation in Chinese Smokers with Chronic Obstructive Pulmonary Disease: A Qualitative Study. Int J Chron Obstruct Pulmon Dis 2022; 17:1107-1120. [PMID: 35573655 PMCID: PMC9091319 DOI: 10.2147/copd.s356935] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/28/2022] [Indexed: 12/29/2022] Open
Abstract
Background Smoking cessation is recommended as a key intervention for chronic obstructive pulmonary disease (COPD) smokers. However, in China, few COPD smokers quit successfully. The aim of this study was to explore in depth the barriers and facilitators for smoking cessation among smokers with COPD in China. Methods A purposive sample of 32 hospitalized smokers with COPD were included, 17 ex-smokers and 15 current smokers, participated in the semi-structured interviews. Interviews were analyzed thematically and using a deductive approach guided by Capability, Opportunity, Motivation-Behavior (COM-B) framework. Results Three inter-related themes were generated: smokers’ motivation was a prerequisite for quitting, maintaining capability to quit smoking, and opportunities that facilitated smokers to quit. Motivation to quit for most participants was activated by COPD-related symptoms, although they had a limited knowledge of COPD. Physical benefits from quitting and strong willpower were facilitators for maintaining quitting, while exposure to smoking environment and strong addiction to nicotine were frequent reasons for relapse. Most ex-smokers quit smoking by their own willpower rather than professionally delivered smoking cessation interventions. Smokers’ attitudes toward these interventions depended on their effectiveness and convenience. Very few participants had experienced pharmacotherapy or behavioral support from physicians. However, interviewees preferred auricular acupressure to pharmacotherapy. Conclusion Motivation to quit among smokers with COPD was usually initiated by COPD-related symptoms. Physical benefits observed by quitting and strong willpower facilitated smoking cessation, while exposure to smoking environment and strong addiction to nicotine led to relapse. COPD smokers in China preferred auricular acupressure to pharmacotherapy.
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Affiliation(s)
- Ying-Ying Zhang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Wen-Tao Tang
- Pingyi Hospital of Traditional Chinese Medicine, Linyi, Shandong, People’s Republic of China
| | - Hong Zhang
- Fangshan Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Jing Wang
- Fangshan Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Xiao-Xu Bai
- Fangshan Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yan-Hui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, People’s Republic of China
| | - Nicola Robinson
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
- Institute of Health and Social Care, London South Bank University, London, UK
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
- Correspondence: Jian-Ping Liu, Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, People’s Republic of China, Email ;
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Zhong R, Li Z, Zhang X, Chen Q, Lin W. Current Cigarette Smoking Is Associated With a High Seizure Frequency and Anxiety Symptoms in People With Epilepsy. Front Neurol 2022; 13:834694. [PMID: 35309587 PMCID: PMC8930813 DOI: 10.3389/fneur.2022.834694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThis study aims to answer the following questions: how many people with epilepsy (PWE) have cigarette smoking habits? Which demographic or clinical characteristics are associated with cigarette smoking? Is cigarette smoking related to depressive and anxiety symptoms in PWE?MethodsA total of 524 PWE were included in the final analysis. Demographic and clinical data were gathered and recorded. Smoking status was identified. The associations of smoking status with the clinical features of epilepsy and depressive and anxiety symptoms were evaluated by logistic regression models.ResultsThe overall prevalence of cigarette smoking was 23.5% (123 PWE) in this sample. In the multivariate logistic regression model, men (adjusted OR = 10.414, 95% CI: 5.552–19.535, P < 0.001), high seizure frequency (adjusted OR = 1.474, 95% CI: 1.043–2.084, P = 0.028), and anxiety symptoms (adjusted OR = 2.473, 95% CI: 1.483–4.112, P = 0.001) were shown to have independent associations with cigarette smoking in PWE.ConclusionOur findings suggested that the overall prevalence of cigarette smoking was 23.5% in adults with epilepsy, which is slightly lower than that (26.6%) in general adults in China. In the present study, cigarette smoking was associated with men, high seizure frequency, and anxiety symptoms in PWE. Further prospective clinical studies with larger sample sizes are required to confirm our findings.
