| Section 1 Smoking prevalence among rural population in urbanizing China:a representative surveyBackground:Different countries are at different stages in the tobacco epidemic. China, with 20% of the world's population, produces and consumes about 30% of the world's cigarettes, and already suffers about a million deaths a year from tobacco. When, rural population in China accounted for a dominant position. The progress of urbanization make the suburban rural areas become gradually representative. However, little information of smoking prevalence has been focused on the villages in urbanizing China.Objective:Focus on the prevalence of smoking among the most representative population in china.Discuss the factors'relation with different levels:ever smoking, willingness to quit and smoke cessation.Investigate the role of nicotine dependence in transitions of different smoking status.Provide suggestions for tobacco control interventions and policies to rural population, the major group of population in china.Methods:Sample one natural village in Beijing suburb, investigate all 1901 villagers. Face-to-face survey was conducted to examine their information about smoking habit. Descriptive statistics was applied to portray all the rerated factors of different smoking status. Logistic regression was used to explore risk factors of different smoking status.Results:1. Prevalence, moving factors and influencing factors of smokingAmong the whole 1733 peoples, smoking rate was 35.8%. Ever smokers'average age was 24.57±15.06 years. They smoked an average of 16.88±10.14 cigarettes per day. Their smoking index (SI) was at a median of 17.5 (23.0) pack years. Male gender, secondary school or less education level, middle-income levels were higher smoking rate level groups.The chances of repeated sputum in smokers were as 2.29 times as non-smokers, and the chances of repeated shortness in smokers were as 1.76 times as non-smokers.Nearly 69.4% of the ever smokers had the existence of nicotine dependence, with their average Fagerstrom Test for Nicotine Dependence (FTND)score of 3.27±2.56 points.86.6% of ever smokers had been exposure to smoking before they started smoking; 73.8% of smokers started smoking while they had already been working. The most common incentive to start smoking were:curiosity, influence from classmates or colleagues, social influence.Male gender and the middle level of income was the risk factor of smoking. A higher educational level was a protective factor.2. Passive smokingThe rate of passive smoking in 1112 non-smokers was 62.0%. The average age of passive smoking was 19.55±11.61 years, the average amount of passive smoke (sticks/ day) was 5.35±4.81. Only 24.4% of the overall population were neither smokers nor passive smokers.3. Willingness to quitIn all 621 ever smokers, there were 291 (46.9%) people had the willingness to quit. Elder age, having respiratory symptoms, having the existence of nicotine dependence were the groups with higher rates of willingness to quit.The smokers who were willing to quit had accepted more advocacy from family members, friends, doctors or hospitals and less from media publicity over quitting than smokers who did not want to quit.Male gender, elder age, having shortness of breath and the existence of nicotine dependence were the positive impact factors of willingness to quit.4. Action of quit64.5% of the 621 ever smokers had never tried to quit.35.5% of the total had tried or were trying to quit. The rate of smokers who were just trying to quit was 1.4%. The rate of relapse in all those who had ever quit smoking successfully (maintain a complete abstinence greater than 6 months) was 29.4%.The vast majority (93.9%) of smoking cessation method was self-service method, 6.1% required the help of others,0% was from the community and hospital.Urging to smoke, depression, weight gaining were the most common consequences of quitting process.5. Smoking cessationThe overall rate of abstinence was 12.4%, successful smoking cessation rate was higher in those groups of elder age, lower educational level, lower income level, having repeated coughing and sputum, always having breathlessness after event, no nicotine dependence and lower FTND score. Elder age, middle level of education status was positive impact factors of successful smoking cessation. Having nicotine dependence may be the negative impact factor to reach the long term abstinence.Conclusion:Ways to reduce the prevalence of smoking is divided into two aspects:prevention and control.Schools should be the most important places to carry out smoking prevention. Students who were male gender or had poor performance at school should be paid more attention to. Increase the educational level of young people and develop the smoke-refusing atmosphere will be the effective way to prevent young people from smoking initiation.The attempt to develop the quit willingness should be focus on groups of those who were young, having no nicotine dependence and respiratory discomfort. Advocacy from family, friends, hospital, community will motivate smokers to quit. At present, the publicity and education of smoke preventing from community and hospital were clearly insufficient in rural area.The tobacco control efforts in rural areas should be strengthened. Improving rural health care system should be the main measures of the government. For it can increase the obtaining of useful medical information, which will help improve the health awareness of rural population, raise the rate of quit willingness and abstinence. Increasing the rate of smoking cessation in rural areas will help the rural population obtaining higher living standards.In terms of dependence, the existent of nicotine dependence was more closely related with willingness to quit and cessation than the level of FTND score.Nicotine dependent smokers were more likely to have the motivation to quit. So we should focus the motivational interviewing on those smokers who have no existence of nicotine dependence. For the nicotine dependent smokers, smoking cessation was more difficult, so we should give them more assistance and arrangement. Section 2 Asynchrony between left and right lungs in evaluation of early smoking-related lung abnormalitiesBackground:At present, pulmonary physicians confront a difficult situation when trying to reveal early lung abnormalities caused by smoking because no simple and convenient tools are available that can easily be applied in clinical practice.Objective:The goal of this study were to observe the asynchrony patterns between left and right lungs in smokers and non-smokers, to assess the role of vibration response imaging(VRI) in the early detection and evaluation of smoking-related lung abnormalities.Methods:Data collected steps are as follows:(1) asked past history and smoking history; (2) exhaled CO test confirmed that the subjects'smoking status; (3) VRI test. VRI system output the curve of Breath Energy Unit (BEU), which is an energy versus time graph of the breath energy. The asynchrony between left and right lungs was derived from this graph; (4) pulmonary function testing. In the end,26 villagers, with normal spirometry findings, were included in the study. The subjects were divided into ever-smoking group and never-smoking group.Results:The BEU lung asynchrony was 2.0 (3.0) frame in Never-smoking group,2.0 (3.0) frame too in ever-smoking group. Rank sum test show that there is no significant difference (z=-0.29, p= 0.77) between never-smokers and ever-smokers in the lung asynchrony. Rank correlation analysis suggests that in the ever-smoking group, smoking index and BEU asynchrony have significant correlation (r= 0.61, p= 0.03). In never-smoking group, the coefficient of passive smoking index and lung asynchrony is 0.52 (p= 0.07). The p value of the coefficient between passive smoking index and lung asynchrony is nearly 0.05, scatter between them can be seen a presence of a certain trend.Conclusion:Though the BEU asynchrony of left and right lungs among ever-smokers and never-smokers has no significant differences, the lung asynchrony and ever-smokers' smoking level (Smoking index) have the existence of dose-effect relationship. Thus, the lung abnormalities caused by the exposure to passive smoking is probably as same as the abnormalities caused by direct smoking.
|
PDF Full Text Request