Helping women quit smoking: results of a community intervention program

OBJECTIVES: This intervention was implemented to reduce the prevalence of cigarette smoking among women. METHODS: We used community organization approaches to create coalitions and task forces to develop and implement a multicomponent intervention in 2 counties in Vermont and New Hampshire, with a special focus on providing support to help women quit smoking. Evaluation was by pre-intervention and post-intervention random-digit-dialed telephone surveys in the intervention counties and the 2 matched comparison counties. RESULTS: In the intervention counties, compared with the comparison counties, the odds of a woman being a smoker after 4 years of program activities were 0.88 (95% confidence interval = 0.78, 1.00) (P = .02, 1-tailed); women smokers' perceptions of community norms about women smoking were significantly more negative (P = .002, 1-tailed); and the quit rate in the past 5 years was significantly greater (25.4% vs 21.4%; P = .02, 1-tailed). Quit rates were significantly higher in the intervention counties among younger women (aged 18 to 44 years); among women with household annual incomes of $25,000 or less; and among heavier smokers (those who smoked 25 or more cigarettes daily). CONCLUSIONS: In these rural counties, community participation in planning and implementing interventions was accompanied by favorable changes in women's smoking behavior.     

护理专业学生劝阻吸烟现状调查

目的 了解护理专业学生劝阻吸烟现状及影响因素,为开展控烟教育提供科学依据。方法 采用整群抽样方法,于2014年11-12月对重庆市主城2所公立医学高等学校5210名在校护理专业学生进行问卷调查。结果 护理专业学生劝阻亲友吸烟率为45.5%,在有明显戒烟标志的公共场所见到陌生人吸烟,有34.0%会上前劝阻。在公共场所劝阻陌生人吸烟单因素分析结果显示,性别、年级、本人及父母吸烟情况,控烟相关知识、态度,对社会控烟环境的感知及参与控烟实践等14个因素有统计学意义(均P<0.05)。多因素分析结果显示,控烟知识得分高、反对二手烟(被动吸烟)、赞成主动提供戒烟服务、愿意参加控烟活动、关注媒体控烟信息、与他人交流过烟草的危害、有效劝阻他人吸烟的护理学生更倾向于在公共场所劝阻吸烟(均P<0.05)。结论 护理专业学生在公共场所劝阻吸烟受多种因素影响,应加强学生控烟教育,积极开展多种控烟实践活动,提高学生控烟技能,并加大社会控烟宣传,形成良好的社会控烟环境。     

农村社区居民吸烟及影响因素分析

目的探讨农村社区居民吸烟的影响因素，为开展控烟教育及行为干预提供依据。方法采用横断面问卷调查方式。对江苏省常州市武进区18岁以上常住居民进行吸烟行为流行病学调查。结果该区18岁以上常住人群总吸烟率为30．0％，男性吸烟率为68．4％，远高于女性的1．7％；男性40～50岁组吸烟率最高为75．4％，〈30岁组吸烟率最低为45．7％。在男性中，农民吸烟率最高（70．0％），家务劳作者最低（26．1％）；吸烟者中，25岁前开始吸烟者占76．0％，每天吸烟10支以上者占88．5％，戒烟成功率为14．1％，被动吸烟率为71．7％。结论目前苏南农村社区居民的吸烟状况不容乐观，应大力开展控烟的宣教及吸烟相关因素的干预活动。     

Helping adolescents quit smoking:a needs assessment of current and former teen smokers

This study compared the survey responses of 280 current and former adolescent smokers for what they perceived would be helpful (or what had helped) in quitting smoking. The survey was developed from focus groups and was structured using Prochaska and DiClementes Stages of Change health behavior framework. Results showed that former smokers and current smokers in the preparation stage of change shared beliefs about the importance of interpersonal support, those who were contemplating a quit decision worried about obstacles and internal issues, and current smokers not thinking about quitting focused on external rewards. The findings that significant differences exist based on the adolescent smokers Stage of Change imply that this framework can be appropriately applied to this context.     

