Determinants of use of smoking cessation aids in 27 European countries

ObjectiveTo identify determinants of use of smoking cessation aids among current and former smokers in the European Union (EU).MethodsData from n = 9921 current and ex-smokers from 27 European countries (Eurobarometer 77.1, February–March 2012) were analysed. Multivariate binary logistic regression was used to assess for correlates of use of any recommended aid with proven efficacy, defined as use of pharmacotherapy or psychosocial counselling (p < 0.05). The regression analyses assessed for socio-demographic characteristics, EU region, as well as scope of national smoking cessation policies.ResultsAmong current smokers who had made a quit attempt and ex-smokers, 19.9% had used any recommended aid with proven efficacy. Respondents from Northern (adjusted odds ratio [aOR] = 1.90), Western (aOR = 3.21) and Eastern Europe (aOR = 1.69) were more likely to have used an efficacious smoking cessation aid compared to respondents from Southern Europe (all p < 0.05). Respondents in countries with comprehensive tobacco cessation programmes that offered cost-covered national quit lines, medication, and other cessation services had increased likelihood of using efficacious cessation aids (OR = 1.29; 95% Confidence Interval: 1.07–1.55).ConclusionsThese findings underscore the need for enhanced and sustained efforts to ensure increased access to cessation services and aids as part of a comprehensive tobacco control programme.     

Short-term weight gain by menstrual phase following smoking cessation in women

Prevention of early weight gain may be critical to avoid relapse among women with a fear of weight gain. Menstrual phase has physiological fluctuation of fluid resulting in short-term weight gain, suggesting menstrual phase of smoking cessation may impact short-term weight gain. This study examined the effect of smoking abstinence and menstrual cycle on short-term weight gain. Women were randomized to quit smoking during the follicular or luteal phase of their cycle and followed for four weeks. Weight, among other measures, was recorded at five post-quit date visits (days 2, 5, 9, 12 and week 4). Participants (n = 152) were grouped based on randomized quit phase and smoking status after assigned quit date: 1) follicular (F), quit < 24 h, 2) F, quit ≥ five days, 3) luteal (L), quit < 24 h, and 4) L, quit ≥ five days. Participants who quit smoking experienced significantly more weight gain than those who quit for less than 24 h. There were no significant increases in short-term weight gain based on menstrual cycle phase during attempted smoking cessation.     

Tasas de abstinencia de vareniclina frente a bupropión y terapia sustitutiva con nicotina en la cesación del tabaco en atención primaria

ObjectiveThe objective of this study was to estimate the continuous abstinence rates of varenicline, bupropion and nicotine replacement therapy (NRT) in smoking cessation in 2 Primary Care (PC) External Support Units.DesignObservational, multicentre, longitudinal study using a retrospective review of medical records.SettingSix Primary Care Centres.ParticipantsPatients > 18 years, who began smoking cessation treatment between 1/01/2006 and 1/12/2008 with varenicline, bupropion or NRT were included in the analysis.ContinuationPatient follow-up was conducted from time-baseline (day 1) and assessed at 6 and 12 months. Main variables: comorbidities, effectiveness (continuous abstinence) and pharmacological tolerability. Statistical analysis: logistic regression models and Kaplan-Maier survival curves; P < .05.ResultsA total of 957 smokers treated with NRT (53.0%), bupropion (25.1%) and varenicline (21.9%) were included in the analysis. Mean age: 47.6 (11.3) years; 58.6% men. 32.0% of smokers attended due to physical dependence. Average duration of smoking: 19.5 (6.7) years. At 6 months, 61.2% (95% CI: 54.6-67.8%) of participants in the varenicline group continuously abstained from smoking compared with 56.9% (95% CI: 50.6-63.2%) in the bupropion group, and 52.3% (95% CI: 48.0-56.6%) in the NRT group; P = .003. At 12 months, the rate of continuous abstinence was 57.4% (95% CI: 50.7-64.1%) in the varenicline group compared with 52.9% (95% CI: 46.6-59.2%) in the bupropion group and 47.1% (95% CI: 42.8-51.4%) in the NRT group; P = .002.ConclusionOne year-follow up results suggest that varenicline is an appropriate alternative compared with bupropion and NRT on smoking cessation in the PC setting.     

