Understanding smoking and cessation among Hmong smokers

This qualitative study was designed to explore beliefs and experiences related to smoking and cessation among the Hmong population in the United States. Three separate focus groups were conducted with male and female Hmong smokers. Analysis revealed that the Hmong viewed smoking as prevalent in their community and perceived numerous barriers to cessation. Barriers to cessation differed based on gender and acculturation. For instance, women were concerned about having their smoking status revealed if they were to seek help, because of cultural prohibitions against female smokers. Less acculturated Hmong believed U.S. commercial tobacco to be more addictive than the homegrown tobacco they were used to. This formative research suggests that smoking is becoming an increasing problem among the Hmong in the United States and points to a need for additional research to inform the development of effective tobacco control strategies for this community.     

Smoking cessation behavior among intermittent smokers versus daily smokers

Nondaily intermittent smokers (ITS) are common, but their cessation behavior remains elusive. We examined cessation of native-ITS (n = 2040), converted-ITS (n = 1808), and daily smokers (DS; n = 25 344). All ITS were more likely than were DS to make a quit attempt (native-ITS adjusted odds ratio [AOR] = 1.60, 95% confidence interval [CI] = 1.42, 1.80; converted-ITS AOR = 3.33, 95% CI = 2.93, 3.78). Native-ITS (18%) and converted-ITS (27%) were more likely than were DS (13%) to quit smoking (native-ITS AOR = 1.34, 95% CI = 1.07, 1.67; converted-ITS AOR = 2.36, 95% CI = 2.01, 2.78), but the low cessation rates of ITS challenge their nonaddicted status.     

Smoking cessation rates in the United States: a comparison of young adult and older smokers