Patterns of smoking, quit attempts and services for a cohort of 15- to 19-year-olds

Objectives To establish patterns of smoking among 15‐to 19‐year‐olds within mixed urban and suburban area and explore preference for the nature of services to assist quitting. Design Postal survey and depth interviews with focus group validation. Setting People registered with health services in the Borough of Solihull, UK. The borough has a diverse population with areas of high deprivation to the north and a range of prosperity elsewhere. Participants Questionnaires were sent to 50% of those registered and 20 people interviewed aged from 15 to 19 years. Main outcome measures The survey contained demographic questions relating to educational attainment and family, smoking status, history and quit attempts, use of facilities for quit attempts. Qualitative themes explored attitudes and experience of quitting, utilization of cessation services, barriers to access and nicotine replacement therapy. Results Total survey response rate was 32.6%. Three in five reported smoking a cigarette sometime, 17.2% current regular smokers, 7.2% current occasional smokers. Median age of starting smoking was significantly lower (P = 0.004) for current regular smokers, distinguishable in two groups; weekend smokers and all week smokers. More quit attempts had been made or planned by current regular smokers but were often short lived. Weekend smokers had a slightly longer duration of quitting (P = 0.03). Eight‐two per cent were optimistic about quitting in the future although the majority (80%) had already made one quit attempt. Knowledge and use of existing services was poor, with concerns about privacy and confidentiality. Models based on autonomy were identified as potentially useful. Conclusion Teenage smoking is characterized by optimism about quitting despite the failure of many quit attempts, lack of regard for existing services and barriers to uptake.     

河北省城乡居民吸烟现状比较研究

目的 了解河北省城乡居民的吸烟现状。方法 采取多级分层整群随机抽样方法，选取5998户的16640名15岁及以上常住居民为调查对象，用统一规格的调查表进行询问调查。结果 调查人群的吸烟率为26.08％，农村高于城市；不同性别、年龄组、婚姻状况和职业的人群吸烟率不同；开始吸烟的平均年龄为21．76岁；日平均吸烟量为15．26支，农村高于城市，与2年前比较有增加趋势。结论 河北省城乡居民的吸烟率低于1998年第2次国家卫生服务调查的全国水平，高于本省水平；农村居民的吸烟率和吸烟量均高于城市。     

中国农村地区现在吸烟者戒烟意愿及其影响因素研究

目的 了解中国农村地区现在吸烟者戒烟意愿,探索其影响因素,为控烟工作提供参考。方法 本研究数据来源于2018年中国慢性病及危险因素监测,采用多阶段分层整群抽样的方法抽取184 509名≥18岁居民,其中10 241名农村现在吸烟者纳入研究。采用χ²/F检验对戒烟意愿与人口学信息、烟草使用情况、烟草相关危害知识的认知、慢性病患病情况等因素进行单因素分析,多因素分析采用非条件多因素logistic回归分析。结果 3 453名（37.46%）考虑在未来12个月内戒烟。logistic回归分析显示,偶尔吸烟者的戒烟意愿高于每天吸烟者（OR=0.693,95%CI：0.494~0.971）,每天吸烟量<1包者的戒烟意愿高于≥1包者（OR=0.628,95%CI：0.511~0.771）,12个月内有戒烟经历者的戒烟意愿高于12个月内未戒过烟的现在吸烟者（OR=0.438,95%CI：0.357~0.537）,烟草危害认知程度高者戒烟意愿更高（OR=1.056,95%CI：1.028~1.086）,差异均有统计学意义（P<0.05）。结论 中国农村地区现在吸烟者戒烟意愿与吸烟状况、吸烟量、戒烟情况、烟草危害认知有关。建议加强对农村地区的健康教育宣传,提供简短的戒烟干预,提高农村现在吸烟者的戒烟意愿。     

