Motivation and difficulties to reduce or quit smoking

The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research

BACKGROUND

The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women.

METHODS

The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant.

RESULTS

The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081).

CONCLUSIONS

The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.

Using the Unified Theory of Acceptance and Use of Technology (UTAUT) and e-health literacy(e-HL) to investigate the tobacco control intentions and behaviors of non-smoking college students in China: a cross-sectional investigation

BACKGROUND

Non-smoking college students are starting to smoke in increasing numbers, which shows that their tobacco control situation seems not optimistic. The UTAUT and e-HL are commonly used models and theories to predict health behaviors, while there are few studies on tobacco control. This paper aims to study the influencing factors of tobacco control intention and behavior of non-smoking college students in China by combining the UTAUT and e-HL.

METHODS

Based on the stratified sampling method, 625 college students from 12 universities were selected. Data were collected using a self-made questionnaire designed based on the UTAUT and e-health literacy scales. Data were analyzed by SPSS 22 and AMOS 26, including descriptive statistics, one-way variance analysis and structural equation model analysis.

RESULTS

The results of one-way variance analysis showed that there were significant differences in the score of non-smoking college students' tobacco control intention or behavior by hometowns, monthly living expenses, and parents' smoking history. Performance expectancy, effort expectancy, social influence had direct positive effects on behavioral intention. Facilitating condition, behavioral intention had direct positive impacts on use behavior and e-HL had an indirect positive impact on use behavior.

CONCLUSIONS

The combination of the UTAUT and e-HL can be used as an appropriate framework to predict the influencing factors of non-smoking college students' intention and behavior of tobacco control. Improving performance expectancy, effort expectancy, and e-HL among non-smoking college students, creating positive social environments, and providing facilitating condition are key aspects of increasing their tobacco control intention and behavior. It is also beneficial to promote the implementation of smoke-free campus and smoke-free family projects.

Análise retrospectiva de um programa para cessação do tabagismo em município do leste mineiro

Introdução: O programa “Deixando de Fumar sem Mistérios” foi desenvolvido para ajudar os participantes a cessar o tabagismo. Objetivo: Avaliar o número de participantes que cessaram o tabagismo após 12 meses do programa “Deixando de Fumar sem Mistérios”, mensurar o nível atual de dependência da nicotina dos que não cessaram o hábito e detectar os fatores envolvidos na falta de adesão ao programa. Metodologia: Entrevista foi realizada com 39 participantes do programa “Deixando de Fumar sem Mistérios” em um município mineiro, para a aplicação do teste de Fagerström e de questionário sobre o funcionamento do programa. A análise dos dados foi realizada por meio do cálculo das frequências absolutas (n) e relativas (%). Resultados: Dos entrevistados, 23% relataram ter parado de fumar, 51% não faltaram às reuniões, e 74% declararam satisfação com o resultado do programa. O nível de dependência do tabaco dos participantes que não cessaram o tabagismo foi moderado (5,2±2,8 pontos), com consumo médio de 22,9±17,3 cigarros/dia e 35,0±15,5 anos de consumo. Os fatores que mais contribuíram para a falta de adesão foram questões logísticas (56%) e crenças pessoais (36%). Conclusão: O grau de satisfação com o programa foi elevado. A desatualização cadastral dificultou o contato com grande parte dos participantes, evidenciando a necessidade de adaptações logísticas para que o programa contribua mais efetivamente com a cessação do tabagismo dos participantes.

The Frequency of Tobacco Smoking and E-Cigarettes Use among Primary Health Care Patients-The Association between Anti-Tobacco Interventions and Smoking in Poland

The aim of this study was to assess the prevalence of smoking and e-cigarette use among primary care patients during the COVID-19 pandemic and to assess the frequency of minimal anti-tobacco interventions by family doctors. A cross-sectional study was conducted from January 2020 to December 2021 encompassing 896 patients over 18 years of age who used primary health care in the city of Lodz, Poland. In total, 21.2% of the respondents were smokers, 11.6% were e-cigarette users, and 7.3% dual users. In addition, 68.4% of smokers had been asked about smoking, while 62.9% of non-smokers and 33.7% of smokers were advised to quit smoking; furthermore, 71.1% of e-cigarette users and 72.3% of dual users were asked about tobacco use, and 17.3% and 21.5%, respectively, had been advised to quit smoking. Multivariate logistic regression analysis found men and alcohol users to receive more minimal anti-tobacco advice than women and non-alcohol users (OR = 1.46; p < 0.05 and OR = 1.45; p < 0.05), socio-demographic and health correlates did not increase the chances of obtaining minimal anti-tobacco interventions among smokers. People with a medium level of education had a higher chance of receiving minimal anti-tobacco intervention from their family doctor when using e-cigarettes and when they were dual users (OR = 2.06; p < 0.05 and OR = 2.51; p < 0.05). Smokers were less likely to receive minimal anti-tobacco interventions than reported in previous studies. Measures should be implemented to increase the minimum interventions provided by GPs in their daily work among all patients, not only those who use tobacco. Non-smokers should be encouraged to abstain.

Longitudinal treatment of smoking in Primary Health Care: an evaluation research

ABSTRACT Objectives: to evaluate the coordination of the attention for continuing treatment for smoking cessation in the Primary Health Care, from the perspective of users. Methods: the conceptual base was longitudinal care, which is an attribute of the National Policy of Primary Care. The methodological framework was that of an evaluative research, as informed by theory-based evaluation. Data collection used observation with moderate participation in the groups to abandon smoking, intensive interviews with 22 users, and analysis of medical records. The interviews used initial and focused coding, which are analytical stages of the Grounded Theory, with the aid of the MaxQDA® software. Results: the interviewees had a positive evaluation of their treatment for smoking, although they mentioned limitations for medium- and long-term continuity. Final Considerations: the smoking treatment sessions, even if infrequent, were found to be a successful experience for smoking cessation.