Objectives. We compared smoking quit rates by age in a nationally representative sample to determine differences in cessation rates among younger and older adults.Methods. We used data on recent dependent smokers aged 18 to 64 years from the 2003 Tobacco Use Supplement to the Current Population Survey (n=31625).Results. Young adults (aged 18–24 years) were more likely than were older adults (aged 35–64 years) to report having seriously tried to quit (84% vs 66%, P<.01) and to have quit for 6 months or longer (8.5% vs 5.0%, P<.01). Among those who seriously tried to quit, a smoke-free home was associated with quitting for 6 months or longer (odds ratio [OR]=4.13; 95% confidence interval [CI]=3.25, 5.26). Compared with older smokers, young adults were more likely to have smoke-free homes (43% vs 30%, P<.01), were less likely to use pharmaceutical aids (9.8% vs 23.7%, P<.01), and smoked fewer cigarettes per day (13.2% vs 17.4%, P<.01).Conclusions. Young adults were more likely than were older adults to quit smoking successfully. This could be explained partly by young adults, more widespread interest in quitting, higher prevalence of smoke-free homes, and lower levels of dependence. High cessation rates among young adults may also reflect changing social norms.A key goal of tobacco control is to increase smoking cessation among young adults, because quitting at an early age increases the chances that a smoker will avoid the more serious health consequences of smoking.1 During the 1980s and 1990s, older smokers (50 years and older) were the most successful quitters,2^,3 and annual rates of successful quitting increased for all age groups.2 However, increases in cessation rates in the 1990s were greatest among young adults aged 20 to 34 years.2 Furthermore, among young adult smokers, but not older smokers, the increase in cessation rates was higher in states with higher cigarette prices and highest of all in California, which had a comprehensive statewide tobacco control program,2 suggesting that environmental factors may especially influence cessation rates among young adults. Projecting these national trends, we hypothesized that by 2003, young adults may have been the most successful quitters of any age group. Understanding recent changing influences on successful quitting could help increase the effectiveness of public health programs that aim to encourage cessation.Rates of successful quitting can differ between age groups because of differences in the proportion of smokers who try to quit, or because of differences in success rates among those who try. There is evidence that changes in the social norms surrounding smoking can lead to changes in the proportion of smokers who try to quit and that these norms can be influenced by tobacco-related news coverage4 and mass media advertising campaigns,5 both of which increased in the United States in the late 1990s with the Master Settlement Agreement and with the start of the American Legacy Foundation campaign.6 Young people (aged 0–29 years) may be particularly responsive to such influences,7 and throughout the 1990s, California’s tobacco control program used targeted media campaigns to specifically influence social norms about smoking.8Changes in social norms can also influence behavior associated with success in quitting. In particular, a decrease in levels of nicotine dependence among recent cohorts of smokers could partly explain higher rates of successful quitting among younger adults. Less-dependent smokers are more likely to successfully quit, presumably because of less-intense withdrawal symptoms.9^–11 Following the 1992 Environmental Protection Agency report classifying environmental tobacco smoke as a carcinogen,12 there was a rapid increase in social norms supporting restrictions on smoking,13 and increased restrictions on smoking at work and in public places have been associated with reduced levels of daily cigarette consumption.14^,15During the 1990s, an increasing proportion of smokers, particularly parents, banned smoking in the home.16 There is a strong association between smoke-free homes and successful quitting,17^,18 perhaps in part because a lapse, for example after a meal, is less likely. It is possible that recent birth cohorts who took up smoking under these restrictions at home and work may develop lower levels of dependence than previous cohorts,19 and they may themselves be more likely to live in a smoke-free home.During the 1990s, pharmaceutical aids became available to help overcome withdrawal symptoms, and these aids were associated with quitting success.20^,21 However, once these aids became easily available over the counter in 1996, their apparent effectiveness in population studies disappeared.22^,23 More in-depth analysis has suggested that effective use of pharmaceutical aids may be limited to smokers who are motivated to quit, such as those with a smoke-free home.24 Thus, differences in patterns of use of pharmaceutical aids between age groups may also contribute to recent differences in quitting success rates.We used a large nationally representative survey to compare US smoking cessation rates and associated tobacco-related behaviors between age groups. We compared attempted quitting rates across age groups each year as well as success rates among those who tried to quit smoking and explored whether there were important differences between age groups in prevalence of known correlates of cessation. We used multivariate logistic regression to establish whether differences in such correlates could account for differences in cessation rates, or whether younger smokers were quitting at higher rates than might be predicted by, for example, lower levels of addiction and a higher prevalence of smoke-free homes.     

Tobacco industry direct mail receipt and coupon use among young adult smokers

ObjectiveTo examine young adult smokers' receipt of tobacco industry direct mail and use of coupons to purchase cigarettes.MethodA total of 699 young adults from a 2011 national survey who reported smoking every day/some days provided self-report data on past-six month receipt of direct mail and past-six month use of coupons to purchase cigarettes. Multivariable logistic regression models were used to calculate adjusted odds of direct mail receipt and coupon use.ResultsOverall, 25.1% of young adult smokers reported receiving direct mail from a tobacco company and 24.2% had used a coupon to buy cigarettes in the past 6 months. Direct mail receipt and coupon use to purchase cigarettes were significantly higher among females, daily smokers, and whites. Nearly 70% of smokers who received direct mail had also used a coupon to purchase cigarettes in the preceding 6 months. Brand websites were the most commonly reported means of joining a direct mailing list.ConclusionThis study adds to limited research showing receipt of direct mail and use of price reducing coupons by young adults. Also, higher rates of direct mail receipt and coupon use among females suggest that these strategies may be especially effective in encouraging smoking in females.     

Characteristics and correlates of quitting among black and white low-income pregnant smokers

OBJECTIVES: To examine race-specific differences in correlates of cessation in low income pregnant women. METHODS: Two hundred forty-eight low-income black and white pregnant women who smoked regularly prior to pregnancy were interviewed to assess several potential correlates of quitting. RESULTS: Race differences emerged in characteristics commonly thought to influence quitting including income, education level, marital status, nicotine dependence, and smoking history. However, race was not correlated with having quit smoking, nor did it influence the effect of other variables in quitting. CONCLUSIONS: Factors that influence the decision to quit smoking during pregnancy do not appear to differ between low-income black and white women.     