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Affiliation(s)
- Rui Zhong
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Zhuan Li
- Department of Emergency, Linyi Central Hospital, Linyi, China
| | - Xinyue Zhang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Qingling Chen
- Department of Hepatology, Second People's Clinical College of Tianjin Medical University, Tianjin, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Weihong Lin
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Makvandi Z, Mostafavi F, Bashirian S, Zamani-Alavijeh F, Kelishadi R. Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran. Int J Qual Stud Health Well-being 2021; 16:1857043. [PMID: 33435855 PMCID: PMC7808745 DOI: 10.1080/17482631.2020.1857043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose: Waterpipe tobacco smoking (WTS) is currently a serious and growing public health threat in the world, especially in adolescents and young women. The aim of the study was to explore sociocultural factors contributing to WTS among adolescents and young adult women in Iran. Methods: This qualitative study was conducted from August 2017 to January 2019 in Isfahan and Hamadan cities, Iran; it included 13-30-year-old females with experience of WTS. For data collection, in-depth semi-structured personal interviews were conducted at participants' preferred time and place. Concurrent with data collection, data were analysed through conventional content analysis. Results: The study participants described the various sociocultural factors contributing to WTS. These factors were categorized into four following main categories: waterpipe glamorization by its producers and sellers, media advertisement or silence, common sociocultural traditions, and governmental policies and regulations. Conclusion: A wide range of sociocultural factors affects WTS among Iranian adolescents and young adult women. Therefore, interdisciplinary multidimensional strategies are needed for WTS management and prevention among these at-risk groups. Public education, strict supervision of tobacco import, export, and selling, ample employment opportunities for young people and effective leisure time management are essential to reduce WTS.Abbreviation WTS: Waterpipe Tobacco Smoking; MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco.
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Affiliation(s)
- Zeinab Makvandi
- Student Research Committee, School of Heath, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical sciences, Hamadan, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Cao N, Li X, Chen H, Li X, Li W. Decisional Balance of Smoking and Planning to Quit Smoking: A Moderated Mediation Model among Chinese Male Smokers. J Psychoactive Drugs 2021; 54:158-166. [PMID: 34423746 DOI: 10.1080/02791072.2021.1942339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Decisional balance in quitting smoking involves positive and negative attitudes toward smoking. This study explored the relationship between the decisional balance of smoking and planning to quit smoking, and examined the mediating role of willingness to quit smoking and the moderating role of social support. A questionnaire survey was conducted among 326 daily male smokers from China in 2016, including the decisional balance of smoking, willingness to quit smoking, social support, planning to quit, and nicotine dependence. The results showed: (1) willingness to quit smoking mediated the relationship between the decisional balance of smoking and planning to quit smoking; (2) the relationship between the decisional balance of smoking and planning to quit smoking was moderated by emotional support rather than instrumental support. Smokers with a higher level of emotional support for quitting smoking were more likely to progress to planning to quit smoking, while this relationship was not found among smokers with a lower level of emotional support. These findings suggested that smokers' willingness to quit smoking would be key to promoting their planning to quit. Meanwhile, the dynamic process of planning to quit smoking was moderated by emotional support from others.
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Affiliation(s)
- Ningmeng Cao
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Xinwei Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Haide Chen
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Xinyu Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Weijian Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
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Luo T, Li M, Williams D, Fritz J, Phillippi S, Yu Q, Kantrow S, Chen L, Chen Y, Beiter K, Tseng TS. Urban and Rural Disparities in a WeChat-Based Smoking Cessation Intervention among Chinese Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136731. [PMID: 34201450 PMCID: PMC8268404 DOI: 10.3390/ijerph18136731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Tobacco use, which is directly responsible for 10% of total deaths per year globally, remains consistently high, with approximately 20% of the population reporting regular consumption globally. Moreover, health disparities regarding tobacco consumption and smoking cessation are growing between rural and urban populations worldwide. Social media interventions for tobacco cessation may effectively reach both groups. The objective of this study was to evaluate the efficacy of a WeChat-delivered smoking cessation intervention among rural and urban Chinese smokers, and to assess moderating variables that may contribute to differential intervention efficacy. METHODS WeChat was used to recruit smokers into this intervention study between 1 July and 5 August 2019. Participants were randomized to one of three intervention schedules: participants in the Standard Group and the Enhanced Group received 20 smoking-related messages over 2 weeks, whereas participants in the Enhanced Group received an extra 6 oral health-related messages for one week. Participants in the control group received 20 smoking-related messages after the post-intervention assessment. Participants completed questionnaires at baseline and at 4 weeks follow-up. Our primary outcome was smoking cessation stage of change and secondary outcome was 24-h point prevalence abstinence (PPA). Urban and rural areas were based on self-reported living areas. Chi-squared test, Fisher's exact test, ANOVA test, linear regression, and logistic regression were used for analysis. RESULTS Overall, 403 participants completed the intervention (233 rural, 107 suburban, 63 urban). Compared to urban participants, rural participants were more likely to have progressed to a later stage of change (β = 0.40, 95% CI: 0.13, 0.67) and to report higher 24-h PPA rates at follow-up (aOR = 3.23, 95% CI: 1.36, 7.68). After stratification by living area, the intervention effects in stage of change and 24-h PPA rate at follow-up were only found in the urban subgroup. DISCUSSION Smokers who lived in rural areas reported better smoking cessation outcomes compared with urban smokers; however, the efficacy of a WeChat-based smoking cessation intervention was only found for participants living in an urban area. WeChat based smoking cessation interventions should be used to promote smoking cessation in urban, suburban, and rural areas.
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Affiliation(s)
- Ting Luo
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA 92122, USA; (M.L.); (K.B.)
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (D.W.); (S.P.); (T.-S.T.)
