| BackgroundSmoking, included exposure to second-hand smoking, continues to be the leading preventable cause of chronic noninfectious disease, disability and early death, and leads to huge economic losses directly or indirectly. China is the world’s largest tobacco manufacturing and consuming country, and the production of tobacco and the prevalence of smoking still have been increasing gradually. Particularly in the rural area of China, the prevalence and amount of smoke have continued been at a high level, and both higher than the urban area. Therefore, in our country, especially in the rural area, to develop effective tobacco control programs to contain the high prevalence of tobacco is imperative and urgent.In recent years, studies about factors of smoking cessation have been emerging continuously, various tobacco control programs also have been implemented in the whole society, but promoting smokers to quit is a vital aspect of the tobacco control programs. Related studies show that the characteristics of smoker, such as age, age onset, occupation, education and marital status are important factors of smoking cessation, and studies about the association between reasons for smoking and successful smoking cessation have been appeared continuously. However, with different respondents group, the factors of smoking cessation also change constantly, and there is no study to reveal the relative importance of the reasons for smoking to the successful smoking cessation. Therefore, our research apply case-control study which is based on community population, to investigate the factors of smoking cessation, and to reveal the relative importance of the reasons for smoking to the successful smoking cessation with Russell Reason for Smoking Questionnaire (RRSQ), which will provide theoretical evidence to develop effective tobacco control programs in the rural area of China.Objectives1. To describe the contribution of the reasons for smoking.2. To investigate the relative importance of the reasons for smoking to the successful smoking cessation.MethodsDuring April to May in 2013, at the Health Research Base (HRB) of Public Health School, Shandong University, which are included 17 villages that are situated in three countries (Liang Shan, Ju Nan, and Ping Yin), our study chose the male smoking quitters as interviewees who were aged 18 or more and participated in the smoking baseline investigation in 2009, applied face-to-face method to investigate related questions with<Smoking Questionnaire> which was designed independently. On this basis, a community-based case-control study was conducted with spontaneous successfully smoking quitters (those who conform to the criterion of smoker and have been quitting smoking continuously for more than 2 years) as the cases, and spontaneous failed smoking quitters (those who conform to the criterion of smoker and ever quitted but relapsed or have been quitting smoking continuously equal to or less than 2 years) as the controls.The general demographic characteristics of the respondents included age, marital status, occupation and education:age was divided into youth group (younger than 45), middle group (45-60) and old group (no younger than 60); marital status was divided into married, spinsterhood and others; according to the situation of interviewees, occupation was divided into farmer and others; education was divided into below primary school, primary school and junior high school, above junior high school. And the smoking status information included age onset, smoking amount per day, pack years of smoking, years of smoking, and pack years of smoking was defined to be (smoking amount per day)/20*(years of smoking).We applied RRSQ to investigate the reasons for smoking, and compare the difference of reasons for smoking between the cases and the controls; we applied dominance logistic regression to investigate the relative importance of the reasons for smoking to the successful smoking cessation.Main Results1. The difference of age, age onset, years of smoking, marital status and education between the cases and the controls had statistical significance (P<0.05). As for age aspect, the old group proportion and average age of the cases were larger than the controls; as for marital status aspect, the married proportion of the cases was smaller than the controls; as for education aspect, middle and high education level of the cases were smaller than the controls; and the smoking years and age onset of the cases were smaller than the controls.2. The reliability of RRSQ was quite good, and fit for investigating reasons for smoking of the respondents in our study.3. The Sedative Subscale score and Stimulation Subscale score of the cases were larger than the controls, and the difference between the cases and the controls had statistical significance (P<0.01).4. The correlations of Sedative Subscale and Stimulation Subscale with the success of quitting smoking were negative, and both had statistical significance. As for the relative importance to the successful smoking cessation, Sedative Subscale and Stimulation Subscale took the top two place.Conclusion1. Through comparing the difference between the cases and the controls, we find that age, age onset, years of smoking, marital status and education are important factors of smoking cessation. And with larger age, smaller age onset, less years of smoking, unmarried and lower level of education, the quitter are tended to quit smoking successfully.2. With larger score of Sedative Subscale and Stimulation Subscale, the quitter have less rate of quitting smoking successfully. As for the relative importance to the successful smoking cessation, Sedative Subscale and Stimulation Subscale took the top two place, and dominance weight of both subscales were much higher than other subscales of the RRSQ. The result reveal that reduce negative psychology (such as anxiety and tension) during the smoking cessation and the demand of tobacco stimulation, are important aspects to develop effective tobacco control programs in the rural area of China. |
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