The health-related quality-of-life of never smokers, ex-smokers, and light, moderate, and heavy smokers.

BACKGROUND: Health related quality-of-life is recognized as an important health outcome measure; how ever, it may also have a significant application in smoking reduction and cessation programs. METHODS: Representative population data (n = 3010) was used to compare the quality-of-life status of differ ent smoking categories with never smokers. RESULTS: Statistically significant differences in mean quality-of-life scores, as measured by the SF-36 health status questionnaire, were observed between never smokers, as the reference group, ex-smokers, all smokers, and light, moderate, and heavy smokers. Heavy smokers also scored significantly lower than both other groups of smokers, scoring as low as the 29th percentile of the population on the general health dimension and lower than the 36th percentile of the population on all the mental health dimensions. CONCLUSIONS: The design of public health smoking cessation programs should consider the varying characteristics of different segments of the smoking population. The advantages of improved quality-of-life may strengthen the argument for encouraging heavier smokers to become light smokers as a precursor to total cessation.     

A survey of smoking and quitting patterns among black Americans.

A sample of adult Black policyholders of the nation's largest Black-owned life insurance company was surveyed in 1986 to add to limited data on smoking and quitting patterns among Black Americans, and to provide direction for cessation initiatives targeted to Black smokers. Forty per cent of 2,958 age-eligible policyholders for whom current addresses were available returned a completed questionnaire. Population estimates for smoking status agree closely with national estimates for Blacks age 21-60 years: 50 per cent never-smokers; 36 per cent current smokers; 14 per cent ex-smokers. Current and ex-smokers reported a modal low-rate/high nicotine menthol smoking pattern. Current smokers reported a mean of 3.8 serious quit attempts, a strong desire and intention to quit smoking, and limited past use of effective quit smoking treatments and self-help resources. Correlates of motivation to quit smoking were similar to those found among smokers in the general population, including smoking-related illnesses and medical advice to quit smoking, previous quit attempts, beliefs in smoking-related health harms/quitting benefits, and expected social support for quitting. Methodological limitations and implications for the design of needed Black-focused quit smoking initiatives are discussed.     

Social correlates of cigarette smoking cessation: findings from the 1995 microcensus survey in Germany

BACKGROUND: An increasing percentage of smokers are quitting this unhealthy behavior during their life course. The aim of this study is to analyze which social factors play an important role regarding ex-smoking in Germany. METHODS: Data were derived from the 1995 German Microcensus, which is a representative survey for the population in Germany. Included in the analysis were 44,553 current smokers and 23,780 ex-smokers. The independent variables were education, occupational status, family status, unemployment/social welfare, household income, and community size. A two-stage statistical modeling procedure was used, initially to assess the most important effects of the independent variables on smoking cessation and secondly, to analyze the cumulative effects of the independent variables. RESULTS: The most striking effects observed for smoking cessation were family status and education. For example, in males aged 30 to 49 years, the percentages of ex-smokers of all ever smokers were 44.7% for married males with high education compared with only 14.6% for males with low education. The corresponding percentages for females were 44.0% and 17.6%. CONCLUSIONS: Such striking differences in the social polarization of smoking cessation in Germany demonstrate the importance of anti-smoking policies and new strategies that avoid a further increase in the social inequality of smoking behavior.     

Smoking cessation among Hong Kong Chinese smokers attending hospital as outpatients: impact of doctors' advice, successful quitting and intention to quit

To identify factors affecting current smokers' intention to quit smoking and factors associated with successful quitting among ex-smokers in Hong Kong. A cross-sectional survey of Chinese patients attending medical and surgical Specialist Outpatient Clinics (SOPCs) of public hospitals in Hong Kong, using a structured questionnaire. Results of the 642 respondents, 21% were current smokers, 9% were ex-smokers and 69% were non-smokers. 74% of the smokers reportedly received quitting advice from doctors. Among the current smokers, past quitting attempts, receiving information from sources other than doctors, believing that doctor's advice was useful, believing that all smokers should quit smoking and a positive attitude towards quitting were associated with intention to quit. Among those who had attempted to quit, being older (aged 50 or above), being retired/unemployed and consuming more than 10 cigarettes per day were associated with successful quitting. We found that advice from doctors on quitting smoking did not have any impact on Chinese smokers quitting or future intention to quit and reflect the inadequacy of advice given by Hong Kong doctors. The predictors of intention to quit and successful quitting identified in the study could be used to design future smoking cessation services.     

