拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应分析

目的 分析拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应。方法 采用以社区人群为基础的病例对照研究设计,以642例男性自发性戒烟成功者为病例组,700例男性自发性戒烟失败者为对照组。吸烟危害认知水平由12个评分项目的总分评估,拒烟自我效能由拒烟自我效能问卷评估。总效应被分解为直接效应和间接效应,通过基于KHB法的logistic回归分析探讨各效应。结果 调整潜在混杂因素(包括年龄、开始吸烟年龄、职业、教育水平、婚姻状况)后,拒烟自我效能的中介效应仅占吸烟危害认知对戒烟成功影响总效应的6.03%,吸烟危害认知对戒烟成功影响的直接效应占总效应的93.97%;在3种拒烟自我效能情境(包括积极、消极、习惯情境)下的中介效应占吸烟危害认知对戒烟成功总效应的比例分别为6.80%、3.08%和2.32%。结论 拒烟自我效能在吸烟危害认知对戒烟成功的影响具有部分中介效应。提高吸烟者的危害认知水平可直接促使其戒烟成功,并可通过增大拒烟自我效能促使其成功戒烟。

Mediating effect of smoking abstinence self-efficacy on association between awareness of smoking hazard and successful smoking cessation

Objective To estimate the mediating effect of smoking abstinence self-efficacy (SASE) on the association between awareness of smoking hazard and successful smoking cessation. Methods A community-based case-control study was conducted in 642 smokers who successfully stopped smoking,and 700 smokers who failed in smoking cessation were used as controls. The awareness of smoking hazard was evaluated by total score of 12 items. The SASE was assessed by using Smoking Abstinence Self-Efficacy (ASES-S). The total effect was classified as direct effect and indirect effect through logistic regression analysis based on the KHB method. Results After adjusting the potential confounders,including age,age of smoking initiation,occupation,educational level and marital status,the mediating effect of SASE accounted for 6.03% among the total effect of awareness of smoking hazard in those who successfully stopped smoking while the direct effect accounted for 93.97% among the total effect. In the three specific situation of SASE,the mediating effect of SASE accounted for 6.80% (positive/social situations),3.08% (negative/affective situations) and 2.32% (habit/addictive situations) among the total effect,respectively. Conclusion SASE has part mediating effect to influence on the association between the awareness of smoking hazard and successful smoking cessation. Improving smokers'' awareness of smoking hazard may not only promote successful smoking cessation directly,but also contribute to quit smoking through improving the score of SASE.