- Correspondence:
| | - Mirandy Li
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA 92122, USA; (M.L.); (K.B.)
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (J.F.); (S.K.)
| | - Donna Williams
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (D.W.); (S.P.); (T.-S.T.)
| | - Jackson Fritz
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (J.F.); (S.K.)
| | - Stephen Phillippi
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (D.W.); (S.P.); (T.-S.T.)
| | - Qingzhao Yu
- Biostatistics, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA;
| | - Stephen Kantrow
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (J.F.); (S.K.)
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Yongchun Chen
- Department of Clinical Nutrition, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, China;
| | - Kaylin Beiter
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA 92122, USA; (M.L.); (K.B.)
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (J.F.); (S.K.)
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA; (D.W.); (S.P.); (T.-S.T.)
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11
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Chen N, Kim CG. The Moderating Effect of Community-Level Deprivation on the Association between Individual Characteristics and Smoking Behavior among Chinese Adults: A Cross-Level Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115785. [PMID: 34072249 PMCID: PMC8199057 DOI: 10.3390/ijerph18115785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/24/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022]
Abstract
China joined the World Health Organization (WHO) Framework Convention on Tobacco Control in 2006; however, the overall Chinese smoking rate is still high. The aim of this study is to provide new evidence for the direct effects of community-level deprivation, and the effects of interactions between community-level deprivation and individual characteristics, on smoking intensity, by using cross-sectional data from the 2015 China Health and Nutrition Survey (CHNS). The results show that there is a strong association between community-level deprivation and individual smoking intensity, and that community deprivation moderates the relationship between individual perceived stress and smoking intensity. The findings imply that adequate interventions should be conducted in the context of deprived neighborhoods, and should consider differences between levels of individual perceived stress and between sexes, especially focusing on highly stressed women who live in deprived communities.
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Affiliation(s)
- Nan Chen
- Major in Chinese Studies, Department of Global Business, Kosin University, Busan 49104, Korea;
| | - Chang-Gyeong Kim
- Department of Chinese Studies, Pukyong National University, Busan 48513, Korea
- Correspondence: ; Tel.: +82-51-629-5342
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12
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Liao Y, Tang J, McNeill A, Kelly BC, Cohen JE. Impact of cigarette package warnings on attitudes towards sharing and gifting cigarettes in China: a nationwide study of smokers and non-smokers. Tob Control 2021; 31:750-753. [PMID: 33436459 DOI: 10.1136/tobaccocontrol-2020-056160] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/27/2020] [Accepted: 12/11/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Sharing and gifting cigarettes are common in China. These social practices promote cigarette consumption, and consequently may reduce quit rates in China. This study investigated sharing and gifting cigarettes, and the relationship of observing pictorial health warnings to attitudes towards sharing and gifting cigarettes in China. METHODS We conducted an online nationwide cross-sectional study of 9818 adults in China. Experiences of sharing and gifting cigarettes, and attitudes towards sharing and gifting cigarettes before and after viewing text and pictorial health warnings on the packages were assessed, and compared between smokers and non-smokers. RESULTS Most current smokers reported experiences of sharing (97%) and gifting (around 90%) cigarettes. Less than half of non-smokers reported sharing cigarettes and receiving gifted cigarettes, but over half (61.4%) gave cigarettes as a gift to others. More than half of non-smokers but less than 10% of smokers disagreed with sharing and gifting cigarettes. After observing both text and pictorial health warnings on the packages, disagreement with sharing and gifting cigarettes increased by more than 10 percentage points among both smokers and non-smokers. CONCLUSION Having pictorial health warnings on cigarette packages may reduce sharing and gifting cigarettes in China.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China .,Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China .,Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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13
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Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103744. [PMID: 32466270 PMCID: PMC7277525 DOI: 10.3390/ijerph17103744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/29/2023]
Abstract
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants' health.
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14
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Luo M, Ding D, Bauman A, Negin J, Phongsavan P. Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data. BMC Public Health 2020; 20:99. [PMID: 31973695 PMCID: PMC6979381 DOI: 10.1186/s12889-019-7841-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social engagement forms the basis of social relationships by providing a sense of belonging, social identity, and fulfillment. Previous research demonstrates that social engagement was associated with positive health behaviors among older adults. However, the results have been different across health-related behaviors, and mostly based on data from high-income countries. For example, studies from the US and UK showed that social engagement was protective against smoking, while others found social engagement encouraged more smoking in many Asian cultures. In this study, we aim to examine the association between social engagement and a range of health-related behaviors and subjective well-being among older adults in six low- to middle-income countries. METHODS Data from the WHO Study on Global Ageing and Adult Health (SAGE Wave 1) were used. A total of 33,338 individuals aged 50 and older in China, Russia, India, Ghana, South Africa, and Mexico were included. Social engagement, tobacco use, alcohol consumption, fruit and vegetable intake, physical activity, sedentary behavior, sleep duration, depression symptoms, self-rated health status, and quality of life were assessed using established self-reported measures. Multiple logistic regression models were used to examine the relationship between social engagement and nine outcome variables, adjusting for socio-demographic characteristics. RESULTS Lower levels of social engagement were positively related to physical inactivity, prolonged sitting time, unhealthy sleep duration, perceived depression, poor self-rated health, and low quality of life. However, the associations between social engagement and tobacco use, excessive drinking, and insufficient fruit and vegetable intake were mixed across countries. CONCLUSION This international study found high social engagement as a potential health-promoting factor in some low- to middle-income countries. Although the impacts of social engagement on tobacco and alcohol use and diet were complicated and culture-specific, interventions at both individual and community levels should encourage healthy lifestyles through positive social engagement.