男性饮酒行为与吸烟行为及戒烟意愿的关系

目的探讨男性饮酒与吸烟行为及戒烟意愿之间的关系。方法按多阶段分层整群随机抽样方法,在江苏省14个慢病监测点,抽取≥18岁男性常住居民进行问卷调查,采用非条件logistic回归方法,分析饮酒与吸烟、戒烟意愿之间的关系。结果男性成人现在吸烟率和饮酒率分别为56.90%、60.16%。饮酒者现在吸烟率为66.54%,饮酒者现在吸烟的比例高于不饮酒者(OR=2.77,95%CI:2.40~3.19),且随饮酒频率和饮酒量的增加而显著增加。现在吸烟者中,打算戒烟比例为26.56%,饮酒频率越高者打算戒烟的比例越低(P=0.023)。结论饮酒会促进吸烟行为的发生,并降低吸烟者的戒烟意愿。     

Opportunities for improving inpatient smoking cessation programs: a community hospital experience

BACKGROUND: This cohort study examined the role of smoking during hospitalization, duration of cessation counseling, patient awareness of the hospital's smoke-free policy, belief that smoking is associated with a current symptom or disease, and the presence of withdrawal symptoms with 12-month smoking cessation among inpatients enrolled in a smoking cessation program. METHODS: Inpatients in four community hospitals (N = 1,317) participated in a smoking cessation intervention consisting of face-to-face counseling at baseline and four follow-up counseling phone calls. Patients were classified as nonsmokers only if they reported not smoking at both the 6- and the 12-month interviews. All patients lost to follow-up were considered smokers. RESULTS: At 1 year the smoking cessation rate was 22.5%. Cessation was independently associated with reporting no smoking during hospitalization, noting no withdrawal symptoms at baseline, and believing that a current illness or symptom is related to smoking. Length of counseling interview and awareness of the hospital's smoke-free policy were not independently associated with cessation. CONCLUSIONS. Smoking cessation programs and hospital policies that decrease smoking during hospitalization, address withdrawal symptoms during hospitalization, and make clear the connection between a patient's health and cigarette smoking may increase the effectiveness of their smoking cessation efforts.     

Retrospective cohort study of smoking and lung cancer incidence in rural prefecture,Japan

Objectives We conducted an epidemiological study of the relationship between lung cancer incidence and smoking, with special reference to the benefits of smoking cessation for reducing lung cancer incidence, to promote a local smoking control program. Methods The study was a retrospective cohort study. The population studied was 16,383 male examinees of lung cancer health examinations in 1995 in Tottori Prefecture, Japan. Smoking status from the questionnaire during the health examination was used as the exposure variable. Endpoint (lung cancer incidence) was obtained from the Tottori population-based cancer registry. A multivariable analysis using the Cox proportional hazard model was adapted for statistical analysis. The average follow-up period was 4.3 years. Results The hazard ratio of current smokers for the incidence of lung cancer was 4.9, whereas that of ex-smokers was 2.2. The dose-response relationship between lung cancer incidence and lifetime cigarette consumption (pack year) was determined. The ratio increased among younger subjects (under 65 years old). The hazard ratio of ex-smokers decreased with years just after quitting smoking, and reached the level of never smokers after 10–19 years from smoking cessation. Conclusions We reconfirmed that the magnitude of risk estimates of smoking for lung cancer incidence was similar to those of previous studies, and smoking cessation was effective for reducing lung cancer risk.     

中国中西部农村地区居民吸烟、被动吸烟及戒烟现状调查

目的了解中西部农村地区居民吸烟、被动吸烟及戒烟现状,为改善中西部农村地区吸烟状况提供建议。方法采用多阶段分层随机抽样方法,对山西、甘肃、青海、新疆4个省(自治区)中16个项目县84个行政村5486名15-69岁的居民进行问卷调查。以吸烟率、开始吸烟年龄、被动吸烟率、戒烟率和对烟草危害健康的知晓率作为调查指标,调查中西部地区农村居民吸烟现状。结果调查对象的吸烟率为20．9%,其中,男性吸烟率为44．8%,女性吸烟率为2．O%;汉族吸烟率高于少数民族,不同性别、民族和文化程度者的吸烟率差异有统计学意义(P<0．001)。吸烟者开始吸烟平均年龄为(21．3±5．6)岁,男性早于女性。被动吸烟率为37．8%,其中男性31．9%,女性40．4%,女性受到的被动吸烟危害高于男性。调查人群戒烟率为1．9%。结论中西部农村地区居民吸烟和被动吸烟状况面临挑战,尤其是戒烟率较低,政府及相关部门应采取相应有效干预措施,以减少烟草对居民健康的危害。     

