Study On Smoking Status Of Public Place Workers And Effective Of Tobacco Control Interventions Using Short-Message Service

Objective To examine the smoking and passive smoking status among public placeworkers in Hefei City, their perceptions on tobacco control knowledge and their attitudetowards tobacco control, and to analyse the influence factors of them to provide basisfor tobacco control．And to determine the effectiveness of tobacco control interventionsusing mobile phone short-message service on improve the tobacco control knowledgeand attitude towards tobacco control measures and change of smoking behavior.Methods The cross-section study: The study were conducted at medical examinationcenters of5CDCs(Center for Disease Prevention and Control) in Hefei City. Publicplaces workers who came to take health examination in5CDCs were recruited to take aface-to-face interview with stratified sampling method. A self-made questionnaire wasdesigned to investigate smoking status, their perceptions on tobacco control knowledgeand their attitude towards tobacco control measures. The intervention study: The studywas designed as a randomized control trial. Respondents were randomized into anintervention group that received text messages providing smoking and healthknowledge, or to a control group. The trial lasted for3months and75messages weresent to each intervention group member. After intervention, a telephone interview wasconduct to follow the tobacco control knowledge, attitude towards tobacco controlmeasures and change of smoking behavior.Results The cross-section study: A total of1211public place workers were investigated,608of them were male and603of them were female. Overall smokingprevalence was25.9%(48.8%in male and2.8%in female). Current smoking prevalencewas23.7%(44.7%in male and2.5%in female). There were notable differences insmoking rate of different type of workers. The occupations with the highest smokingrate were entertainment places workers(43.2%), foods processing workers orcooks(42.3%) and healthcare or hairdressing workers(38.1%). The FTND scale wasused to measure smokers’ nicotine addiction, and the average score is2.01±1.99. Therewere significant differences in smokers’ FTND score with different age, marital status,working place and payment level.25people (7.6%) had quitted smoking within314smokers, and287people (56.1%) intended to quit smoking in one year within314current smokers.60.9%of workers surveyed reported to be exposed to SHS whileworking.71.9%of male workers reported to be exposed to SHS, and49.4%of femaleworkers reported to be exposed to SHS. The occupations with the highest SHS exposerate were salesman (78.7%), entertainment places workers (73.0%) and hotel workers(67.9%).80.7%of the respondents were aware that baby’s birth defects is associatedwith the mother’s smoking;78.3%were aware that lung cancer is associated withsmoking;75.0%agreed that effect of SHS were serious. While only13.7%ofrespondents aware that nicotine does note causes cancer but causes addiction;29.5%were aware that Heart diseases is associated with stroke;31.5%were aware that heartdiseases is associated with smoking. Result of attitudes towards control measuresshowed:84.5%of the respondents supported that cigarettes mustn’t be sold to minors;62.8%of the respondents supported a total ban of tobacco advertising;82.5%of therespondents supported ‘no-smoking’ in public places. The results of logistic regressionanalysis showed that risk factors of smoking were: male, age, mother’s smokingexperience, friends smoking’s smoking experience, agree with “smoking lookscharming and attractive”, and protective factors were: getting a college or above degree,objection by friends and mother, agree with “smoking looks bad mannered”. The intervention study: After3-month intervention, the awareness of tobacco control in theintervention group improved significantly by3.22(tobacco control score). Furthermore,the growth of the score in the intervention group was1.03higher than that in the controlgroup. The awareness for9of all the14knowledge points was significantly improvedin the intervention group than that in the control group. The low-awareness knowledgepoints at baseline, such as ‘nicotine is the chemical carcinogen for the majority of allcancers’,‘smoking is associated with elevated cardiovascular risk’ and ‘passivesmoking contributes to adulthood cardiovascular risk’, presented much significantimprovement after intervention when comparing with other points. Compared with thecontrol group, the increase of proportion for subjects who supported3tobacco controlmeasures (selling cigarette to juveniles should be prohibited, tobacco advertisementshould be banned, smoking in public place should be prohibited) was significantlyhigher in the intervention group. After3-month intervention, the smoking rate in theintervention group increased from14.6%to17.6%, while the proportion of regularsmokers in the intervention group has decreased from16.3%to15.8%. As for thecontrol group, the smoking rate has increased from26.2%to26.9%, while the numbersof seldom smokers and regular smokers have both increased. Nevertheless, nosignificant differences were found on smoking status between2groups afterintervention. Furthermore, no optimal change has been observed on smoking behaviorand smoking degree in the intervention group in the present study.Conclusion The cross-section study: Public places workers’ smoking rate andcurrent smoking rate was slightly lower than surveys conduct in other cities in China,was also lower than smoking rate of residents in Hefei City. Smokers’ FTND averagescore was lower than researches in China and abroad. Knowledge of the specific effectsof tobacco in respect of active and passive smoking needs to be improved. Theinfluence factors of smoking are smoking experience of respondents’ mother and friends and attitude towards smoking. The intervention study: These findingssuggested that a3-month tobacco control interventions by employing SMS improvedthe awareness of tobacco control related knowledge and increased the level of supportfor tobacco control measures among public place workers. However, our interventiondid not optimally influence smoking behavior and smoking degree.