天津市戒烟门诊158名就诊吸烟者戒烟状况调查

目的 了解天津市戒烟门诊就诊吸烟者的人群特点、吸烟情况、戒烟情况,为更有效的开展戒烟门诊服务提供科学依据。方法 调查前来三家戒烟门诊就诊的158名吸烟者,并于一个月后进行随访。结果 就诊吸烟者中50%(79/158)是通过医生推荐或转诊至戒烟门诊,47.5%(75/158)决定戒烟的原因是自身患病,59.5%(94/158)的人尝试过戒烟;就诊吸烟者的平均烟龄为19.5年,平均每日吸烟量为16.3支;一个月随访的应答率为86.7%(137/158),一个月随访的时点戒烟率为43.1%(59/137),未戒烟者的一个月时点减烟率为56.4%(44/78);27.0%(37/137)的人认为医生或药物对其戒烟帮助最大。结论 天津市戒烟门诊能提高吸烟者的戒烟率,但目前就诊人数较少,还应继续加大戒烟门诊的宣传力度。     

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.     

农村男性吸烟者戒烟意愿影响因素分析

目的 了解农村男性现在每天吸烟者戒烟意愿影响因素及其相对重要性。方法 采用横断面研究方法,以山东省临沂市莒南县14个行政村的男性现在每天吸烟者为研究对象,逐一入户,进行面对面问卷调查,共得有效问卷1 287份。应用logistic回归分析、优势logistic回归分析探讨戒烟意愿影响因素及其相对重要性。结果 1 287名每天吸烟者中有318人（24.7%）打算在未来6个月内戒烟。logistic回归分析显示,有既往戒烟经历（OR=1.691,95%CI：1.458～1.962）、吸烟量少（OR=0.751,95%CI：0.639～0.884）、烟草危害认知程度高（OR=1.038,95%CI：1.001～1.077）、患慢性病（OR=1.765,95%CI：1.013～3.075）的男性吸烟者更倾向有戒烟意愿。优势logistic回归分析显示,既往戒烟经历是戒烟意愿首位影响因素,其他依次是吸烟量、烟草危害认知以及慢性病患病情况。结论 农村男性吸烟者戒烟意愿比例较低。戒烟意愿主要与吸烟者自身因素有关,其中有既往戒烟经历是增加戒烟动机的首位影响因素。     

Smoking cessation and receipt of cessation advice from health professionals among older smokers in Taiwan

ObjectivesTo examine the prevalence and correlates of smoking cessation and receiving professional cessation advice among older smokers in Taiwan.MethodsCross-sectional data from the 2008–2010 and 2012 Taiwan Adult Smoking Behavior Survey was used to form a sample of 4081 recent active smokers aged 50 +, comprising current smokers and former smokers who quit smoking within the past 12 months. We examined three outcome variables: quit attempt in the past 12 months, successful cessation for at least 3 months, and receipt of health professional cessation advice. Multivariate logistic regressions were used to identify significant correlates.ResultsDuring the study period, the annual quit attempt rate was 41.4%, annual successful cessation rate was 4.7%, and prevalence of receiving cession advice among smokers who visited health professionals within the past 12 months was 72.3%. After controlling for other covariates, quit attempts were significantly higher in 2009 and positively associated with higher education, poorer health status, smoke-free homes, and receipt of cessation advice. Successful cessation was significantly higher in 2009, positively associated with older age, higher income, and smoke-free homes, and negatively associated with receiving cessation advice. Receipt of cessation advice was significantly lower in 2010 and 2012, positively associated with male gender, older age, and poorer health status, and negatively associated with higher education.ConclusionsOur results suggest that targeting lower educated and lower income subgroups, adopting effective strategies to increase voluntary smoke-free home rules, and improving professional cessation advice will have great potential to further reduce smoking prevalence in older smokers.     