Effect of a smoking cessation intervention for women in subsidized neighborhoods: A randomized controlled trial

ObjectiveTo evaluate the effectiveness of a community based participatory research (CBPR) developed, multi-level smoking cessation intervention among women in subsidized housing neighborhoods in the Southeastern US.MethodsA total of n = 409 women in 14 subsidized housing neighborhoods in Georgia and South Carolina participated in this group randomized controlled trial conducted from 2009 to 2013. Intervention neighborhoods received a 24-week intervention with 1:1 community health worker contact, behavioral peer group sessions, and nicotine replacement. Control neighborhoods received written cessation materials at weeks 1, 6, 12, 18. Random coefficient models were used to compare smoking abstinence outcomes at 6 and 12 months. Significance was set a p < 0.05.ResultsThe majority of participants (91.2%) were retained during the 12-month intervention period. Smoking abstinence rates at 12 months for intervention vs. control were 9% vs. 4.3%, p = 0.05. Additional analyses accounting for passive smoke exposure in these multi-unit housing settings demonstrated 12 month abstinence rates of 12% vs. 5.3%, p = 0.016. However, in the multivariate regression analyses, there was no significant effect of the intervention on the odds of being a non-smoker (OR = 0.44, 95% CI: 0.18–1.07). Intervention participants who kept coach visits, attended group sessions, and used patches were more likely to remain abstinent.ConclusionsThis CBPR developed intervention showed potential to engage smokers and reduce smoking among women in these high-poverty neighborhoods. Effectiveness in promoting cessation in communities burdened with fiscal, environmental and social inequities remains a public health priority.     

The relation of tobacco use during hospitalization to post-discharge smoking cessation among US veterans

ObjectiveThe objective of this study was to determine if tobacco use while in the hospital was associated with post-discharge cessation rates.MethodsDuring 2006–2008, smokers from three Veterans Affairs hospitals (n = 354) were surveyed during their hospitalization and again 6 months later. Data analysis was conducted in 2009.ResultsWhile veterans smoked an average of 19 cigarettes per day, prior to admission, the average was 6–7 cigarettes per day during hospitalization. About 40% (n = 140) were able to quit smoking for more than 24 h and the median days quit was 29. The 6-month self-reported quit rate was 15% (n = 53). Multivariate analyses showed that veterans who quit tobacco use during their hospitalization had nearly 4 times increased odds of quitting smoking for more than 24 h and 2.7 times increased odds of quitting at 6 months post-hospitalization as compared to veterans that did not quit using tobacco during hospitalization.ConclusionMany veterans quit tobacco use during hospital admissions and those who do not quit, tended to decrease their use. Veterans who quit tobacco use were more likely to be abstinent at 6-month follow-up. State-of-the-art cessation interventions need to be provided to smokers hospitalized in Veterans Affairs hospitals.     

Sustained body weight reduction by an individual-based lifestyle intervention for workers in the construction industry at risk for cardiovascular disease: Results of a randomized controlled trial

