Physician-delivered advice to quit smoking among Italian smokers

OBJECTIVE: A clinical practice guideline for smoking cessation was released in Italy in 2002, but to date little is known about the implementation of these recommendations among primary care physicians. The objectives of this study were to estimate the prevalence of receiving physician-delivered advice to quit smoking and to determine what factors were related to the receipt of advice among adult Italian smokers. METHODS: The data were collected as part of the Italian 2004-2006 adult tobacco surveys (analyzed in 2007), conducted by DOXA, the Italian branch of the Gallup International Association, and representative of the population aged>or=18 years. Each year smokers were asked whether they had received advice to quit smoking from their family physician during the previous year. Demographic, socioeconomic, tobacco-related, and physician-related variables were examined for their association with the receipt of advice. A logistic regression model was then fit to the data to determine which variables were related to receiving advice to quit smoking. RESULTS: Overall, 22% of smokers reported receiving advice to quit smoking from their physician in the previous year. Less likely to receive advice to quit were smokers who: were single (compared to divorced, widowed, or separated); lived in the South; had a higher level of education; were lighter smokers; had no previous quit attempts; and had physicians who likely smoked. CONCLUSIONS: The data suggest that Italian physicians are not advising smokers to quit at a high rate. Future research should focus on methods that encourage physicians to counsel smokers to quit during a patient-provider encounter.     

武汉市大学生吸烟现状及现在吸烟影响因素分析

目的 了解武汉市大学生吸烟现状,分析影响大学生现在吸烟的因素,为高校控烟工作提供科学依据.方法 采用分层整群抽样方法,抽取武汉市4所高校的3 000名大学二年级学生进行自填式问卷调查.采用x2检验和Logistic回归对大学生吸烟行为及其现在吸烟影响因素进行分析.结果 2 891名大学生中,27.33％的大学生有尝试吸...     

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。     

甘肃省15～69岁现在吸烟者戒烟意愿及影响因素

  目的  了解甘肃省现在吸烟者的戒烟意愿以及影响因素,为烟草防控工作提供科学依据。  方法  采用多阶段抽样方法,随机抽取15~69岁现在吸烟者作为调查对象。采用《全国居民吸烟情况调查问卷》开展面对面调查,分析不同特征现在吸烟者的戒烟意愿,采用Logistic回归分析模型分析现在吸烟者戒烟意愿的影响因素。  结果  甘肃省现在吸烟者的戒烟意愿为16.4%（95%CI:15.5%~17.3%）,农村地区（OR=1.199,95%CI:1.022~1.408,P=0.026）、家中禁止吸烟（OR=1.767,95%CI:1.273~2.454,P=0.001）、12个月内就医时医务人员劝阻吸烟（OR=1.599,95%CI:1.359~1.842,P < 0.001）、去过戒烟门诊（OR=3.089,95%CI:2.031~4.698,P < 0.001）、初中、高中、大专及以上文化程度（OR=1.383,95%CI:1.101~1.736;OR=1.627,95%CI:1.252~2.116;OR=1.374,95%CI:1.009~1.873,均有P < 0.05）、高烟草危害知识得分为1~,3~,5~6（OR=1.248,95%CI:1.030~1.514;OR=1.574,95%CI:1.289~1.922;OR=2.288,95%CI:1.879~2.786,均有P < 0.05）是现在吸烟者戒烟意愿的促进因素;年龄20~、30~岁组以及烟龄20~、30~年是现在吸烟者戒烟意愿的阻碍因素。  结论  甘肃省现在吸烟者戒烟意愿总体不高,今后应进一步在全社会普及烟草危害知识,加强医务人员戒烟服务能力培训,在诊疗过程中开展戒烟服务,同时应鼓励和支持医疗机构加快戒烟门诊建设。     

Postpartum return to smoking among usual smokers who quit during pregnancy

BACKGROUND: Many women stop smoking while they are pregnant, but the majority resume smoking in the postpartum. The objective is to describe postpartum tobacco use of women who quit during pregnancy and factors predicting postpartum smoking relapse. METHODS: Secondary analysis of two surveys of new mothers. Survey A conducted in three maternity hospitals, including 685 women interviewed after birth and who answered a postal questionnaire at 5 months postpartum; survey B conducted in four 'départements' (administrative areas), including 636 women who answered a postal questionnaire at 6 months postpartum. Response rates were respectively 90% and 68%. Smoking status was recorded for three time periods: before pregnancy, during pregnancy, and at 5-6 months. Social characteristics and preventive behaviour were compared for regular smokers who had quit smoking during pregnancy and those who had not, and among quitters, who had resumed smoking postpartum and those who had not. RESULTS: In survey A, 37% were smokers before pregnancy, 34% of them stopped during pregnancy, and among the latter, 48% had resumed smoking 5-6 months after delivery. In survey B, the percentages were respectively 43, 54 and 57%. The most predictive factor of postpartum smoking relapse was the partner's smoking behaviour. CONCLUSION: Return to smoking after delivery is frequent, but nearly half of the regular smokers who had stopped during pregnancy were still non-smokers 5-6 months after the birth. However, to increase this proportion, interventions need to include partners, especially if they are smokers.     