A path model of smoking cessation in women smokers of low socio-economic status

The goals of this study were to (i) determine how factors commonly implicated in smoking cessation processes influenced smoking cessation in low socio-economic status (SES) women and (ii) elucidate the pathways through which these factors may lead to quitting smoking. Secondary analysis was conducted on data from 644 women smokers aged 18-45 years who had participated in an earlier experimental evaluation of a smoking cessation program, were still smokers at the 2-month post-intervention survey and completed an interview 6 months later. Path analysis (LISREL 8) was used to test a conceptual model in which (i) factors considered as precursors to quitting (motivation, self-efficacy, confidence, action and intention to quit) directly predicted subsequent quitting and (ii) health concerns, social pressure to quit and daily stress influenced quitting indirectly through their effects on the precursor factors and (iii) mediated the effects of background characteristics (race, education, single motherhood, pregnancy and exposure to the earlier smoking cessation intervention) on quitting. Overall, results supported this conceptual model and its applicability to low-SES women smokers and indicated significant pathways among specific factors. In particular, (i) only plans to quit, confidence and social pressure to quit directly predicted quitting; (ii) both health concerns and social pressure increased motivation to quit and (iii) the negative effect of daily stress on quitting was mediated through decreased self-efficacy.     

Subjective health of male ex-smokers: relationship with time since smoking cessation,intensity and duration of tobacco consumption

BACKGROUND: To examine the relationship of subjective health with time since smoking cessation and amount and duration of tobacco consumption among male ex-smokers. METHODS: Pooled analysis of three household interview surveys conducted in 1993 (n = 8,494), 1995 (n = 2,556), and 1997 (n = 2,624) on samples representative of the noninstitutionalized population aged 16 and over in Spain. RESULTS: After controlling for the main confounders, ex-smokers with smoking burden < or =13 pack-years had a lower frequency of suboptimal health (fair, poor, or very poor) than current smokers (OR, 0.59; 95% Cl, 0.38-0.91) during the first year after cessation; thereafter, it reached a value similar to that of never-smokers 11 years or more after cessation. Among those with burden >13 pack-years, frequency of suboptimal health during the first year after cessation was higher than in current smokers (OR, 1.28; 95% CI, 1.00-1.63). Afterwards, it fell progressively, approaching the value of never-smokers 11 years or more after cessation. Frequency of suboptimal health in ex-smokers increased with duration (years) of smoking (P linear trend = 0.045), but did not vary with the number of cigarettes smoked. CONCLUSIONS: Suboptimal health declined with time since smoking cessation, to reach the frequency of never-smokers. Longer duration of tobacco consumption is associated with worse subjective health.     

Smoking cessation should have more emphasis within Tobacco Control? The case for

Smoking cessation is usually mentioned last in the chain of established measures to improve Tobacco Control. This seems logical, as smoking cessation is a secondary or tertiary preventative measure only. In the recently proposed Tobacco Control Scale (TCS) using 6 Tobacco Control measures pricing is considered most important, and smoking cessation least important. For current smokers secondary or tertiary preventative measures are necessary with smoking cessation being the most effective one as its impact on health is immediate. Pricing, on the other hand, is less effective in inciting current smokers to quit. Further, the vast majority of smokers would like to quit if they were able; so help in achieving this goal is welcome. Other Tobacco Control measures, on the other hand, are mostly negatively perceived by smokers because they perceive them as curtailment of their freedom. This is a psychological advantage the health professional active in this area has over other people involved in Tobacco Control and must be exploited.There is also strong evidence that smoking cessation is cost-effective, especially when comparing costs involved in addressing other important health risk factors, such as hyperlipidemia and arterial hypertension.Finally, the role of smoking cessation in helping to decrease social acceptability of smoking should not be underrated as every smoker who quits sets an example for other smokers to follow or for children not to start. In summary, smoking cessation continues to be of paramount importance among Tobacco Control measures, and should get more emphasis especially in health care settings.     