ObjectiveTo evaluate the effectiveness of a lifestyle intervention for male workers in the construction industry at risk of cardiovascular disease (CVD).MethodsIn a randomized controlled trial performed in the Netherlands between 2007 and 2009, usual care was compared to 6 months of individual counseling using motivational interviewing techniques, delivered face to face and by telephone. Participants aimed at improving energy balance-related behavior or smoking cessation. Linear regression analyses were performed to determine the effects.ResultsBody weight had significantly decreased at 6 (β = ?1.9, 95% CI ?2.6; ?1.2) and 12 months (β = ?1.8, 95%CI ?2.8; ?1.1). The intervention effects were also significant for diastolic blood pressure at 6 months (β = ?1.7, 95% CI ?3.3; ?0.1). Among participants who had aimed at energy balance, the intervention had a significant favorable effect on body weight at 6 (β = ?2.1, 95% CI ?2.9; ?1.3) and 12 months (β = ?2.2, 95% CI ?3.1; ?1.3) and at HDL cholesterol (β=0.05, 95% CI 0.01; 0.10) and HbA1c (β = ?0.06, 95%CI ?0.12; ?0.001) at 12 months, although there was no intervention effect on these variables over time.ConclusionIndividual-based counseling resulted in significant beneficial long-term effects on body weight. This is an important finding for occupational health, considering the rising prevalence of obesity and CVD.     

Sex/gender differences in smoking cessation: A review

Data from treatment studies tends to show women are less likely to quit smoking than men, but these findings have been disputed, typically based on contradictory evidence from epidemiological investigations. The purpose of this review was to shed light on this conflict. We conducted a qualitative review in January 2016 to examine sources of variation in sex/gender differences for smoking cessation. We identified 214 sex/gender difference tests from 190 studies through Medline and studies were categorized into efficacy trials (k = 37), effectiveness trials (k = 77), prospective observational studies of cessation (k = 40; current smokers transitioning to former smokers), prospective observational studies of relapse (k = 6; former smokers transitioning to current smokers), cross-sectional investigations of former smoker prevalence (k = 32), and community-based interventions (k = 4). We also summarized evidence across time periods, countries, outcome assessments, study sample, and treatment. Evidence from efficacy and effectiveness trials, as well as prospective observational studies of relapse, demonstrated that women have more difficulty maintaining long-term abstinence than men. Findings from prospective observational studies and cross-sectional investigations were mixed and demonstrated that bio-psycho-social variation in samples across place and time may determine whether or not women or men are less likely to quit smoking. Based on these findings, we consider whether sex/gender differences in quitting meet criteria for a disparity and outline directions for further research.     

Toll-like receptor 8 (TLR8) polymorphisms are associated with non-progression of chronic hepatitis C in HIV/HCV coinfected patients

Toll-like receptor 8 (TLR8) polymorphisms have been related to hepatitis C virus (HCV) infection. The aim was to estimate the association of TLR8 polymorphisms with HCV-related outcomes in HIV/HCV coinfected patients. We performed a cross-sectional study of 220 patients who underwent a liver biopsy. TLR8 polymorphisms were genotyped using GoldenGate® assay. The outcome variables were non-fibrosis (F0), mild-inflammation (A0/A1), and non-steatosis [fatty hepatocytes (FH) < 10%]. Logistic regression analysis was used to compare the outcome variables according to TLR8 polymorphisms. Four polymorphisms were analyzed (rs1013151, rs5744069, rs17256081 and rs3764880rs1013151). Female patients had higher frequency of TLR8 major alleles at rs17256081 and rs101315, and minor alleles at rs3764880 and rs5744069. Male patients had higher frequency of TLR8 minor alleles except for rs3764880, where major alleles were higher (p < 0.01). Two TLR8 polymorphisms (rs1013151 and rs5744069) were significantly associated with non-fibrosis (F0) [adjusted odds ratio (aOR) = 4.42 (95% of confidence interval (95%CI) = 1.54; 12.68) (p = 0.006) and aOR = 4.76 (95%CI = 1.69; 13.37) (p = 0.003); respectively]. When data were stratified by gender, rs1013151 and rs5744069 polymorphisms remained significant for male patients [adjusted odds ratio (aOR) = 4.49 (95%CI = 1.08; 18.62) (p = 0.039) and aOR = 6.17 (95%CI = 1.45; 26.20) (p = 0.014); respectively]. When data were stratified by major HCV genotypes, patients infected with HCV genotype 1 (GT1) had significant values for both rs1013151 and rs5744069 polymorphisms [aOR = 5.79 (95%CI = 1.44; 23.32) (p = 0.013) and aOR = 8.01 (95%CI = 2.16; 35.65) (p = 0.005); respectively]. Finally, none of the TLR8 polymorphisms were significantly associated with mild-inflammation or non-steatosis. In conclusion, TLR8 polymorphisms seem to be related to non-progression of liver fibrosis in HIV/HCV coinfected patients, particularly in males and those patients infected with GT1.     