Psychosocial factors and smoking cessation behaviors among smokers who have and have not ever tried to quit

Relationships between smoking cessation behaviors and demographic characteristics and attitudes were analyzed among two groups of smokers, those who had and had not ever tried to quit. Telephone interviews were completed with 1501 smokers at baseline and at a 3 month follow-up. Multiple logistic regression analyses were used to identify factors that were associated with planning to quit, attempting to quit and quitting smoking within the two groups of smokers. Different patterns of correlates were found across groups and within the three outcome measures, indicating the potential importance of targeting interventions according to whether or not smokers have made a prior quit attempt. These findings also support the value of using multiple outcome measures in the smoking cessation process.     

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.     

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。     

Intention to quit smoking, attempts to quit, and successful quitting among Hong Kong Chinese smokers: population prevalence and predictors

PURPOSE: To assess the prevalence of each step in the smoking-cessation process (intention to quit, attempts to quit, and successful quitting) and to examine the factors associated with them among Chinese smokers. DESIGN: A cross-sectional survey of subjects from randomly selected households. SETTING: Four thousand one hundred forty-two households in Hong Kong. SUBJECTS: A total of 11,779 persons, aged 15 years or older, were enumerated (response rate = 74.0%). MEASURES: A validated structured questionnaire was used for data collection. The questionnaire sought information on the subject's sociodemographic background, smoking habits, and workplace attitude to smoking. The predictors for successful quitting, past quitting attempts, and intention to quit were assessed by chi2 tests and multiple logistic regression. RESULTS: Of the respondents, 14.4% were current smokers, 7.5% were ex-smokers, and 78.1% were nonsmokers. Of the daily smokers, 52% intended to quit. The factors associated with quitting were being married, being in the student/retired/others category, being older, having received higher education, not smoking to kill time, and smoking because of curiosity. Being married and not smoking to kill time were associated with past quitting attempts. Being male, married, and not smoking to kill time were associated with the intention to quit smoking. CONCLUSION: The findings of this study indicate that differing predictors may contribute to the different transitional stages of smoking cessation. Population-based smoking-cessation programs should take these predictors into consideration in the design of interventions.     

Smoking ban policies and their influence on smoking behaviors among current California smokers: A population-based study

ObjectiveTo assess whether smoking ban policies are associated with smoking reduction and quit attempts among California smokers.MethodsData were examined for 1718 current smokers from follow-up telephone interviews conducted in 2011 of persons previously identified as smokers in a representative sample of the adult population of California. Population weighted logistic regressions controlling for demographic and other variables were used to evaluate the association between smoking ban policies (home, work, and town) and changes in tobacco use (past year quit attempt or reduction in smoking rate).ResultsLiving in a home with a total ban was significantly associated with smoking reduction (adjusted odds ratio, AOR: 2.4, 95% CI: 1.4–4.2) and making a quit attempt (AOR: 2.3, 95% CI: 1.3–3.9) compared to living in a home with no home ban. Self-reported perception of an outdoor ban in one's city/town was associated with smoking reduction (AOR: 1.7, 95% CI: 1.02–2.7) and making a quit attempt (AOR: 1.8, 95% CI: 1.05–2.9).ConclusionThese results indicate that smoking bans not only protect nonsmokers from the harms of secondhand smoke, but are also associated with smoking reduction and cessation.     

Contemplating to quit current smoking status: differences in behavioural and psychosocial patterns in a population-based cohort of current smokers