北京市社区吸烟者尝试戒烟行为及其影响因素研究

目的调查分析北京市成年吸烟者的尝试戒烟行为及影响因素。方法2018年12月至2019年8月,基于流行病学横断面研究,采用面对面问答式问卷调查。调查对象为18岁以上的社区吸烟者,调查内容包括基本人口学信息、烟草使用情况、尝试戒烟行为、烟草相关知识的认知、戒烟支持环境评估等;采用描述性分析统计调查对象的戒烟尝试行为,并采取χ2检验对其戒烟尝试行为与其社会人口学指标、烟草使用情况、烟草相关问题认知、戒烟支持环境等因素进行关联分析;采用二分类Logistic回归进一步探讨各因素与尝试戒烟行为的关系。结果共纳入449名调查对象,其中男性410人(91.3%),尝试戒烟与未尝试戒烟的分别为272人(60.6%)和177人(39.4%);月收入水平、烟草相关知识评估得分、周围人对戒烟的支持程度、过去1年是否就医、就医次数、过去1年是否有医务人员规劝戒烟、是否被医务人员询问过吸烟情况等因素为尝试戒烟行为的相关因素(P<0.05);Logistic回归分析显示,使尝试戒烟行为可能性提高的因素有月收入水平(OR=1.271,95%CI:1.081~1.493)、周围人对戒烟的支持(OR=1.251,95%CI:1.035~1.512)、过去1年有医务人员建议戒烟(OR=2.382,95%CI:1.054~5.381)。结论健康状况、环境支持、危害认知、经济水平、医生劝导等因素皆影响着尝试戒烟行为,自我毅力不足和他人影响是导致戒烟失败的主要原因。将社区场所作为干预基本单位,结合专业指导,形成医院-社区-线上综合联动的戒烟干预模式,是烟草依赖管理模式优化的新思路。     

Smoking in Pregnancy and Parenthood: What is the Role of Depression, Anxiety and Nicotine Addiction?

This paper presents some of the findings from the Smoking in Pregnancy study of attitudes towards smoking among pregnant women, mothers of young children and their partners in East Surrey. As part of the study, respondents completed a General Health Questionnaire to identify mental health difficulties and, if they were smoking at the time of the study, they also completed the Fagerstrom nicotine addiction test. Eleven female respondents had high scores on the General Health Questionnaire, suggesting symptoms of depression, anxiety and/or social dysfunction for these women. There was no evidence that smokers were suffering from greater mental health difficulties than ex-smokers or non-smokers. However, the General Health Questionnaire scores of smokers were positively associated with their level of nicotine dependence. Furthermore, when General Health Questionnaire scores of all respondents were compared with self-reported health status there was a marked discrepancy suggesting under-reporting of symptoms by women.     

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.     

Prevalence and socio-economic correlates of smoking among lone mothers in Australia

OBJECTIVE: To report smoking prevalence among Australian lone mothers by age and socio-economic group and to examine the extent to which the difference in smoking prevalence between lone mothers and other women is due to socio-economic factors. METHODS: This was a secondary analysis of data from the 1995 National Health Survey (NHS), which was conducted by the Australian Bureau of Statistics (ABS). Information was collected from 53,800 respondents using face-to-face interviews. This analysis was limited to single mothers (n=1,184) who had at least one dependent child aged under 15. The outcome measure was smoking status, distinguishing regular smokers from occasional smokers, ex-smokers and never-smokers. RESULTS: The overall smoking prevalence among lone mothers was 46.3% (Cl 43.5%-49.1%). Lone mothers who were younger, less educated, received government pension/benefits, occupied rental housing or who lived in more disadvantaged areas were more likely to smoke than others. A strong 'lone mother effect' remained after controlling for socio-economic variables. The odds of smoking for lone mothers were 2.4 times greater than for married mothers (95% Cl 2.0-2.9) and twice as large as those for women living alone (95% CI 1.62.4). CONCLUSION: As the prevalence for this population group is considerably higher than the prevalence for other women within each age category, programs to assist lone mothers to quit smoking are a priority for the long-term health of these women and their children. Furthermore, we discuss how policies and interventions that enhance the material conditions and social circumstances of lone mothers can bring about a decline in their smoking prevalence.     

Prevalence and characteristics of smoking in primary healthcare workers in Iquique, Chile

OBJECTIVE: To determine the prevalence and characteristics of the smoking habits of primary healthcare workers in Iquique, Chile. Study design: Cross-sectional study through a survey of all personnel working in primary health care in Iquique, Chile. METHODS: The following variables were investigated: biodemographical characteristics and aspects of smoking, knowledge of the adverse effects of smoking, and some lifestyle factors. RESULTS: Among the study population, a high prevalence of smokers was found (37%) and a further 26% were ex-smokers. The smokers were predominantly practical nurses, female, aged 25-45 years and married. The only significant relationship was between age and smoking habit (P=0.02), with smoking prevalence among younger groups being very high (56%). There was a high level of awareness about the adverse effects of smoking and its addictiveness (99 and 93%, respectively). Forty-three percent of participants had been smoking for more than 15 years, and the main reasons for smoking were 'social consumption' and 'stress' (36 and 29%, respectively). Thirty-two percent of the ex-smokers ceased smoking for discomfort or health reasons. There were no differences between smokers and ex-smokers with respect to participation in sports or working shifts. Fifty-two percent of those surveyed reported they they were annoyed when others smoked near them. CONCLUSION: This study revealed a high prevalence of smoking, particularly among practical nurses. Regarding attitudes to health, a dichotomy between knowledge and behaviour was found in this group. In pursuing the commitment to smoking cessation in healthcare personnel, a deeper review of cultural issues and motivation should be considered.     