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Affiliation(s)
- Mengyun Luo
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025 People’s Republic of China
| | - Ding Ding
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
| | - Adrian Bauman
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
| | - Joel Negin
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
| | - Philayrath Phongsavan
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
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15
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Daoud N, Jung YE, Sheikh Muhammad A, Weinstein R, Qaadny A, Ghattas F, Khatib M, Grotto I. Facilitators and barriers to smoking cessation among minority men using the behavioral-ecological model and Behavior Change Wheel: A concept mapping study. PLoS One 2018; 13:e0204657. [PMID: 30356254 PMCID: PMC6200188 DOI: 10.1371/journal.pone.0204657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 09/12/2018] [Indexed: 01/11/2023] Open
Abstract
Background and aim Universal smoking cessation strategies are not always successful for minorities, among whom smoking is highly prevalent despite high intention to quit. This study identifies facilitators for smoking cessation, as perceived by minority male smokers, that can inform a culturally appropriate national plan for smoking prevention and cessation. Methods We conducted in 2013 a three-stage study among Arab minority male current and former smokers (ages 18–64) in Israel, among whom smoking is very high: first, a Concept Mapping (CM) study with 102 and 202 participants in the brainstorming, and sorting and rating phases respectively. Second, we assigned clusters identified in the CM study to contingency levels using the Behavioral Ecological Model (BEM). Third, we classified clusters into intervention functions and policies using the Behavior Change Wheel (BCW). Findings The CM study revealed 58 barriers and facilitators for smoking prevention and cessation that were sorted into 11 clusters by the participants. These clusters were analogous to four BEM level contingency of smoking (social, institutional, community and individual). We classified it into two main policy categories, based on the BCW: 1- restructuring the socio-political environment of smoking through affirmative government's policies towards Arab minority in Israel, and 2-developing a culturally appropriate plan for smoking cessation in Arab local authorities including: raising awareness about tobacco hazards; enforcing anti-smoking laws; strengthening community institutional action; providing smoking cessation services; considering raising prices for tobacco products, addressing psychological sources of smoking in Arab men. Conclusions Our study revealed barriers, facilitators and contingencies of smoking prevention and cessation with two main policy action items among the Arab minority in Israel: changing the socio-political environment of smoking, and developing a culturally appropriate smoking prevention and cessation national plan. Our study framework can inform policies and culturally appropriate interventions for smoking prevention and cessation in other minorities.
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Affiliation(s)
- Nihaya Daoud
- School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- * E-mail:
| | - Ye Eun Jung
- School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Ruth Weinstein
- Division of Public Health, Ministry of Health, Jerusalem, Israel
| | - Amir Qaadny
- School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Mohammad Khatib
- Division of Public Health, Ministry of Health, Jerusalem, Israel
| | - Itamar Grotto
- Division of Public Health, Ministry of Health, Jerusalem, Israel
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16
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Lee M, Hu D, Bunney G, Gadegbeku CA, Edmundowicz D, Houser SR, Wang H, Ma GX. Health behavior practice among understudied Chinese and Filipino Americans with cardiometabolic diseases. Prev Med Rep 2018; 11:240-246. [PMID: 30210996 PMCID: PMC6129966 DOI: 10.1016/j.pmedr.2018.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 05/17/2018] [Accepted: 06/01/2018] [Indexed: 01/09/2023] Open
Abstract
Lifestyle modification and health behavior practice among the individuals with cardiometabolic diseases (CMD) are important for secondary prevention and disease control. This study was designed to investigate and compare health behavior practices among Chinese and Filipino Americans with CMD. Three hundred seventy-four Asian Americans (211 Chinese and 163 Filipino) who reside in the greater Philadelphia region and had either CMD or no identified disease were included in the study. Information on smoking, alcohol intake, physical activity, and salt and sweets consumption was collected, as well as demographic and acculturative characteristics. Of the 374 participants, 241 (64.4%) had CMD and 133 (35.6%) had no identified disease. The majority of Chinese and Filipino Americans with CMD failed to meet the dietary and physical activity guidelines, and only a small percentage of them restricted their amount of salt added to food and amount of sweets consumption. Compared to participants with no disease, Chinese participants with CMD were more likely to "never" add salt to food (AOR 4.42 compared to "frequently"). Filipino Americans with CMD were less likely to be those who "never" consume sweets than those who frequently consume sweets (AOR = 0.12). Among the participants with CMD, Chinese participants with CMD were less likely to restrict drinking (AOR 0.11) than Filipinos with CMD. The findings suggest that tailored interventions for Chinese and Filipino Americans with CMD should be developed to enhance their compliance to behavioral guidelines to prevent further disease progression and complications.