BACKGROUND: Smokers actively considering to quit smoking were compared with hard-core smokers completely unwilling to change smoking habits with respect to psychosocial variables. METHODS: A total of 3,229 current regular smokers aged 25-74 years were drawn from three population-based MONICA/KORA Augsburg surveys conducted between 1984 and 1995. Among them, 592 (8.4%) subjects were defined as active contemplators (AC) and 776 (22.6%) as immotives (IM). Multivariate logistic regression analysis stratified by sex was used to identify active contemplators. RESULTS: No differences between ACs and IMs were observed for sex and age. Active contemplating in females was strongly mediated by impaired self-rated health [Odds ratio (OR) 2.29; 95% CI 1.42-3.69] and somatic complaints (OR 2.10; 95% CI 1.29-3.48). For men, depression (OR 2.49; 95% CI 1.64-3.79) and not living alone (OR 2.20, 95% CI 1.51-3.20) promoted being AC. Long-term survival was impaired for IM compared to AC. The odds ratio for smoking cessation of ACs compared to IMs was 1.77 (95% CI 1.25-2.50). CONCLUSIONS: Sex-specific differences in factors associated with the intention to quit smoking were observed and may lead to sex-specific targets in prevention strategy. IMs may be victims of a conceited healthy smoker effect triggered by the absence of disabling body or affective symptoms.     

Predicting alcohol misusers' readiness and ability to quit smoking: a critical review

AIMS: The prevalence of smoking among individuals with alcohol use disorders (AUD) and other substance use disorders is alarmingly high, and long-term success rates of smoking cessation interventions in this group are low. One way to improve treatment efficacy for this population is through a more comprehensive understanding of individual- and treatment-level variables that affect the motivation to quit as well as the outcomes of smoking cessation attempts. In this paper, we review the relevant research on factors that may influence readiness to quit and the efficacy of smoking cessation interventions in this population and highlight gaps in the knowledge base that require further investigation. METHODS: We conducted a review of the literature on smoking among adults with AUD in order to examine predictors of motivation to quit smoking and outcome of cessation attempts. RESULTS: No consistent predictors of motivation for smoking cessation were identified. Although the results were not unanimous, a greater length of abstinence from alcohol and other substances predicted smoking cessation success. CONCLUSIONS: Empirical work identifying factors associated with the motivation and ability to quit smoking among individuals with AUD is in its early stages. Mixed results and a dearth of research in this area prohibit strong conclusions from being made. Future researchers are encouraged to consider alternative methods of conceptualizing and measuring motivations to quit in this group and to routinely include analyses that examine predictors of outcome in intervention studies.     

Motives for smoking cessation are associated with stage of readiness to quit smoking and sociodemographics among German industrial employees

PURPOSE: To test the relationships among particular motives for smoking cessation, stage of readiness to quit (preparation or contemplation), and sociodemographic characteristics. DESIGN: A cross-sectional study to examine attitudes toward and use of health promotion at the worksite, using a self-administered questionnaire. SETTING: Two German metal companies. SUBJECTS: Of 1641 responding employees (response rate 65% in company A and 44% in company B), 360 smokers who intended to quit immediately (n = 105) or in the near future (n = 255) were analyzed. MEASURES: The questionnaire comprised of sociodemographic characteristics, smoking behavior, smoking history, readiness to quit smoking, motives to quit, such as coworkers' complaints and health-related or financial concerns. Chi-squared tests and multiple logistic regression analyses were performed. RESULTS: Health-related reasons (94%) predominated financial (27%) or image-related (14%) reasons for smoking cessation. Participants in the cessation preparation group were more likely to report an awareness of being addicted (79.6% vs. 58.2%; p < .001) and the negative public image (22.5% vs. 11.6%; p < .01) as reasons for quitting compared with those in the contemplation group. In multivariable regression models, the motives for smoking cessation, including reduced performance, family's and coworkers' complaints, pregnancy/children, and negative public image, but not health-related and financial concerns, differed significantly by gender, age, marital status, education, and occupational status. CONCLUSIONS: Motives for smoking cessation vary according to the individual's level of readiness to quit and sociodemographic background.     

Smoking and quitting history correlates of readiness to quit in multiethnic adolescents

OBJECTIVES: To describe smoking and quitting history among multiethnic adolescent smokers and examine these as correlates of readiness to quit. METHODS: Data were analyzed from 121 high school smokers. Sociodemographic characteristics, self-reported smoking history, number and duration of recent quit attempts, attitudes toward smoking/quitting, and readiness to quit were included. RESULTS: Smoking and quitting history variables were associated with adolescents' stage of readiness to quit. A reasonably consistent pattern emerged in which those in the preparation stage were significantly different from the precontemplators and contemplators. CONCLUSIONS: Results are discussed in terms of interventions matched to individuals' readiness to quit.     

Motivation and reasons to quit: predictive validity among adolescent smokers

OBJECTIVES: To examine reasons to quit among adolescents in a smoking cessation program, and whether reasons were associated with subsequent cessation. METHODS: Participants were 351 adolescents. At baseline, adolescents reported motivation, reasons to quit, and stage of change for cessation. Quit status was assessed at end of treatment. RESULTS: Girls were more likely to endorse image and appearance reasons to quit. Cessation was more likely among adolescents with higher motivation and those wanting to quit because of friends. CONCLUSIONS: Different reasons to quit were associated with motivation and cessation. Baseline motivation strongly predicted cessation, suggesting the relative value of assessing global motivation.     