Beliefs of Turkish and Moroccan immigrants in The Netherlands about smoking cessation: implications for prevention

Tobacco smoking is a very important preventable cause of mortality and morbidity, and this is also the case in immigrant populations. Therefore, smoking cessation interventions need to take these groups into account. Insight into the applicability of behavioral smoking cessation interventions for non-Western populations is necessary. The objective of our study is to gain insight into the beliefs of smoking cessation in Turkish and Moroccan immigrants in The Netherlands using the I-Change Model. In this model, intention and behavior are supposed to be determined by three types of (psychosocial) factors: attitudes, social influences and self-efficacy expectations. Face-to-face structured interviews among Turkish and Moroccan immigrants were conducted. Results indicate that in contrast to smokers, ex-smokers perceived fewer advantages of smoking and more advantages of smoking cessation. They also perceived less social pressure that encourages smoking (e.g. by being offered cigarettes) and a high self-efficacy of being able to quit. The I-Change Model explained 66% of the observed variance. We conclude that the basic factors identified in social cognition theories were replicated in this study. When developing smoking cessation interventions, the results show that it is important to include ethnic-specific salient beliefs, such as the subjective norms of the religious leader.     

中国控烟干预策略的研究综述

由于烟草中的尼古丁易使吸烟者成瘾,加之心理、社会等因素的影响,尽管吸烟的危害广为宣传,但吸烟人群中的戒烟率仍相当低。通过制定控烟政策、健康促进、社会心理和行为干预,提高戒烟率,减少二手烟危害,使青少年不吸第一支烟,已成为控烟工作者关注的重点领域。该研究就我国大陆过去控烟实践研究成果内涵的健康教育等主要干预策略进行回顾性分析,并对今后相关研究工作提出若干建议和设想。     

Smoking in Pregnancy and Parenthood: What is the Role of Depression,Anxiety and Nicotine Addiction?

This paper presents some of the findings from the Smoking in Pregnancy study of attitudes towards smoking among pregnant women, mothers of young children and their partners in East Surrey. As part of the study, respondents completed a General Health Questionnaire to identify mental health difficulties and, if they were smoking at the time of the study, they also completed the Fagerstrom nicotine addiction test. Eleven female respondents had high scores on the General Health Questionnaire, suggesting symptoms of depression, anxiety and/or social dysfunction for these women. There was no evidence that smokers were suffering from greater mental health difficulties than ex-smokers or non-smokers. However, the General Health Questionnaire scores of smokers were positively associated with their level of nicotine dependence. Furthermore, when General Health Questionnaire scores of all respondents were compared with self-reported health status there was a marked discrepancy suggesting under-reporting of symptoms by women.     

Smoking habits in relation to reproductive events among Japanese women: Findings of the Japanese Nurses' Health Study

Objective

The purposes of this study were to examine smoking habits in relation to the reproductive events of pregnancy and menopause and clarify the reasons for smoking cessation among ex-smokers.

Method

This is a cross-sectional study based on a baseline survey of a prospective cohort study. From 2001 to 2007, a self-administered questionnaire survey was conducted on 49,927 female nurses from all 47 prefectures in Japan. Logistic regression models were used to estimate age-adjusted odds ratios.

Results

Of the respondents, 17.2% were current smokers, 11.6% were ex-smokers and 69.8% had never smoked. The prevalence of smoking during pregnancy was 7.8%. Among ex-smokers, 30.3% gave “reproductive events” as their reason for smoking cessation. Current smoking and the number of cigarettes smoked per day before menopause were significantly related to onset of menopause.

Conclusion

Women's smoking habits have mutual relationships with reproductive events such as pregnancy and menopause. Although “reproductive events” were an important reason for smoking cessation among women, 7.8% of women still smoked during pregnancy. Smoking was correlated with onset of menopause. Support for smoking cessation is an important healthcare issue throughout women's lifetimes.     