海宁市40～74岁城乡居民吸烟行为特征分析

  目的   探讨男性吸烟者吸烟利弊的权衡及其与戒烟意向的关系,为促进男性吸烟者采取戒烟行动和改善戒烟效果的干预提供理论依据。  方法   于2016年3 — 4月通过网络招募自愿参加调查的326名男性吸烟者进行问卷调查,内容包括一般人口学资料与吸烟情况问卷、尼古丁依赖评估量表、戒烟意向问卷和吸烟利弊决策量表。  结果   男性吸烟者感知吸烟益处和吸烟危害得分分别为（2.82 ± 0.66）和（3.09 ± 0.61）分,感知吸烟益处得分低于吸烟危害得分（t = 6.37,P ＜ 0.001）;326名男性吸烟者中,有60.74 %的人感知到吸烟的危害程度高于吸烟益处,有27.61 %的人感知的吸烟危害程度低于吸烟益处,有11.66 %的人吸烟危害和益处感知程度相等。男性吸烟者戒烟意愿和戒烟计划得分分别为（3.17±1.11）和（2.42±1.55）分,戒烟意愿得分高于戒烟计划得分（t = 9.10,P＜0.001）;相关分析结果显示,男性吸烟者吸烟利弊权衡与戒烟意愿、戒烟计划均呈负相关（r = – 0.39、– 0.24,均P ＜ 0.001）;多层次线性回归分析结果表明,男性吸烟者吸烟利弊权衡对戒烟意愿和戒烟计划均具有负向预测作用。  结论   男性吸烟者对吸烟的态度表现为既爱又恨,其戒烟意向往往处于高意愿低计划的状态;吸烟利弊权衡是其戒烟意向的重要预测因素。     

Smoking habits, exposure to passive smoking and attitudes to a non-smoking policy among hospital staff

A survey was carried out into the smoking habits and exposure to passive smoking among health staff in the hospitals of Faenza, Forli and Rimini (Emilia-Romagna, Northern Italy). 2453 subjects answered anonymously a 41 question questionnaire. 53% of the subjects were professional nurses, 16% doctors, 15% maintenance staff, 10% ancillary staff, 1% non-medical graduates, 2% were administrators and 3% were assigned to the category ‘others’.Of the subjects answering the questionnaire 39% were smokers, 19% ex-smokers and 42% non smokers. The highest number of smokers was found among women (41%) compared to men (37%) and among ancillary staff (48%) compared to nurses (41%) and doctors (31%). The males were mostly heavy smokers (≥20 cigarettes/d) and smoked strong cigarettes (≥12 mg/cig condensate content). The females were mostly light smokers (<10 cigarettes/d) and smoked light cigarettes (1–6 mg/cig condensate content). A high percentage of subjects (87%) smoked at work especially in areas reserved for staff. 43% and 26% of shift workers and non-shift workers tended not to modify their habit when on morning or afternoon shifts. During night shifts the majority of them increased their tobacco consumption.Around 87% of hospital employees stated they were exposed to passive smoking inside the hospital especially in cooking areas, at information desks and corridors. Nurses, ancillaries and maintenance staff were those most exposed and for a greater number of hours per day compared to doctors. Almost all subjects were aware of the harm caused by passive smoking. 56% of smokers, 65% of ex-smokers and 72% of non smokers said they were willing to participate in future campaigns to limit smoking in their hospitals.     