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Affiliation(s)
- Minsun Lee
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Danielle Hu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Gabrielle Bunney
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Crystal A. Gadegbeku
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Section of Nephrology, Hypertension and Kidney Transplantation, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Daniel Edmundowicz
- Temple Heart and Vascular Institute, Temple Health Care System, Philadelphia, PA, USA
- Section of Cardiology of Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Steve R. Houser
- Cardiovascular Research Center, Department of Physiology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Hong Wang
- Center for Metabolic Disease Research, Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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17
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Mao A, Bottorff JL, Oliffe JL, Sarbit G, Kelly MT. A Qualitative Study on Chinese Canadian Male Immigrants' Perspectives on Stopping Smoking: Implications for Tobacco Control in China. Am J Mens Health 2018; 12:812-818. [PMID: 27099344 PMCID: PMC6131442 DOI: 10.1177/1557988316644050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
China has the largest number of smokers in the world; more than half of adult men smoke. Chinese immigrants smoke at lower rates than the mainstream population and other immigrant groups do. This qualitative study was to explore the influence of denormalization in Canada on male Chinese immigrant smoking after migration. Semistructured interviews were conducted with 22 male Chinese Canadian immigrants who were currently smoking or had quit smoking in the past 5 years. The study identified that, while becoming a prospective/father prompted the Chinese smokers to quit or reduce their smoking due to concern of the impacts of their smoking on the health of their young children, changes in smoking were also associated with the smoking environment. Four facilitators were identified which were related to the denomormalized smoking environment in Canada: (a) the stigma related to being a smoker in Canada, (b) conformity with Canadian smoking bans in public places, (c) the reduced social function of smoking in Canadian culture, and (d) the impact of graphic health messages on cigarette packs. Denormalization of tobacco in Canada in combination with collectivist values among Chinese smokers appeared to contribute to participants' reducing and quitting smoking. Although findings of the study cannot be claimed as generalizable to the wider population of Chinese Canadian immigrants due to the small number of the participants, this study provides lessons for the development of tobacco control measures in China to reverse the current prosmoking social environment.
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Affiliation(s)
- Aimei Mao
- Kiang Wu Nursing College of Macau, Macau,
China
| | - Joan L. Bottorff
- University of British Columbia, Kelowna,
British Columbia, Canada
- Australian Catholic University, Melbourne,
Australia
| | - John L. Oliffe
- University of British Columbia, Vancouver,
British Columbia, Canada
| | - Gayl Sarbit
- University of British Columbia, Kelowna,
British Columbia, Canada
| | - Mary T. Kelly
- University of British Columbia, Kelowna,
British Columbia, Canada
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18
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Sheer VC, Mao C. Cigarette Initiation Among Chinese Male Teenagers in Early Smoking Interactions. HEALTH COMMUNICATION 2018; 33:392-400. [PMID: 28094557 DOI: 10.1080/10410236.2016.1266742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
To collect in-depth information regarding cigarette initiation interactions in the early smoking experimentation among male youth in China, twenty focus groups with male teenagers (N = 165) were conducted. Focus group discussions indicated a high prevalence of cigarette initiation among peers, and such initiation often translated into immediate smoking. Of the identified cigarette initiation appeals, "face" and normative pressure appeals were the most difficult to reject. Upon first initiation attempts, more teenagers accepted cigarettes than rejected them. The reasons behind both cigarette initiation and acceptance primarily related to facilitating social interaction. Upon being rejected, initiating teenagers (agents) who insisted on offering cigarettes often gained compliance. Profiles of peer agents were constructed in this study. Key practical implications suggest simultaneously prioritizing efforts to reduce cigarette initiation and encouraging cigarette refusal.
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Affiliation(s)
- Vivian C Sheer
- a Department of Communication Studies , Hong Kong Baptist University
| | - Chang Mao
- b School of Communication , Ohio State University
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19
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Silva ACD, Vargas LS, Lucchese R, Calixto BDS, Guimarães RA, Vera I, Castro PAD, Pagotto V, Fernandes IL. Patterns of tobacco consumption among residents of a rural settlement: a cross-sectional study. Rev Saude Publica 2017; 51:100. [PMID: 29166444 PMCID: PMC5697925 DOI: 10.11606/s1518-8787.2017051006781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 11/02/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Investigate patterns and factors associated with tobacco consumption among residents of a rural settlement. METHODS A cross-sectional study conducted between September and November 2014, with 172 residents of a rural settlement in the Midwest region of Brazil. We analyzed as dependent variables tobacco consumption at some point in life; current tobacco consumption; tobacco abuse; and the high risk of nicotine dependence, with sociodemographic variables associated with tobacco use, and we applied the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and Self-Reporting Questionnaire (SRQ-20). RESULTS The prevalence of tobacco use in life, current use, tobacco abuse, and high risk of nicotine dependence were 62.2%, 20.9%, 59.8%, and 10.3%, respectively. Advanced age, low education level, evangelical religion, marijuana use, hypnotic or sedative consumption, and male gender were factors associated with smoking patterns in the settlers. CONCLUSIONS There was a high prevalence of smoking patterns, evidencing the need for public policies on tobacco prevention and control in this population.