Sociocultural factors associated with cigarette smoking among women in Brazilian worksites: a qualitative study

This study examined the contextual factors associated with smoking initiation and cessation among women in Brazilian worksites (Curitiba, Paraná, Brazil). A total of 22 focus groups were conducted among 108 women in private and public worksites. The most frequently endorsed negative factors that contributed to smoking initiation included exposure to smoking-prompting behaviors through family members, peer pressure, media and easy access/low cost of cigarettes. Positive factors that served as protective mechanisms against initiation included smoking-related health effects and strong influence from parents and family members. The most salient negative factors associated with smoking cessation included stress/anxiety-relieving benefits, weight control, access/low cost of cigarettes, being around smokers and risk-exempting beliefs. Positive factors included smoking restrictions at home and workplace and concerns about appearance. Current and former smokers reported that they had never received any assistance from their physicians to quit smoking, nor did they rely on smoking cessation programs or aids or believe in their effectiveness. There are specific contextual factors that contribute to smoking initiation/cessation among women in Brazilian worksites which have important clinical, research and policy implications.     

A low-cost, practical method for increasing smokers' interest in smoking cessation programs

BACKGROUND: Low participation rates reduce the public health impact of smoking cessation programs. Two barriers for improving participation are the cost of media campaigns and the proportion of smokers motivated to quit smoking. The objective of this study was to examine the feasibility of using classified newspaper ads and messages aimed at each stage of change to enhance participation in smoking cessation programs. METHODS: Three classified ads were run concurrently in a local daily newspaper for five consecutive days. The ads were designed to engage smokers in each of Prochaska's five stages of change. Each ad invited smokers or former smokers to call the local health department to participate in a paid focus group to design a new health department program. RESULTS: Calls were received from 181 eligible smokers, including 124 who provided data for the study. Thirty-seven, 34, and 29 percent of smoking respondents were in precontemplation, contemplation and preparation respectively. Half of ex-smokers were in the action stage. Ads cost 174 dollars (Cdn), thus the cost per recruit was less than a dollar. CONCLUSION: Classified ads can recruit smokers from all stages of change. Compared to traditional mass media, classified ads may also be a highly cost-efficient promotional strategy. Results provide justification for further research.     

青岛市成人戒烟现况及影响因素分析

目的 分析青岛市成人戒烟状况和戒烟意愿的影响因素。方法 采取多阶段分层随机抽样的方法,在青岛市抽取5 000名15岁及以上的居民,采取入户调查的方式进行问卷调查。根据2010年第六次普查人口加权计算,采用戒烟率、尝试戒烟次数、医生戒烟建议等指标描述戒烟行为,采用复杂抽样Logistic单因素和多因素分析,探讨吸烟者戒烟意愿的影响因素。结果 青岛市成年吸烟者戒烟率为20.2%;吸烟者尝试戒烟和意愿戒烟的比例分别为24.8%和13.5%,54.6%的尝试戒烟者在过去12个月尝试戒烟2次以上;就诊的吸烟者中有66.8%的人接受过医生的戒烟建议。多因素分析显示,在控制其它影响因素后,只有烟草危害知识知晓情况和是否尝试过戒烟会影响戒烟意愿。结论 青岛市人群目前尝试戒烟率较低,应提高戒烟服务的专业性和可及性,促进吸烟者尝试戒烟,同时制定针对性的控烟宣传策略,提高未来戒烟意愿。     

Smoking status and health-related quality of life: as findings from the 2001 Behavioral Risk Factor Surveillance System data

PURPOSE: To examine the relationship between smoking status and health-related quality of life (HRQOL). DESIGN: Our study used a cross-sectional analysis with self-reported data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). SETTING: United States. SUBJECTS: Subjects were a representative sample of noninstitutionalized adults aged 18 years and older. After excluding respondents who reported being pregnant and for whom smoking status could not be determined, we included 209,031 respondents. MEASURES: Multiple logistic regressions were performed to examine the associations of smoking status with the four HRQOL items, controlling for demographic and health-related characteristics. RESULTS: Current smokers had a higher likelihood of reporting poor general health status compared with nonsmokers and ex-smokers. Compared with nonsmokers, current smokers had a higher likelihood of reporting > or = 14 days of poor physical health (odds ratio [OR] = 1.64, 95% confidence interval [CI] = 1.51-1.77), poor mental health (OR = 1.99, 95% Cl = 1.84-2.16), and activity limitations (OR = 1.80, 95% Cl = 1.63-2.00). Similarly, compared with ex-smokers, current smokers had a higher likelihood of reporting > or = 14 days of poor physical health (OR = 1.30, 95% CI = 1.19-1.42), poor mental health (OR = 1.65, 95% CI = 1.50-1.81), and activity limitations (OR = 1.48, 95% CI = 1.32-1.65). Age, income, and presence of comorbidities also significantly explained variation in HRQOL. CONCLUSIONS: Our study reaffirms the significant association between smoking and HRQOL in a large nationally representative sample. Poor health associated with smoking persists as a major public health problem, and effective preventive and smoking cessation efforts should be undertaken.