Epidemiology Study On Smoking-related Behavior Of Different Groups Of People

IntroductionTobacco has been identified as the important risk factor of lung cancer,respiratory disease,cardiovascular disease,stroke,etc.There are 1.1 billion smokers all over the world.One such country,the world's largest producer,consumer and victim of tobacco, is China.Currently,China is home to 350 million smokers(30%of the world's smokers) and loses approximately 1 million persons per year directly or indirectly due to tobacco-related deaths(TRD).If the smoking situation cannot be controlled effectively, it is estimated that about 2 million smoking-related deaths will occur among Chinese men by the year 2025,and 200 million children currently living in China will become smokers,50 million of whom will die from smoking-attributable diseases.Thus,we must strengthen our late start tobacco control campaigns,but smoking cessation among adults is the best way to prevent the death rates before mid-21st century.However,the survey results show that:smoking cessation rate was only 4.78% (4.17%for male,9.73%for female),and 68.37%by the reasons of illness,in China. Too low success rate of quitting smoking and too late by the main reasons for suffering from smoking-related diseases,are prompting us to develop effective smoking cessation programs.However,the efficacious design of smoking cessation strategies for smokers is hampered by the relative absence of information.Much of our current knowledge on smoking cessation has come from Western countries.Various studies have noted that adolescence is a major risk period in the process of becoming tobacco dependent.The younger the age at which young people start to smoke,the more likely they are to become regular smokers in adulthood.However,a huge proportion of smoking experimentation occurs during this period.In China, research has shown that the prevalence of smoking is alarming high in the adult population,but little is known about adolescents smoking because few studies have focused specifically on this population. According to the Report on Tobacco Control in China for 2007,540 million non-smokers are suffering from secondhand smoke,including 180 million children aged below 15.China's high prevalence of smoking and tremendous burden from tobacco-induced diseases make tobacco prevention an essential health priority. However,China doesn't have a smoke free law with Chinese characteristics at the national level,let alone one aimed at the population within recreational venues,which are all common venues for smoking and passive smoking exposure. cObjectiveTo explore the determinants of the willingness to quit smoking among regular smokers,and to provide a scientific basis for establishing smoking cessation strategies for adult smokers.To provide information on the determinants and prevalence of cigarette smoking among school students in Shenyang,and develop a practical and effective intervention strategy.To provide information on the determinants of smoking behavior in recreational venues,and to develop a practical and effective smoking intervention strategy for recreational venuesMethodsThe study was the baseline survey for the International Tobacco Control(ITC) China Survey of Shenyang,conducted between April to October 2006.The Survey used a stratified multistage cluster sampling design.Within Shenyang,10 Jie Dao were randomly selected,with probability of selection proportional to the population size of the Jie Dao.Within each of these Jie Dao,two Ju Wei Hui were selected,again with probability of selection proportional to the population size of the Ju Wei Hui,from which a city-identified list of family households was used to sample 300 households from every Ju Wei Hui using a simple random sampling method without replacement. Information on age,gender and smoking status for all adults living in these 300 households was collected.The enumerated 300 households were then randomly ordered, and individuals 18 years or older who had smoked at least 100 cigarettes in their lifetime were then approached following the randomized order until 40 adult smokers were surveyed.To increase the sample size for women smokers,one male smoker and one female smoker from every selected household were surveyed whenever possible. The Next Birthday Method was used to select a respondent in households with more than one eligible male smoker.A self-administered anonymous questionnaire survey was conducted among 1855 high and middle school students,and 1117 university students selected from 9 middle schools,9 high schools,3 vocational schools,and 2 universities located in different districts of Shenyang from Nov.2005 to May.2006.2935 questionnaires were collected with a response rate of 98.8%.The ITC China Survey used a stratified multistage cluster sampling design in which six cities were first selected based on geographical representations and levels of economic development.These six cities were:Shenyang,Beijing,Shanghai, Guangzhou,Changsha,and Yinchuan.Within each city,the more detailed description can be found in 1.ResultsThe voluntary quitting smoking rate among smokers in Shenyang,was only 30.7%, with 29.8%in male far less than in female(46.7%).Among different occupations, "Leaders of government,Chinese Com.party org.,companies & institute" with the highest of 47.5%,then was "Retired"(36.7%),"Operators of prod.or transportation. equipment & related personnel" with the lowest of 21.4%.The following factors were significant predictors of voluntary quitting smoking among smokers:family members' objects,public opinion,the health effects of smoking,advocacy efforts of tobacco control,low number of health effects reported,and The popularity of health warning information.Among the surveyed students,34.6%had experienced smoking.The prevalence of smoking was 46.9%in male,21.2%in female,with a significant difference between sexes;the prevalence of current smoking was 11.3%(18.5%in male,3.4%in female). The smoking-related knowledge and attitude were found out through Logistic analysis. "Exposed to smoking environment","don't know how to refuse other's free cigarettes", and "sad depressed mood" were the significant factors affecting the cigarette smoking behavior.Of all adult smokers,60%attended recreational venues at least once in the last six months.Of them,84%reported smoking in these settings.Analyses showed that the smoke-free laws had been exempted in various kinds of recreational venues,with only 32.0%of the patrons reporting bans on smoking in these locations.The following factors were significant predictors of smoking in recreational venues:absence of bans on smoking,support for non-bans,to be aged 18-24 years,positive smoking-related attitudes,low number of health effects reported,and living in cities other than Beijing.ConclusionsThe percentage of smokers contemplating quitting was low in Shenyang.The study shows that smokers in Shenyang must be mobilized to contemplate quitting and then to take action.It was a serious problem that the current smoking rate of adolescent was high in Shenyang.The students in polytechnics were the priority objects in prevention of smoking.The cognize about the harm of smoking was not widely understood or misunderstood.So it is essential to take action in educating and giving help to the quitting in adolescent smoking.The findings point to the importance of informing the Chinese public about the harmfulness of smoking and of second-hand smoke in both building support for smoke-free laws in recreational venues and in reducing smokers' desire to smoke in such venues.They also point to the importance of good enforcement(without exemptions) of smoke-free laws when they are implemented.Such strategies could serve to de-normalize smoking in China,a key strategy for reducing smoking in general.