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Affiliation(s)
| | - Lorena Silva Vargas
- Secretaria Municipal de Saúde de Catalão. Programa Municipal de Controle do Tabagismo. Catalão, GO, Brasil
| | - Roselma Lucchese
- Universidade Federal de Goiás. Departamento de Enfermagem. Catalão, GO, Brasil
| | | | | | - Ivania Vera
- Universidade Federal de Goiás. Departamento de Enfermagem. Catalão, GO, Brasil
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20
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Bai X, Chen JY, Fang Z, Zhang XY, Wang F, Pan ZQ, Fang PQ. Motivations, challenges and coping strategies for smoking cessation: Based on multi-ethnic pregnant couples in far western China. ACTA ACUST UNITED AC 2017; 37:439-445. [PMID: 28585135 DOI: 10.1007/s11596-017-1754-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/24/2017] [Indexed: 11/29/2022]
Abstract
The present study aimed to clarify the smoking cessation motivations, challenges and coping strategies among pregnant couples. A qualitative design using a grounded theory approach was applied. Data were collected by individual semi-structured interviews with 39 married individuals (21 non-smoking pregnant women and 18 smoking or ever-smoking men with a pregnant wife) and 3 imams in an ethnically diverse region of far western China. The most common theme for smoking cessation motivation was "embryo quality" (i.e., a healthier baby), followed by family's health. Most interviewees reported that husband's withdrawal symptoms were the greatest challenge to smoking cessation, followed by the Chinese tobacco culture. Coping strategies given by the pregnant women typically involved combining emotional, behavioral and social interventions. Social interventions showed advantages in helping to quit smoking. Pregnancy appears to be a positive stimulus for pregnant couples' smoking cessation. Our results suggest that pregnancy, a highly important life event, may help to reduce barriers to smoking cessation at the social level (e.g., limiting access to cigarettes, avoiding temptation to smoke), but does little to help with the withdrawal symptoms. Professional guidance for smoking cessation is still necessary.
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Affiliation(s)
- Xue Bai
- School of Health and Medicine Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jiang-Yun Chen
- School of Health and Medicine Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zi Fang
- Department of Financial Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Yan Zhang
- School of Policy and Public Administration, Hubei University, Wuhan, 430000, China
| | - Fang Wang
- Medical Department, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 430000, China
| | - Zheng-Qiong Pan
- School of Health and Medicine Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Peng-Qian Fang
- School of Health and Medicine Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Sheer VC, Mao C, Yeo TED. Chinese male adolescents resisting cigarettes from peers: qualitative research on tactics, perceptions and contextual characteristics. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1291581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Vivian C. Sheer
- Department of Communication Studies, Hong Kong Baptist University, Communication Studies, Kowloon Tong, Hong Kong and
| | - Chang Mao
- School of Communication, Ohio State University, Columbus, United States
| | - Tien Ee Dominic Yeo
- Department of Communication Studies, Hong Kong Baptist University, Communication Studies, Kowloon Tong, Hong Kong and
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22
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Yang T, Barnett R, Jiang S, Yu L, Xian H, Ying J, Zheng W. Gender balance and its impact on male and female smoking rates in Chinese cities. Soc Sci Med 2016; 154:9-17. [PMID: 26943009 DOI: 10.1016/j.socscimed.2016.02.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/27/2016] [Accepted: 02/21/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although gender differences in smoking have received much attention, few studies have explored the importance of contextual effects on male and female smoking rates. The aim of this study is to examine the association between variations in city-level sex ratios and gender differences in smoking in China. METHODS Participants included 16,866 urban residents, who were identified through multi-stage sampling conducted in 21 Chinese cities. RESULTS The study found that, independent of personal characteristics, cities with more males had higher male smoking rates and lower female rates. CONCLUSIONS Our research underscores the importance of city-level contextual effects in understanding gender differences in smoking in China.
