Relationships between household smoking restrictions and intention to quit smoking among Korean American male smokers in California

Non-daily Cigarette Smoking: Stability and Transition to Abstinence in Young Adults

INTRODUCTION

There is increasing recognition that non-daily cigarette smoking is common in early adulthood but less is known about its stability over time, or what influences transitions to heavier or nonsmoking. We examined the stability of non-daily smoking in a sample of young adults, and tested whether social and cognitive factors predicted transitions to other smoking patterns over time.

AIMS AND METHODS

Participants were 579 young adults (18-24 years old at enrollment, 52% male) who were non-daily and never-daily cigarette smokers and California residents. Participants completed 13 waves of assessment over 3 years. We used descriptive statistics to evaluate the frequency of consistent abstinence, defined as no cigarette use at two consecutive waves and no cigarette use at any subsequent waves. Cox and logistic regression were used to test predictors of consistent abstinence.

RESULTS

We found that 55% of participants smoked intermittently throughout the study, while 43% were consistently abstinent by the end of the study; few transitioned to daily smoking. Stopping smoking was associated with having fewer smoking friends, smoking less in social situations, having lower positive reinforcement expectancies for smoking, and having stronger intent to quit. Post hoc analyses indicated those who stopped smoking tended to report reductions in positive reinforcement expectancies and increased intent to quit in the 6 months before stopping.

CONCLUSIONS

Findings suggest a substantial minority of young adult non-daily smokers may stop on their own, but that the majority continue smoking and may require intervention. Interventions for this population should address social motives and reinforcement expectancies.

IMPLICATIONS

The majority of young adults who are non-daily cigarette smokers appear to maintain this habit over an extended period and may require intervention. Interventions that focus on reducing expectancies for positive effects of and social motives for cigarette use and on increasing intent to quit smoking may be most effective.

Household Smoking Restrictions, Time to First Cigarette and Tobacco Dependence

OBJECTIVE

Environmental factors, such as household smoking restrictions (HSR), may impact a range of smoking-related outcomes. The current study examined the effects of various levels of HSR on smoking behaviors, including the number of cigarettes smoked per day and levels of nicotine dependence in a population of adult smokers. (1) Having specific HSR reduces the urges to smoke (path A); (2) having specific HSR reduces CPD (path B); (3) having specific HSR results in lower overall nicotine addiction (path C), and later, TTFC will be associated with (4) lower urges to smoke in the morning (path A'), (5) fewer CPD (path B'), and (6) lower levels of nicotine addiction (path C').

METHOD

Regression models using self-reported data from the Pennsylvania Adult Smoking Study (N = 353) were used. TTFC was measured minutes between waking and the first cigarette of the day. Household smoking restrictions were measured as follows: (1) full ban on smoking in the home, (2) partial ban, or (3) no ban.

RESULTS

Subjects with no household smoking restrictions had lower incomes and education than those with at least some household smoking restrictions; those with full bans smoked less and had an earlier TTFC than those with at least some household smoking restrictions. Smokers with a full ban had a later TTFC, mediated by fewer cigarettes per day and lower cravings. Among those with partial bans, there is no reduction in cigarettes per day and an increase in urges to smoke.

CONCLUSIONS

Partial household smoking restrictions are no better than no household smoking restrictions with regard to cigarettes per day and TTFC, and may cause an increase in urges to smoke in the morning.

Cigarette Smoking in South Korea: A Narrative Review

Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

Factors associated with desire to quit smoking among Estonian physicians: Cross-sectional data of 2002 and 2014

INTRODUCTION

Smoking is a major health threat and quitting smoking would be a notable benefit. The aim of the present study was to explore factors associated with desire to quit smoking among Estonian physicians in 2002 and 2014.

METHODS

Self-reported data of current smokers were drawn from Estonian physicians' cross-sectional postal surveys in 2002 (n=322) and 2014 (n=189). A logistic regression model was used to analyse the association between desire to quit smoking and factors related to smoking behaviour among 'current smokers'.

