The Study On The Addiction Of Smoking Behavior In Urban Residents

BackgroundNowadays,the total number of smokers all over the world has reached more than 1.1 billion,82%of which live in the medium or low income countries.China is the biggest tobacco production and consumption country,the number of smokers in China is about 0.35 billion,more than any other countries,and the young smokers' proportion is rising.Smoking behavior has great relation with people's health,world health report of the year 2002 pointed out that among the first ten dangerous factors that influence human health,smoking standed in the fourth position.Every year, about 5.4 million people die from the lung,heart,or other diseases which are induced by smoking,that means ten deaths in the world,there is one making by smoking.By the year 2030,the deaths of smoking may rise to 8 million per year,about one-sixth adult deaths.The smoke behavior not only harms the health of smokers but also unconsciously harms the health of the people around,smoking has been the most harmful factor of the Public health in the country.Unfortunatly,though smoking has been proved the biggest threaten to human health,the consumption of tobacco all over the world is still rising,smoking is popular in many countries.The motivation for smoking mostly owe to the addiction of Nicotine,burning tobacco may release over 4000 compounds,a big part of which is harmful for people's health.Nicotine is the representative compound.Nicotine may addict smokers.Once the smoker is addiction,he need to smoke every 30 to 40 min to maintain the nicotine level in his cerebra,when the nicotine level falls,he would feel worried,uncomfortable,headache,and eager to smoke,all these feeling and behavior have no different with opium.For nicotine's leading effection,the hypostasis of tobacco addiction is the addiction on nicotine.We may regard tobacco addiction as a complex diease that influence by biologic, genetic,behavior,mental and other factors.So it is meaningful to explore the factors that influence tobacco addiction from the mental and behavior angle.ObjectivesLiterature research,combining with the behavior and mental theory to make sure our research link.We can get the smoking rate after conducting survey,the smokers should be our research objective.Our research used the Fagerstrom Test for Nicotine Dependence(FTND)to judge addiction.First,we should test the reliability and validity of the FTND,then compare it to the Heavy Smoking Index(HSI).Choose several factors including the samples' demographic data,smoking behavior,smoking cessation behavior and so on,try to explore the factors which influence the addiction, the influencing extent and the influencing ways.Methods1.Literature research.We reviewed the literature on smoking behavior,addiction, FTND and so on,combining with the behavior and mental theory to make primary supposion.2.Practical research.1)The samples were chosen from urban residents living in the cities of Hangzhou, Nanjing,Guangzhou and Yinchuang.The smokers would be chosen to our farther research.2)Sampling methords.We used multi-stage sampling.Based on the community of each cities,we randomly chose several communities,then chosen a seris of families from these communities,the targets should include a person who is old then 15 in these chosen families.Our total samples were about 3600,in which the smokers should be about 900 to 1200,and it is enough for our research.3)The questionnaire includes the samples' demographic data,basic smoking situation,FTND,smoking cessation behavior and so on.4)Survey was conducted between February and march in 2008,and used uniform questionnaire established by our research group.Data were obtained randomly via family interview by the professional inquirers.5)Data analysis.Cronbach's alpha parameter and factor analysis were used to test the reliability and validity of the FTND;Descriptive statistal methords were used to analisis the samples' demographic data,seals of smoking rates,the addiction rates and so on;Chi-square test was used to explore the relationship between the demographic data,smoking behavior,smoking cessation behavior and the addiction;Logistic regression model was used to conduct muti-factors analysis between the demographic data,smoking behavior,smoking cessation intention and the addiction.Results:Under our inquirers' strict control,3600 questionnaires were sent,and 3582 returned(response rate 99.5%),of which 3571 questionnaires were proven valid, valid rate is 99.7%.1.The whole number of smokers is 1196,smoking rate is 33.5%,daily smoking rate is 24.3%and occasional smoking rate is 9.2%.Our study of addiction focus on the smokers,so our study samples are 1196,according to previous studies and experience,the number is enough.The male smoking rate is 52.9%,daily smoking rate is 39.2%,occasional smoking rate is 13.8%.The female smoking rate is 7.1%, daily smoking rate is 4.1%,occasional smoking rate is 3.0%.2.Test the FTND,the Cronbach alpha of whole sample is 0.704,relative kappa between each index and the whole score distribute among 0.461 to 0.819,the Cronbach alpha of male sample is 0.707 and female sample is 0.700.We also get the result that HSI with a cutting score≥4 is higher in sensitivity,specificity and ROC area,and it is more suitable for our test demand.The relative kappa between HSI and FIND is 0.721.3.Among the 1196 smokers,the number of people who got smoking addiction is 268,addiction rate is 22.4%,male addiction rate is 22.7%and female addiction rate is 19.6%. 4.Results from reason analysis for demographic data.Nationality affects the smoking addiction.5.Results from reason analysis for smoking behavior.Number of cigarettes per day,age of first start smoking,years of smoking,the price of tobacco,frequency of smoking affects the smoking addiction.6.Results from reason analysis for smoking cessation intention.Consider to take smoking cessation intention affects the smoking addiction.Conclusion:Compare with previous studies and base on our research we drew several conclusions:1.First,we get the smoking rate,daily smoking rate and occasional smoking rate.2.Test the FTND,and compare it with the HSI.The Chinese version of FIND shows good sensitivity and specificity in whole sample,male sample and female sample.When using the HSI as test tool,it is more suitable to take HSI with a cutting score≥4 to distinguish addiction,and it also shows good sensitivity and specificity.The test result of HSI is consistent to that of the FTND.3.Results from reason analysis for demographic data shows that nationality is a influential factor, minority people are more dangerous than Han people in smoking behavior,that means we should pay more attention to the health of minority people.4.Results from reason analysis for smoking behavior.Number of cigarettes per day,years of smoking and frequency of smoking are positive factors of addiction.Age of first start smoking and the price of tobacco are negative factors of addiction.5.Results from reason analysis for smoking cessation behavior.Consider to take smoking cessation behavior affects the smoking addiction.People who never consider to take smoking cessation behavior shows more dangerous than people who taking smoking cessation behavior in addiction.In other words,for people who addictive it is more difficult to get success in smoking cessation.