Tobacco control environment in the United States and individual consumer characteristics in relation to continued smoking: Differential responses among menthol smokers?

ObjectiveWe used a consumer panel augmented with state-specific measures of tobacco control activities to examine the main effects and interactions among consumer behaviors, particularly menthol cigarette smoking, and tobacco control environment on cessation over a six-year period.MethodsWe used the Nielson Homescan Panel, which tracks consumer purchasing behaviors, and tobacco control information matched to panelist zip code. We focused on 1582 households purchasing ≥ 20 packs from 2004 to 2009. Our analysis included demographics; purchasing behavior including menthol versus nonmenthol use (≥ 80% of cigarettes purchased being menthol), quality preferences (average price/pack), purchase recency, and nicotine intake (nicotine levels of cigarettes purchased); and tobacco control metrics (taxation, anti-tobacco advertising, smoke-free policies).ResultsMenthol smoking (Hazard Ratio [HR] = 0.79, 95% Confidence Interval [CI] 0.64, 0.99), being African American (HR = 0.67, CI 0.46, 0.98), being male (HR = 0.46, CI 0.28, 0.74), higher quality premium preferences (HR = 0.80, CI 0.77, 0.91), lower recency (HR = 1.04, CI 1.02, 1.05), and higher nicotine intake rates (HR = 0.99, CI 0.99, 0.99) were related to continued smoking. No significant interactions were found.ConclusionWhile there were no interactions between menthol use and effects of tobacco control activities, we did find additional support for the decreased cessation rates among menthol cigarette smokers, particularly in the African American population.     

Are secondhand smoke-related diseases of children associated with parental smoking cessation? Determinants of parental smoking cessation in a population-based cohort study

ObjectiveLittle is known about whether secondhand smoke (SHS)-related diseases of young children, such as asthma, induce parental smoking cessation during the early child-rearing period. Our objective was therefore to show the association in addition to other potential determinants of parental cessation.MethodsWe analyzed data from the Longitudinal Survey of Newborns in the 21st Century in Japan, from 0.5 years (N = 47,015) to 4.5 years (N = 39,817), having selected participants whose parents smoked at baseline (maternal smoking N = 8,037; paternal smoking N = 28,486). Multivariable log-binomial regression models were used to calculate the prevalence ratios for parental smoking cessation according to the onset of SHS-related diseases of their children, using inverse probability weight to account for non-response at follow-up.ResultsA total of 16.7% of smoking mothers and 14.5% of smoking fathers had stopped smoking at follow-up. The onset of SHS-related children's diseases was not statistically significantly associated with either maternal or paternal smoking cessation after multivariable adjustments. Strong determinants were, for example, number of cigarettes smoked per day and partner's smoking status during follow-up.ConclusionSHS-related children's diseases were not associated with parental smoking cessation. It may therefore be necessary to provide additional support for parental smoking cessation within their child's medical care setting.     