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Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Ross Barnett
- Department of Geography, University of Canterbury, Christchurch 8140, New Zealand
| | - Shuhan Jiang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Lingwei Yu
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Hong Xian
- Department of Biostatistics, Saint Louis University, St. Louis, MO 63104-1314, USA
| | - Jun Ying
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Weijun Zheng
- Department of Preventive Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Mao A, Bottorff JL. A Qualitative Study on Unassisted Smoking Cessation Among Chinese Canadian Immigrants. Am J Mens Health 2016; 11:1703-1712. [PMID: 26819181 DOI: 10.1177/1557988315627140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
It is well-known that majority of smokers worldwide quit smoking without any assistance. This is even more evident among Chinese smokers. The aim of this qualitative study was to explore how Chinese Canadian immigrant men who smoked cigarettes perceived smoking cessation aids and services and how they used any form of the smoking cessation assistance to help them quit smoking. The study was conducted in British Columbia, Canada. Twenty-two Chinese immigrants were recruited by internet advertisement and through connections with local Chinese communities. Ten of the 22 participants were current smokers and the other 12 had quit smoking in the past 5 years. Data were collected using semistructured interviews. Although all participants, including both the ex-smokers and current smokers, had made more than one quit attempt, they rarely used cessation aids or services even after they had immigrated to Canada. The barriers to seeking the cessation assistance were grouped into two categories: practical barriers and cultural barriers. The practical barriers included "Lack of available information on smoking cessation assistance" and "Difficulty in accessing smoking cessation assistance," while cultural barriers included "Denial of physiological addiction to nicotine," "Mistrust in the effectiveness of smoking cessation assistance," "Tendency of self-reliance in solving problems," and "Concern of privacy revelation related to utilization of smoking cessation assistance." The findings revealed Chinese immigrants' unwillingness to use smoking cessation assistance as the result of vulnerability as immigrants and culturally cultivated masculinities of self-control and self-reliance.
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Affiliation(s)
- Aimei Mao
- 1 Kiang Wu Nursing College of Macau, Macau, China
| | - Joan L Bottorff
- 2 University of British Columbia, Kelowna, British Columbia, Canada.,3 Australian Catholic University, Melbourne, Australia
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Yang T, Yang XY, Cottrell RR, Wu D, Jiang S, Anderson JG. Violent injuries and regional correlates among women in China: results from 21 cities study in China. Eur J Public Health 2015; 26:513-7. [PMID: 26490510 DOI: 10.1093/eurpub/ckv193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ecological models depict violent injuries against women being influenced by both individual and environmental characteristics. However, only few studies examined the association between regional variables and the likelihood of violent injuries. Our study is a preliminary assessment of the impact of regional variables on the likelihood that a woman has experienced violent injuries. METHODS Participants were 16 866 urban residents, who were identified through a multi-stage sampling process conducted in 21 Chinese cities. Out of the sampled population, 8071 respondents were female. Subsequent analyses focused solely on the female sample. Multilevel logistic regression analyses were performed to examine regional variation in violent injuries. RESULTS Prevalence of violent injuries against women is 10.7% (95% CI: 7.8%, 15.5%). After controlling for individual-level characteristics, higher regional male-female ratio (OR: 1.97, P < 0.05), population growth rate (OR: 4.12, P < 0.01) and unemployment rate (OR: 2.45, P < 0.01) were all associated with an elevated risk of violent injuries among Chinese women caused by physical attack. CONCLUSIONS The results suggest violent injuries among Chinese women caused by physical attack have become an important social and public health problem. The findings point to the importance of developing effective health policies, laws and interventions that focuses on the unequal economic development between different regions.
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Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China Injury Control Research Center, West Virginia University, Morgantown, WV 26505, USA
| | - Xiaozhao Y Yang
- Department of Sociology, Purdue University, West Lafayette, IN 47907, USA
| | - Randall R Cottrell
- Public Health Studies Program, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - Dan Wu
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China Department of Health Psychology, Guangdong Medical College, Dongguan 52423, China
| | - Shuhan Jiang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - James G Anderson
- Department of Sociology, Purdue University, West Lafayette, IN 47907, USA
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Ramji R, Arnetz J, Nilsson M, Jamil H, Norström F, Maziak W, Wiklund Y, Arnetz B. Determinants of waterpipe use amongst adolescents in Northern Sweden: a survey of use pattern, risk perception, and environmental factors. BMC Res Notes 2015; 8:441. [PMID: 26374502 PMCID: PMC4570251 DOI: 10.1186/s13104-015-1413-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 09/07/2015] [Indexed: 11/13/2022] Open
Abstract
Background Determinants of waterpipe use in adolescents are
believed to differ from those for other tobacco products, but there is a lack of studies of possible social, cultural, or psychological aspects of waterpipe use in this population. This study applied a socioecological model to explore waterpipe use, and its relationship to other tobacco use in Swedish adolescents. Methods A total of 106 adolescents who attended an urban high-school in northern Sweden responded to an anonymous questionnaire. Prevalence rates for waterpipe use were examined in relation to socio-demographics, peer pressure, sensation seeking behavior, harm perception, environmental factors, and depression. Results Thirty-three percent reported ever having smoked waterpipe (ever use), with 30 % having done so during the last 30 days (current use). Among waterpipe ever users, 60 % had ever smoked cigarettes in comparison to 32 % of non-waterpipe smokers (95 % confidence interval 1.4–7.9). The odds of having ever smoked waterpipe were three times higher among male high school seniors as well as students with lower grades. Waterpipe ever users had three times higher odds of having higher levels of sensation-seeking (95 % confidence interval 1.2–9.5) and scored high on the depression scales (95 % confidence interval 1.6–6.8) than non-users. The odds of waterpipe ever use were four times higher for those who perceived waterpipe products to have pleasant smell compared to cigarettes (95 % confidence interval 1.7–9.8). Waterpipe ever users were twice as likely to have seen waterpipe use on television compared to non-users (95 % confidence interval 1.1–5.7). The odds of having friends who smoked regularly was eight times higher for waterpipe ever users than non-users (95 % confidence interval 2.1–31.2). Conclusion The current study reports a high use of waterpipe in a select group of students in northern Sweden. The study adds the importance of looking at socioecological determinants of use, including peer pressure and exposure to media marketing, as well as mental health among users.
