The Association Between Attributing Smoking To Genetic Causes And Successful Smoking Cessation

BackgroundTobacco use continues to be the leading global cause of preventable death. As the world’s largest tobacco consumer and producer, China is facing a public health crisis for current smoking rates. Moreover, in China, the rural population whose smoking rate and smoking amount are both higher than the urban people is in the majority. Therefore, to develop effective tobacco control programs is imperative and urgent in our country, especially in rural areas.Although several strategies are available for conducting tobacco control in the population, however, promoting smokers to quit is one of the main tactics. Leventhal’s Self Regulation Model (SRM) suggests that individuals’perceptions of a health problem, including its causes, influence their perceived control over the problem and their attempts to cope with it, thus, to increase awareness about the health hazard of smoking could promote the smoker’s intention to quit. However, one research showed that attributing smoking to genetic causes was associated with lower levels of perceived control over smoking but not lower quit rates. Therefore, in our report, we use a community-based case-control study to further examine the effects of attributing one’s smoking to genetic causal factors on the successful smoking cessation, smoking abstinence self-efficacy and tobacco dependence which will provides evidence needed to better inform education for tobacco control intervention.Objectives1. To detect the association between attributing smoking to genetic causes and the successful smoking cessation.2. To detect the effects of attributing one’s smoking to genetic causal factors on the smoking abstinence self-efficacy.3. To detect the effects of attributing one’s smoking to genetic causal factors on tobacco dependence.MethodsIn March,2009, Shandong University established a cohort of the Health Research Base (HRB) in three counties (Ping Yin, Ju Nan, and Liang Shan) covering 17 villages, in Shandong, China. A face-to-face interview was conducted based on the cohort mentioned above. After excluding current occasional smokers, a community-based case-control study was conducted with male persons aged 18 or more spontaneous successful smoking quitters as the cases, and spontaneous failed smoking quitters as the controls; Because no suitable measures existed, we developed four items to assess one’s attributing smoking to genetic cause and people were categorized into gene-negative group and gene-positive group. The smoking abstinence self-efficacy (SASE) was assessed using nine-item self-efficacy for coping with tempting situations scale (Smoking Abstinence Self-Efficacy Scale, SASES) and each item is rated on a five-point Likert-type scale ranging from completely sure as 5 to completely unsure as 1. Higher score indicates the higher level of self-efficacy. people1 s level of tobacco dependence (TD) was assessed using the Fagerstrom Test for Nicotine Dependence (FTND) scale. Which consists of six items and each item has a weighted score that ranges from 0 to 3. Higher score indicates the higher level of tobacco dependence. According to the WHO division standard of age, we divided age into youth, middle and old; we divided occupation into farmer and others; we divided education into below primary school, junior and senior high school and above high school; we divided marital status into married, spinsterhood and other. Propensity score as the covariate in the regression model was used to adjust the potential confounding including age, age of smoking initiation, profession, education, and marital status. Logistic regression was used to examine the effect of attributing smoking to genetic cause on successful smoking cessation. Linear regression was performed to explore the impact of attributing smoking to genetic cause on the perceived control over smoking and nicotine dependence.Main results1. Except for profession (P=0.950) and the age of smoking initiation (P=0.421), the differences of age, educational level, and marital status between gene-negative group and gene-positive group were statistically significant (P<0.05)2. Before and after adjusting age, age of smoking initiation, profession, education, and marital status by using propensity score, the attributing smoking to genetic cause had significantly negative effect on the successful smoking cessation (OR=0.672; 95%CI=0.505-0.893) and (OR-0.642,95%CI=0.479-0.859).3. After adjusting age, age of smoking initiation, profession, education, and marital status by using propensity score, smokers who viewed heredity as the cause of their smoking had significantly lower level of perceived control over their smoking behaviors (2.592±0.022 vs.3.052+0.049); in positive/social situations (SASEP), negative/affective situations (SASEN) and habit/addictive situations (SASEH), smokers who attributed smoking to genetic causes had significantly lower level of perceived control than smokers who did not.4. After adjusting age, age of smoking initiation, profession, education, and marital status by using propensity score,smokers who viewed heredity as the cause of their smoking had significantly higher level of FTND (3.447±0.080) than smokers who did not (2.168±0.174) (P<0.05).ConclusionsThis study indicated that the attributing one’s smoking to genetic causes is a risk factor for successful smoking cessation and perceived control over smoking, and an enhancing factor for smokers’ tobacco dependence. This misconception could be a target behavior to be rectified in the future behavioral smoking cessation interventions. These findings need to be confirmed by further researches.