Predictors of smoking reduction and cessation in a cohort of danish moderate and heavy smokers

BACKGROUND: The aim of this study was to examine the extent and gender distribution of unassisted tobacco reduction and cessation in a cohort of moderate and heavy smokers and to identify possible predictor variables associated with these changes in smoking behavior. METHODS: This was a prospective population study of 3,791 moderate and heavy smokers, 15 g tobacco/day or more, who were enrolled in the Copenhagen City Heart Study in 1976-1978 and attended a reexamination 5 years later. Data on smoking behavior were collected at baseline and follow-up. Smoking reduction was defined as a decrease in mean daily tobacco consumption of 10 g or more. Using multivariate logistic regression, subjects who reported reduced smoking or who reported smoking cessation were compared with subjects who continued the habit unchanged. RESULTS: After 5 years 13% of the men and 9% of the women had reduced their tobacco consumption, and 9 and 7%, respectively, had quit altogether. Smoking reduction was strongly associated with high tobacco consumption (25+ g/day) at baseline and also with severely impaired lung function (FEV(1) <50% predicted) and overweight (BMI >25). Predictors of smoking cessation included impaired lung function and a tobacco consumption of 15-24 g/day. Additional determinants of smoking reduction and cessation such as inhalation habits and sociodemographic variables differed by gender. CONCLUSIONS: Several predictors of smoking reduction and cessation were identified, indicating that these subgroups of smokers differ substantially from continuing smokers. This should be taken into account when assessing potential health benefits from these changes in smoking behavior.     

Properties of saliva cotinine in young adult light smokers

The half-life of saliva cotinine and its accuracy at detecting light or intermittent smoking were examined. Five subjects provided daily saliva samples for 23 days and quit smoking on day 4. An average of 2.8 days was required for saliva continue to drop below the cutoff for classification as a smoker. All smokers smoked intermittently at various times after day 9. In most cases the smoking of one or two cigarettes was detected in the saliva sample on subsequent days. Saliva cotinine was sensitive to low rates of smoking and to intermittent smoking.     

广东省男性吸烟者戒烟行为影响因素分析

目的了解广东省男性吸烟者戒烟行为及其影响因素,为制定干预策略提供依据。方法在广东省21个地级市各抽取1个县/区,采用容量比例概率抽样法(PPS法)和基什网格法(KISH法)确定3 181名男性为调查对象,问卷调查吸烟、戒烟行为等相关信息。结果被调查男性现在吸烟率为56.1%,戒烟率为11.9%,戒烟成功率为8.1%,平均戒烟年龄41.6岁,有56.3%男性吸烟者是在<45岁开始戒烟;现在吸烟者打算戒烟率为13.9%,想在6个月内和6个月后戒烟的分别为10.3%和3.6%;过去12个月内尝试戒烟率为21.9%;年龄、信念水平和吸烟程度是影响过去12个月内是否尝试戒烟的危险因子,吸烟年龄和有无慢性病是保护因子。结论广东省男性吸烟者戒烟率较低,影响戒烟的主要因素是年龄、吸烟开始年龄、有无慢性病、信念水平和吸烟程度。     

Predictors of cigarette smoking and smoking cessation among adults with asthma

OBJECTIVES: This study sought to determine the predictors of smoking and time until smoking cessation in a cohort of adults with asthma. METHODS: Adults with asthma (n = 374) in northern California completed structured telephone interviews at baseline and 18-month follow-up. RESULTS: Of the 374 subjects, 156 reported ever having smoked, and 39 indicated that they currently smoked. Earlier birth cohort, lower educational attainment. White race, and presence in childhood residence of an adult who smoked were associated with a greater risk of ever smoking. Lower educational attainment, early smoking initiation, higher daily cigarette consumption, and late-childhood-onset asthma were associated with a longer interval until smoking cessation. CONCLUSIONS: Persons with asthma at high risk of cigarette smoking and delayed quitting can be identified on the basis of clinical and demographic characteristics.