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Affiliation(s)
- Rathi Ramji
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Judy Arnetz
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. .,Department of Family Medicine, College of Human Medicine, Michigan State University, 788 Service Road, East Lansing, MI, USA.
| | - Maria Nilsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Hikmet Jamil
- Department of Family Medicine, College of Human Medicine, Michigan State University, 788 Service Road, East Lansing, MI, USA.
| | - Fredrik Norström
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Wasim Maziak
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
| | | | - Bengt Arnetz
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. .,Department of Family Medicine, College of Human Medicine, Michigan State University, 788 Service Road, East Lansing, MI, USA.
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Mao A, Robinson J. Home smoking restrictions before, during and after pregnancy-a qualitative study in rural China. Health Promot Int 2015; 31:606-13. [PMID: 26071606 DOI: 10.1093/heapro/dav050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Worldwide, many nonsmokers (often women and children) are exposed to second-hand smoke (SHS) in home settings, as men retain their traditional power and control within their family and women and children have limited agency to intervene. This study, set up to explore home smoking management in rural China, found that some women were able to positively intervene to restrict men's smoking at three key stages: prior to conception, during their pregnancy and at the early years of their children's lives. By utilizing dominant social, health and political narratives about the importance of raising a healthy child supported by the One-Child Policy in China, combined with the fear of health risks of SHS to young children, the women were able to use their elevated status as bearer and carers of the only children to subvert the pre-eminence of men in domestic environments, enabling them to positively influence home smoking. While this study highlights the possibility for future smoking cessation initiatives in China by incorporating family carers' elevated awareness of protection of children's health in key stages of childhood, there is also a need for further health education, as family members were unsure why they needed to keep children smoke-free, which may partially explain why few households were smoke-free.
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Affiliation(s)
- Aimei Mao
- Kiang Wu Nursing College of Macau, Est. Repouso No. 35, R/C, Macau, China
| | - Jude Robinson
- School of Law and Social Justice, University of Liverpool, Liverpool L69 7WW, UK
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Mao A, Bottorff JL, Oliffe JL, Sarbit G, Kelly MT. A qualitative study of Chinese Canadian fathers' smoking behaviors: intersecting cultures and masculinities. BMC Public Health 2015; 15:286. [PMID: 25879194 PMCID: PMC4379716 DOI: 10.1186/s12889-015-1646-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/16/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND China is home to the largest number of smokers in the world; more than half of the male population smoke. Given the high rates of Chinese immigration to Canada and the USA, researchers have explored the effect of immigration on Chinese smokers. Reduced tobacco use among Chinese immigrants has been reported in the United States; however, little is known about the social factors underlying men's smoking practices in settings where tobacco control measures have denormalized smoking, and in the context of fatherhood. The purpose of this Canada-based study was to explore the smoking-related experiences of immigrant Chinese fathers. METHODS In this qualitative study, semi-structured telephone interviews were conducted with 22 Chinese Canadian fathers who smoked or had recently quit smoking, and had at least one child under the age of five years old. RESULTS The Chinese fathers had dramatically changed their smoking patterns due to concern for their children's health and social norms and restrictions related to smoking in Canada. The facilitators and barriers for men's smoking were intertwined with idealized masculine provider and protector roles, and diverse Canadian Chinese cultural norms related to tobacco use. CONCLUSIONS The findings have implications for the development of future smoking cessation interventions targeting Chinese Canadian immigrant smokers as well as smokers in China.
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Affiliation(s)
- Aimei Mao
- Kiang Wu Nursing College of Macau, Est. Repouso No.35, R/C, Macau, China.
| | - Joan L Bottorff
- School of Nursing and Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, Canada.
- Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
| | - John L Oliffe
- School of Nursing, University of British Columbia, 302 6190 Agronomy Rd, Vancouver, BC, Canada.
| | - Gayl Sarbit
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, Canada.
| | - Mary T Kelly
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, Canada.
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