Efficacy of a tobacco quitline among adult cancer survivors

ObjectiveThe purpose of the study (conducted 2010–2013) was to determine the efficacy of two common types of tobacco quitlines in adult cancer survivors who regularly smoked cigarettes.MethodAdult onset cancer survivors in Memphis, Tennessee (n = 427, 67% female, 60% Caucasian) were randomized either to a Proactive (i.e., counselor-initiated calls) or Reactive (i.e., participant-initiated calls) quitline. Both conditions also received nicotine replacement therapy. The primary outcome was biochemically-verified (i.e., salivary cotinine) smoking cessation.ResultsWhile 12-month self-reported abstinence was consistent with other published studies of smoking cessation (22% and 26% point prevalence abstinence for Proactive and Reactive conditions, respectively), 48% of participants who were tested for cotinine failed biochemical verification, indicating a considerable falsification of self-reported cessation. Adjusted cessation rates were less than 5% in both intervention conditions.ConclusionOur results are consistent with other studies indicating that traditional smoking cessation interventions are ineffective among cancer survivors. Moreover, self-reports of cessation were unreliable in cancer survivors participating in a quitline intervention, indicating that future studies should include biochemical verification. Given the importance of smoking cessation among cancer survivors and low cessation rates in the current study, it may be necessary to design alternative interventions for this population.ClinicalTrials.gov identifier: NCT00827866.     

Abstinence rates among college cigarette smokers enrolled in a randomized clinical trial evaluating Quit and Win contests: The impact of concurrent hookah use

ObjectiveTo examine baseline characteristics and biochemically verified 1-, 4-, and 6-month tobacco quit rates among college students enrolled in a Quit and Win cessation trial, comparing those who concurrently smoke both hookah and cigarettes with those who deny hookah use.MethodsAnalyses were conducted on data from 1217 college students enrolled in a Quit and Win tobacco cessation randomized clinical trial from 2010–2012. Multivariable logistic regression (MLR) analyses examined group differences in baseline characteristics and cotinine verified 30-day abstinence at 1, 4, and 6-month follow-up, adjusting for baseline covariates.ResultsParticipants smoked 11.5(± 8.1) cigarettes per day on 28.5(± 3.8) days/month, and 22% smoked hookah in the past 30 days. Hookah smokers (n = 270) were more likely to be male (p < 0.0001), younger (p < 0.0001), report more binge drinking (p < 0.0001) and score higher on impulsivity (p < 0.001). MLR results indicate that hookah users, when compared to non-users, had a 36% decrease in odds of self-reported 30-day abstinence at 4-months (OR = 0.64, 95% CI = 0.45–0.93, p = 0.02) and a 63% decrease in odds in biochemically verified continuous abstinence at 6-months (OR = 0.37, CI = 0.14–0.99, p = 0.05).ConclusionCollege cigarette smokers who concurrently use hookah display several health risk factors and demonstrate lower short and long-term tobacco abstinence rates.     

School bullying and susceptibility to smoking among never-tried cigarette smoking students

IntroductionBullying involvement has been linked with substance use; however, less is known about its relationship with pre-initiation stages of adolescent cigarette smoking behavior. This study examined the association between bullying involvement and smoking susceptibility among never tried or experimented with cigarette smoking students. Susceptibility to cigarette smoking in adolescence is a strong predictor of subsequent smoking initiation.MethodsA cross-sectional data on Canadian adolescent and youth were drawn from the 2012/2013 Youth Smoking Survey (n = 28,843). Logistic regression analysis was used to examine the association between bullying and smoking susceptibility among never-smoking students.ResultsAbout 21% self-reported involvement in bullying (as a bully, victim or both). Middle school students (grades 6–8) reported more involvement in bullying (24%) than those in grades 9–12 (16%). The multivariable analyses showed that the association between bullying and smoking susceptibility was significantly different by grade level. Middle school students involved in bullying had higher odds of smoking susceptibility compared to uninvolved students (bully, adjusted odds ratio [AOR] = 2.54, 95% CI = 1.73–3.74; victim, AOR = 1.29, 95% CI = 1.11–1.48; bully–victim, AOR = 2.19, 95% CI = 1.75–2.74). There were no significant associations between all subgroups of bullying and smoking susceptibility for grades 9–12 students.ConclusionsStudents involved in bullying were more susceptible to smoking, although patterns of association varied by grade level. In particular, the findings highlight that non-smoking middle school students involved in bullying were susceptible to future smoking.     