江苏省媒体控烟宣传对吸烟人群戒烟意愿的影响

目的了解各种媒体控烟宣传覆盖现状,探讨媒体控烟宣传对吸烟人群戒烟意愿的影响,为今后利用媒体开展控烟宣传提供依据。方法采用多阶段整群随机抽样方法在江苏省14个疾病监测点中抽取8400名18岁及以上成人进行调查,分析人群接触各种媒体情况和各种媒体控烟宣传覆盖情况,并用非条件logistic回归模型研究控烟宣传媒体暴露数量对吸烟人群戒烟意愿的影响。结果人群中接触率较高的媒体为电视（89．4％）和报纸（54．3％）,且媒体接触率在不同性别、年龄、城乡、文化和收入水平人群中存在差异（P〈0．01）;控烟宣传覆盖较高的媒体为电视（51．8％）和报纸（22．2％）,互联网（6．7％）和电影院（3．3％）相对较低;26．7％现在吸烟者有打算戒烟的意愿;非条件logistic回归分析显示吸烟人群中暴露于控烟宣传媒体数量越多,其打算戒烟的比例也越高,暴露于2种和3种及以上控烟宣传媒体的现在吸烟者打算戒烟比例分别是未暴露者的1．45倍和1．59倍,差异有统计学意义（P〈0．01）。结论公共场所中控烟宣传覆盖比例仍相对较低,应该针对吸烟者自身和环境因素制定媒体控烟宣传策略,加强公共场所媒体控烟宣传力度,促进吸烟者戒烟。     

Aiming at Tobacco Harm Reduction: A survey comparing smokers differing in readiness to quit

Background  

Greece has the highest smoking rates (in the 15-nation bloc) in Europe. The purpose of this study was to investigate Greek smokers' intention and appraisal of capability to quit employing the theoretical frameworks of Decisional Balance (DB) and Cognitive Dissonance (CD).     

Parental smoking and sociodemographic factors related to smoking among German medical students

Smoking among medical students has been found to vary strongly between European countries. Few studies have addressed factors associated with smoking among medical students within countries. In this study, we assessed the association of parental smoking and sociodemographic factors with smoking habits of medical students at the University of Ulm, Germany, Students who entered the 1st, 3rd and 5th year of medical school in fall 1992 were asked to complete a self-administered questionnaire. Questionnaires were returned by 696 (85.2%) of 817 eligible students. Overall, 23.7% of students were current smokers, and 11.9% were former smokers. Smoking habits were related to maternal smoking: Odds ratios for the association of maternal smoking with ever or current smoking of students were 2.11 (95% CI: 1.48–3.03) and 2.01 (95% CI: 1.35–3.01), respectively, after adjustment for potential confounders in multiple logistic regression. In contrast, no asso-ciation was found between paternal smoking and students' smoking status. Male students were more likely to smoke than female students, and living in a large city during secondary school was also associated with ever smoking. No association was found between students' smoking habits and educational achievement of their mothers and fathers. These results suggest a key role of maternal smoking for smoking among medical students in this society.     

Response error in self-reported current smoking frequency by black and white established smokers

As compared with white smokers, black smokers, although they report using fewer cigarettes per day, are at higher risk for most smoking-related diseases. Among black smokers serum cotinine levels are also higher in proportion to cigarettes per day; this observation has led to suggestions of bias in self-reporting. The purpose of this study was to evaluate and compare the extent of errors in self-reported smoking patterns among black and white established smokers. Ninety-seven white and 66 black smokers participated in structured telephone interviews, filled out two self-administered questionnaires one week apart, and collected all of their cigarette butts for a week. Group differences in the validity of self-reported smoking patterns were assessed by comparison with cigarette butt counts and the measured butt lengths. Both black and white smokers significantly overestimated smoking on our measure of smoking frequency (both P < 0.001); the group difference in bias was not significant (P = 0.13). There was no evidence that underreporting was more common among blacks than among whites (P = 0.67). Test-retest reliability was not significantly different in the two groups (P = 0.09). Both groups performed poorly when asked to categorize their smoking frequency according to the cutpoints of the Fagerström Test for Nicotine Dependence. Black smokers smoked more of each cigarette and smoked longer cigarettes, but they smoked fewer total millimeters of cigarettes per day (all P < 0.001). Contrary to an earlier report, the disproportionately high cotinine levels could not be attributed to reporting error.