RESULTS

The prevalence of desire to quit smoking among physicians was 55.3% in 2002 and 52.9% in 2014. Physicians who were concerned about harms of smoking, had higher odds for desire to quit compared with those who were not concerned (OR=9.06; 95% CI: 4.15-19.74). Compared to physicians with no quit attempts, odds for desire to give up smoking were significantly higher among physicians with quit attempts. Wish to set a good example was significantly associated with desire to quit (OR=2.38; 95% CI: 1.12-5.09). Compared to specialist doctors, dentists had higher odds for desire to quit smoking (OR=2.42; 95% CI: 1.25-4.69).

CONCLUSIONS

More than half of Estonian smoking physicians expressed the desire to quit. Desire to quit was associated with concern about harms of smoking, number of previous quit attempts, setting a good example, and medical specialty. The findings suggest that there is a need for smoking cessation counselling services that are addressed, especially for physicians in Estonia.

A randomized controlled trial of a videoconferencing smoking cessation intervention for Korean American women: preliminary findings

Introduction

Korean women are reluctant to pursue in-person smoking cessation treatment due to stigma attached to women smokers and prefer treatment such as telephone and online smoking cessation programs that they can access secretively at home. However, there is some evidence that face-to-face interaction is the most helpful intervention component for them to quit smoking.

Methods

This study is a pilot clinical trial that examined the acceptability and feasibility of a videoconferencing smoking cessation intervention for Korean American women and compared its preliminary efficacy with a telephone-based intervention. Women of Korean ethnicity were recruited nationwide in the United States and randomly assigned at a ratio of 1:1 to either a video arm or a telephone arm. Both arms received eight 30-minute weekly individualized counseling sessions of a deep cultural smoking cessation intervention and nicotine patches for 8 weeks. Participants were followed over 3 months from the quit day.

Results

The videoconferencing intervention was acceptable and feasible for Korean women aged <50 years, whereas it was not for older women. Self-reported abstinence was high at 67% and 48% for the video and telephone arm at 1 month post-quit, respectively. The rates declined to 33% for the video arm and 28% for the telephone arm at 3 months post-quit when salivary cotinine test was performed.

Conclusion

Findings support that both videoconferencing and telephone counseling can be effective, and personal preference is likely an important factor in treatment matching. The deep cultural smoking cessation intervention may account for the outcomes of telephone counseling being better than prior studies in the literature for Korean women.

A Culturally Adapted Smoking Cessation Intervention for Korean Americans: A Mediating Effect of Perceived Family Norm Toward Quitting

Korean men and women have the highest current smoking rates across all Asian ethnic subgroups in the United States. This is a 2-arm randomized controlled study of a culturally adapted smoking cessation intervention. The experimental condition received eight weekly 40-min individualized counseling sessions that incorporated Korean-specific cultural elements, whereas the control condition received eight weekly 10-min individualized counseling sessions that were not culturally adapted. All participants also received nicotine patches for 8 weeks. One-hundred nine Korean immigrants (91 men and 18 women) participated in the study. The rate of biochemically verified 12-month prolonged abstinence was significantly higher for the experimental condition than the control condition (38.2 vs. 11.1 %, χ (2) = 10.7, p < 0.01). Perceived family norm significantly mediated the effect of cessation intervention on abstinence. Smoking cessation intervention for Korean Americans should be culturally adapted and involve family members to produce a long-term treatment effect.

Smoking trajectories among Koreans in Seoul and California: exemplifying a common error in age parameterization

Immigration to a nation with a stronger anti-smoking environment has been hypothesized to make smoking less common. However, little is known about how environments influence risk of smoking across the lifecourse. Research suggested a linear decline in smoking over the lifecourse but these associations, in fact, might not be linear. This study assessed the possible nonlinear associations between age and smoking and examined how these associations differed by environment through comparing Koreans in Seoul, South Korea and Korean Americans in California, United States. Data were drawn from population based telephone surveys of Korean adults in Seoul (N=500) and California (N=2,830) from 2001-2002. Locally weighted scatterplot smoothing (lowess) was used to approximate the association between age and smoking with multivariable spline logistic regressions, including adjustment for confounds used to draw population inferences. Smoking differed across the lifecourse between Korean and Korean American men. The association between age and smoking peaked around 35 years among Korean and Korean American men. From 18 to 35 the probability of smoking was 57% higher (95%CI, 40 to 71) among Korean men versus 8% (95%CI, 3 to 19) higher among Korean American men. A similar difference in age after 35, from 40 to 57 years of age, was associated with a 2% (95%CI, 0 to 10) and 20% (95%CI, 16 to 25) lower probability of smoking among Korean and Korean American men. A nonlinear pattern was also observed among Korean American women. Social role transitions provide plausible explanations for the decline in smoking after 35. Investigators should be mindful of nonlinearities in age when attempting to understand tobacco use.

Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association

BACKGROUND

Poor lifestyle behaviors, including suboptimal diet, physical inactivity, and tobacco use, are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established.

METHODS AND RESULTS

For this American Heart Association scientific statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) Media and educational campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. Effective interventions included specific approaches in all 6 domains evaluated for improving diet, increasing activity, and reducing tobacco use. The writing group also identified several specific interventions in each of these domains for which current evidence was less robust, as well as other inconsistencies and evidence gaps, informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies.

CONCLUSIONS

This systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other stakeholders to understand and implement the most effective approaches. New strategic initiatives and partnerships are needed to translate this evidence into action.

Association of sociodemographic factors, smoking-related beliefs, and smoking restrictions with intention to quit smoking in Korean adults: findings from the ITC Korea Survey

BACKGROUND

Few studies have reported the factors associated with intention to quit smoking among Korean adult smokers. This study aimed to examine sociodemographic characteristics, smoking-related beliefs, and smoking-restriction variables associated with intention to quit smoking among Korean adult smokers.

METHODS

We used data from the International Tobacco Control Korea Survey, which was conducted from November through December 2005 by using random-digit dialing and computer-assisted telephone interviewing of male and female smokers aged 19 years or older in 16 metropolitan areas and provinces of Korea. We performed univariate analysis and multiple logistic regression analysis to identify predictors of intention to quit.

RESULTS

A total of 995 respondents were included in the final analysis. Of those, 74.9% (n = 745) intended to quit smoking. In univariate analyses, smokers with an intention to quit were younger, smoked fewer cigarettes per day, had a higher annual income, were more educated, were more likely to have a religious affiliation, drank less alcohol per week, were less likely to have self-exempting beliefs, and were more likely to have self-efficacy beliefs regarding quitting, to believe that smoking had damaged their health, and to report that smoking was never allowed anywhere in their home. In multiple logistic regression analysis, higher education level, having a religious affiliation, and a higher self-efficacy regarding quitting were significantly associated with intention to quit.

CONCLUSIONS

Sociodemographic factors, smoking-related beliefs, and smoking restrictions at home were associated with intention to quit smoking among Korean adults.

Individual and family factors associated with intention to quit among male Vietnamese American smokers: implications for intervention development

Smoking prevalence among Vietnamese American males remains higher than the U.S. general population. This study examined the associations of individual and family factors with quit intention among Vietnamese male smokers in California to guide intervention development to reduce their smoking prevalence. Data for Vietnamese male current smokers (n=234) in the 2008 California Vietnamese Adult Tobacco Use Survey (N=1101 males) were analyzed to describe quit intention and previous quit attempts. One-third of Vietnamese male smokers (33%) had no intention to quit at any time, 36% intended to quit soon (in the next 30 days), and 31% intended to quit later (beyond the next 30 days). Half (51.7%) of the sample was in "precontemplation," indicating no intention to quit within 6 months. Many (71%) had made a serious quit attempt in the past year, but 68% of those who tried to quit used no cessation assistance. Multivariate logistic regression adjusting for age, depression, smoking intensity, nicotine dependence, health knowledge, children in the household and home smoking ban revealed that having smoking-related family conflicts and a quit attempt in the past year with or without assistance were independently associated with an intention to quit either in the next 30 days or later. Higher education was associated with no intention to quit. Findings underscore the importance of designing strategic interventions that meet the needs of smokers at both individual and family levels to promote quit intention and to facilitate successful quitting in this population.