Violencia de pareja y depresión en mujeres que trabajan en una institución de salud de México

ObjectiveTo assess the effect of intimate partner violence on the risk of depression and depressive symptoms among adult women.MethodWe analyzed data from the Mexican Health Workers’ Cohort study (n = 470). Type and severity of intimate partner violence was ascertained between 2004 and 2011. Self-reported medical diagnosis of depression (2011) was the main outcome; depressive symptoms ascertained with the Centre for Epidemiologic Studies-Depression (CES-D) scale was the secondary outcome. Random-effects regressions were run to model the risk of depression (logistic) and depressive symptoms (linear) in relation to intimate partner violence.Results41.9% women experienced intimate partner violence at baseline. The incidence of depression was 7.2%. The risk of depression increased with any type of IPV (adjusted odds ratio [aOR] = 2.9; 95% confidence interval [95%CI]: 1.4–6.2) and with physical (aOR = 4.3; 95%CI: 1.8–10.1), psychological (aOR = 3.1; 95%CI: 1.4–6.6) and sexual (aOR = 3.1; 95%CI: 1.2–8.2) violence. Depressive symptoms (CES-D) increased slightly with physical and sexual intimate partner violence.ConclusionsIntimate partner violence was associated with a higher risk of depression in this sample of women working in a Mexican health facility. Our results indicate the need to develop infrastructure, to implement strategies of attention and counselling, and to provide a safe environment in the workplace for women who experience intimate partner violence.     

Exercise facilitates smoking cessation indirectly via improvements in smoking-specific self-efficacy: Prospective cohort study among a national sample of young smokers

ObjectiveThe purpose of this study was to examine whether exercise is associated with 2-year follow-up smoking status through its influence on smoking-specific self-efficacy.MethodsLongitudinal data from the 2003–2005 National Youth Smoking Cessation Survey were used, including 1,228 participants (16–24 years). A questionnaire was used to examine baseline exercise levels, baseline smoking-specific self-efficacy, follow-up smoking status, and the covariates.ResultsBaseline exercise was associated with baseline self-efficacy (β = 0.04, p < 0.001) after adjusting for age category, sex, race–ethnicity, education, and nicotine dependence. Baseline self-efficacy, in turn, was associated with 2-year smoking status (β = 0.23, p < 0.001) after adjustments. There was no adjusted direct effect of baseline exercise on 2-year smoking status (β = 0.001, p = 0.95); however, the adjusted indirect effect of baseline self-efficacy on the relationship between exercise and 2-year smoking status was significant (β = 0.008, bootstrapped lower and upper CI: 0.002–0.02; p < 0.05). The mediation ratio was 0.837, which indicates that smoking-specific self-efficacy mediates 84% of the total effect of exercise on smoking status.ConclusionsAmong daily smokers, exercise may help to facilitate smoking cessation via exercise-induced increases in smoking-specific self-efficacy.     

Séroprévalence du VIH et facteurs associés chez les hommes ayant des rapports sexuels avec d’autres hommes au Togo

