| Objective: Smoking is one of the common health risk behaviors.China has been carried out in tobacco control for nearly 30 years.However,the current epidemic situation of tobacco use is still grim in China.The present study aimed to explore the appropriate intervention mode and offer the theoretical foundation for formulating scientifically the smoking control strategies for middle-aged and older people in China.(1)To understand the status and influencing factors of smoking cessation and relapse in middle and old people.(2)To evaluate the effect of smoke-free policies on smoking and smoking cessation behavior in the middle and old.(3)Through qualitative research,the study was to explore the motivation and understand the behaviors of smoking cessation and relapse of middle and old people.Meanwhile,it intended to learn about their attitude towards tobacco control policies.Methods:(1)The data of China Health and elderly care follow-up survey(CHARLS)were used.3708 middle-aged and old people who smoked in 2011 were selected,who were followed up in 2013,2015,and 2018.Through descriptive analysis,single-factor test,and multi-factor logistic analysis,the status and influencing factors of smoking cessation and relapse among middle-aged and older adults were explored.(2)Based on CHARLS of data in 2013 and 2018,the effects of local tobacco control policies of eight cities in the public place that implemented between 2013 and 2018 were evaluated by propensity score matching and difference-in-difference method,which consisted of Ningbo,Shanghai,Fuzhou,Beijing,Nanning,Shenzhen,Lanzhou,and Qingdao.The effects mean that the impacts of tobacco control policies on smoking and smoking cessation of middle-aged and older people.(3)Purposive sampling method was used to select 20 middle-aged and older adults who smoked or quit smoking for in-depth interview.Qualitative research was used to understand the smoking cessation and relapse experience of middle-aged and older people,so as to deeply learn the real feelings of middle-aged and older adults in the process of smoking cessation.Results:(1)This study found that the annual rate of smoking cessation in2011-2015 was about 4.4% and 4.51% in 2015-2018,but the annual rate of relapse increased from 6.82% to 11.78% among smokers aged 45 or above in China.The age,nicotine dependence,and self-perceived health status were related to successful smoking cessation.The older age with lower nicotine dependence and self-perceived poor health had a higher probability of success of smoking cessation.The main contributing factors of smoking relapse were smoking time after getting up,self-perception of health status,and age.(2)Smoke-free laws had no significant effect on smoking for middle and older adults.Similarly,smoking regulations had no significant effect on the smoking cessation of middle and older people.In general,smoking ban policies in 8 cities from 2013 to 2018 did not significantly reduce their smoking and promote smoking cessation for the mid-aged and elderly.(3)The motivation of smoking cessation in middle-aged and old adults mainly included the change of health status,doctors‘ requirements,and the perception of health hazards.The main factors of relapse were social communication,peer effect,mental state and tobacco dependence.Meanwhile,the support rate of smoking control and the regulations on smoking control were low among the middle and older people.Conclusions: The annual smoking cessation rate of middle and older people was higher,but the relapse situation should be paid attention.The tobacco control policies did not affect the smoking and smoking cessation behavior of middle and older people.Middle and older adults had many factors in the process of smoking cessation.In addition,there was insufficient response to smoking control and smoke-free policies.Therefore,this study provided suggestions for the middle-aged and older people in control tobacco from the macro-intermediate-micro level,namely government-Community-individual level. |
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