Contracting for smoking and pregnancy interventions: current practice across England

In order to understand the commissioning of smoking and pregnancy interventions across England prior to the implementation of the Government's national strategy, "Smoking Kills: A White Paper on Tobacco" in 1998, a postal survey was undertaken amongst all 96 Health Authorities (purchasers) and 207 Maternity Service Provider Units (providers) in England. The main outcome measures included the type and duration of contract agreements/service specifications, the level and nature of smoking and pregnancy interventions, barriers to commissioning smoking and pregnancy interventions, data collection and monitoring of activity and quality. A quarter of health authorities were encouraging smoking cessation through contract agreements. The level and complexity of contract agreements and service specifications varied tremendously. Existing smoking and pregnancy interventions were diverse and ad hoc. Data collection and monitoring were haphazard and inconsistent making cross-country comparisons difficult. The commissioning of smoking and pregnancy interventions across England during 1997 and 1998 appeared to be inadequately prioritised. These findings offer a benchmark for observing changes in practice following the recent change of government policy.     

Queer Quit: Gay smokers' perspectives on a culturally specific smoking cessation service

Background  The prevalence of smoking is high among gay males. The need for culturally specific support has been acknowledged, but little is known about gay men's perspectives on such adapted interventions.
Objective  To investigate smoking and intention to quit in gay smokers and to explore their attitudes towards a gay-specific smoking cessation programme.
Design  Quantitative survey and focus groups.
Setting and participants  A total of 325 gay smokers living in Zurich (Switzerland) completed an anonymous survey. Thirteen males participated in two focus groups, theoretically sampled to reflect heterogeneity in terms of age, HIV serostatus and smoking histories. Participants were personally recruited at a variety of events and through advertisements.
Results  Responders reported high consumption of cigarettes, and every second man stated that more than half of his gay friends smoke regularly. The majority planned their quit within the next 6 months. Idealizing attitudes towards smoking were very common. Men stated strong preferences towards a culturally adapted cessation programme for gay men. Higher age, high nicotine dependence, intention to quit, smoking stereotypes and fears for weight gain were significant predictors for interest in participation in the programme. Qualitative results indicate that men felt torn between their wish for support, bonding, and community alternatives to the 'smoking gay' environment and fears for failure and loss of reputation.
Conclusions  Gay men reported likely use of a gay-specific intervention. Such interventions may offer support in abstaining from smoking, without abstaining from gay social life. Health-care providers play an important role in communicating the serious threats caused by smoking to gay men.     

New smokers and quitters. Transitions in smoking status in a national population

BACKGROUND: Few studies have examined individual transitions in smoking status in national populations. METHODS: A representative sample of 21,970 men and women aged 15-64 were questioned regarding current smoking status and smoking status 12 months ago. RESULTS: 1.56% of respondents had started to smoke and 1.58% had quit smoking. Becoming a smoker was significantly associated with younger age and lower social economic status (SES). Among women, many new smokers were between the age of 30 and 34, presumably due to relapse after pregnancy. High SES smokers quit at a younger age then lower SES groups. CONCLUSION: To reduce smoking prevalence in the Netherlands, more attention should be given to women aged 30-34 years and to people from the lower SES groups, especially those under the age of 45.     

Effects of multiple attempts to quit smoking and relapses to smoking on pulmonary function. Lung Health Study Research Group

The effect of intermittent smoking on pulmonary function was assessed among participants in the Lung Health Study, 5887 adult smokers with evidence of early chronic obstructive pulmonary disease (COPD), followed up for 5 years. The mean annual rate of loss in FEV₁% of predicted after year 1 was smallest for those who quit at some point during the first year of the study and stayed quit (−0.33%/year, ±0.05%), intermediate for those who smoked intermittently during the study (−0.58%/year, ±0.05%) and greatest for those who continued to smoke throughout the study (−1.18%/year, ±0.03%). Surprisingly, those who made several attempts to quit smoking had less loss of lung function at comparable cumulative doses of cigarettes than those who continued to smoke. Quitting smoking for an interval followed by relapse to smoking appeared to provide a measurable and lasting benefit in comparison to continuous smoking. In this early COPD population, not only quitting smoking but attempts to quit smoking can prevent some loss of lung function. These results provide some encouragement to exsmokers who relapse on their way to complete cessation.