BackgroundLimited data are available on HIV infection among vulnerable populations in sub-saharan African countries, especially among men who have sex with men (MSM). The aim of this study was to estimate HIV prevalence and the factors associated with HIV infection among MSM in Togo in 2011.MethodA cross-sectional survey was carried out among MSM aged at least 18 years old, living in Togo for at least 3 months. They were recruited through the snowball method in six cities of Togo from November 2011 to January 2012. A survey form was used and an HIV screening test was proposed to the participants. The HIV prevalence was estimated with a 95% confidence interval. Univariate and multivariate analyses were performed to identify factors associated with HIV infection.ResultsA total of 758 MSM were enrolled in this study, including 498 (67.5%) from Lomé, the capital of Togo. The median age was 24 years with an interquartile range of [21–27 years] and 271 MSM (35.7%) were students. The vast majority of MSM were Togolese (90.3%) and 14.6% were married or committed to a woman. HIV testing was accepted by 488 MSM (64.3%) but only 408 (53.8%) finally accepted a blood sample collection. The prevalence of HIV infection was 19.6% [95% confidence interval, 15.9–23.8]. In multivariate analysis, three factors were associated with HIV infection: living in Lomé, with an HIV prevalence of 29.8% against 4.3% in the other cities of Togo [adjusted odds ratio (aOR) = 9.68; P < 0.001]; having a good knowledge of HIV transmission modes (aOR = 0.59; P = 0.049); and not having a regular sex partner (aOR = 1.69; P = 0.049).ConclusionOne MSM out of five was HIV-infected. Intervention programs targeting this vulnerable population are urgently needed, to reduce HIV incidence in Togo.     

Vulnerabilidad de la obesidad definida por el índice de masa corporal,perímetro abdominal y porcentaje de grasa corporal

AimTo ascertain to what extent it is possible to stop being obese (to normalize body mass index [BMI], waist circumference [WC] and/or body fat percentage [BFP]).DesignLongitudinal observational and retrospective study.SiteEleven Spanish health centers.ParticipantsMen and women with BMI ≥ 30 kg/m² (n = 1246) or general obesity (GO), with WC > 102 cm and > 88 cm, respectively (n = 2122) or abdominal obesity (AO) and with BFP > 25% and > 35%, respectively (n = 2436) or excess body fat (EBF), from the PEPAF Study cohort of 4927 participants aged 20-80 years.Main measurementsData from the PEPAF study at baseline and at 6, 12 and 24 months: gender, age, diagnoses of diabetes, hypertension and dyslipidemia, smoking, levels of and compliance with physical activity recommendations, maximum oxygen consumption, weigh, height, WC and three skin-folds (thoracic, umbilical and anterior thigh for men and triceps, suprailiac and anterior thigh for women).ResultsOf 2054 participants with any type of obesity at baseline and valid data at 2 years, 240 (11.6%) had normalized all of their obesity diagnostic indexes. 19.5% (95% confidence interval (95% CI: 17.6-21.4) ceased to have EBF, 12.0% (95% CI: 10.4-13.7) ceased to have AO and 10.5% (95% CI: 8.5-12.7) ceased to have GO.ConclusionsObesity differs from other chronic diseases in that it can be «cured» by normalizing the amount of body fat.     

Sevrage des nourrissons avant six mois à Marrakech : facteurs associés et prévalence

BackgroundIn Morocco breastfeeding has become a declining practice. The objectives of this study were to estimate the prevalence of weaning before the age of 6 months and to identify associated factors.MethodsA cross-sectional survey was conducted among 400 mothers of infants aged 0 to 24 months. Participants were recruited from patients attending 40 randomly selected general practices in Marrakech. A trained interviewer administered a questionnaire to collect data on breastfeeding practice and factors associated with it. Early weaning was defined as a cessation of breastfeeding before the age of 6 months and was studied in mother–child couples whose infants were aged 6 months and older. Three binary logistic regression models were used to model the probability that an infant aged 6 months or more is weaned early.ResultsBreastfeeding was initiated by the majority of respondents (97.5%). Early weaning was observed in 75 infants (28% of registered weaning). Factors associated with early weaning were: mother having an occupational activity (Odds Ratio [OR] = 2.09; 95% confidence interval [CI]: [1.07–4.06]), caesarean delivery (OR = 4.15; 95% CI: [1.74–9.88]) and the fact that the pregnancy was desired (OR = 0.19; 95% CI: [0.05–0.68]).ConclusionWeaning before 6 months of age is a common practice in our context. Identifying factors associated with early weaning is critical to promote breastfeeding.