A Prospective Study Of Smoking Knowledge Attitudes Behavior Among Adult Smokers In Guangzhou

BackgroundTobacco use is highly correlated to the cause of many diseases and death. A large number of scientific researches have proven from different angles that smoking is the significant risk factors for lung cancer,chronic respiratory diseases,coronary heart disease,stroke and even death.Besides that,it is today's one of the most serious public health problems.There are currently 1.1 billion smokers all over the world,and nearly 5 million people die from smoking-related diseases annually.China is the world's largest tobacco producing and consuming country with about 350 million smokers, accounting for more than a third of the global total on both counts.There are evidences showed that different target groups' tobacco-related knowledge and attitudes play important roles on tobacco control by enabling smokers to generate mind or take action to quit smoking,and preventing non-smokers to turn into smokers.Therefore,in order to take corresponding measures for tobacco control,it is important to understand the changes of knowledge and attitudes among smokers and non-smokers.If the knowledge and attitudes were able to change,smokers could develop the belief that smoking is bad for health,and had a positive attitude to quit smoking.In this study,prospective panel methods were used to systematically analyze the differences and changing patterns of health knowledge,tobacco-related knowledge and attitudes among Guangzhou adult smoking and non-smoking populations in recent years.The results will provide evidences for the development of tobacco control measures in the southern areas of China.Objectives To describe adult smokers' health knowledge,smoking-related knowledge and attitudes by using non-smokers in Guangzhou as control,to analyze the changes of tobacco-related knowledge and attitudes among smokers after one year's follow up,to explore the effects of national and local tobacco control policies on smokers' tobacco-related knowledge and attitudes,and so as to provide basis for developing tobacco control policies in Guangzhou.MethodsA Prospective Panel Study method was used for this research.It is the first and second rounds of ITC project which is a 5-year follow-up survey with a total of 5 round investigations.The participants were revisited once every year after the first round survey.In the first round,800 smokers and 200 non-smokers were selected with multiple stages sampling method from "street","household","family" to "individual".The second round survey required the same number of investigations to be completed,and made sure all participants in the first round have conducted follow-up survey.For those who miss the follow-up need to complete the supplementary survey.Both of the two rounds used face to face interview with questionnaires.Then,single factor and multiple factors analysis methods were used to identify the differences of tobacco-related knowledge and attitudes between adult smokers and non-smoker,and the impact of their smoking behavior.Results1,Knowledge of smoking-related disease:the smokers' awareness rate of both lung cancer and emphysema which caused by smoking were 55.2%and 52.1%.Besides that,the knowledge about accelerated ageing(27.5%), coronary heart disease(30.2%),impotence(11.9%),and lung cancer due to passive smoking(43.6%) was obviously insufficient,and which was even lower than the six cities' average level.In contrast,the non-smokers' knowledge of smoking-related disease was higher than that of smokers.The smokers,however,showed improvement in disease knowledge after one year's follow up.2,Knowledge of tobacco:Both smokers and the follow-up smokers were lack of the correct understanding of tobacco knowledge which cigarette filter could reduce the harm of smoking,and nicotine is chemical substances causing majority cancer.They were also not able to differentiate the low tar, light cigarettes and menthol cigarettes.There was no significant change on the knowledge of tobacco use after the one year follow-up.3,Smoking ban in public places:The attitudes towards the smoking ban in schools and public transport were better than those in restaurants and workplaces.The non-smokers' attitudes of ban in public places were significantly higher than those of smokers.After one year's follow up, smokers' the attitudes towards the smoking ban in public transport and restaurants were increased.4,After one year's follow up,the changes in smokers' knowledge and attitudes were noticed to have correlation with sex,education,and the scores of knowledge and attitudes.It was found that they were correlated positively with education,negatively with the awareness rate of knowledge and attitude. Meanwhile,male were noticed to change greater than female.The findings from non-smokers' knowledge and attitudes were also showed negative correlation with the awareness rate.5,The smoking cessation rate in this survey was 4.7 percent.The main reasons for smokers to quit smoking were Health and illnesses.Therefore,for those who concerning their health were more likely to quit smoking.It is also found that smokers whose age ranged from 45 to 54 had higher tendency to drop the habit than those age above 55.High schools or technical schools graduates had higher tendency to give up smoking than those graduated from primary schools or below.According to the survey findings,confidence was also play an important role in smoking cessation.Those smokers who had stong determination had greater possiblility to quit smoking.In contrast, smokers with smoking index "40～160" were more difficult to quit smoking than those above 160.There were no significant differences between smoking cessation tendency and Sex,family incomes,the awareness of tobacco knowledge and attitudes.ConclusionsThe smoker's health knowledge in Guangzhou was lower than the average level of other six cities in China,as well as the awareness of tobacco hazards.After one year's follow up,the understanding of health knowledge were significantly enhanced among smokers.However,they were still lack of the correct understanding of knowledge which "cigarette filter could reduce the harm of smoking","nicotine is chemical substances causing majority cancer","the differences of low tar,light cigarettes and menthol cigarettes". There was no significant change after the one-year follow-up.The contrast of the attitudes for smoking ban in different public places was remarkable.It is found that the attitudes towards the smoking ban in schools and public transport were better than those in restaurants and workplaces.Nevertheless,the smokers showed improvement in understanding the smoking ban in public transport and restaurants after one year's follow up.In Guangzhou,the changes in knowledge and attitudes were found to have positive correlation with education,negative with the awareness rate of knowledge and attitude.The changes in male were greater than female.The smoking cessation rate was 4.7 percent in this survey.It was noticed that age,education,confidence,attempt in quitting smoking,smoking index and health concerning were the factors affecting quitting intention.The main reasons for smokers to quit smoking were Health and illnesses.