The Smoking Behaviors And Associated Factors Among Young Male Adults With First-ever Stroke

Objective1. To evaluate the smoking behaviors of young male smokers with first-ever stroke before stroke and investigate the factors associated with consumption per day in smokers.2. To investigate the smoking behaviors of young male smokers with first-ever stroke after discharge; to evaluate the changes of smoking behaviors before and after stroke among young patients with first-ever stroke; to explore the reasons for quitting or continuing smoking after discharge and the vulnerable time to smoke again among smokers who succeeded in quitting smoking after discharge; to explore the factors associated with quitting smoking after discharge among young smokers with first-ever stroke.3. To provide the basic information for the effective intervention programs to the young male smokers after first-ever stroke.Methods1.209file cases were chosen randomly among the young smoking patients with first-ever stroke between February2010and February2012in Tianjin HuanHu Hospital. The information about smoking behaviors and epidemiological characteristics were used to analyze the patterns of smoking behaviors and the factors associated with consumption per day among young smokers with first-ever stroke.2. From March,2012to June,2013,157young smokers with first-ever stroke were recruited in this study in Tianjin HuanHu Hospital. The participants were assessed three times. First, a baseline assessment was conducted after patients gave consent to participate in the study on admission. Sociodemographic and medical details of the patients were obtained from medical records by the research nurse. Nicotine addiction and psychological problem were assessed by FTND scale and Anxiety and Depression scale. The discharge follow-ups were conducted to mainly assess smoking status and function status at three-month and six-month by telephone interviews. The association of the variables with quitting smoking was examined by Chi square test. A multivariable logistic regression analysis was performed to identify the factors leading to quitting smoking after discharge.Results1. The number of cigarettes per day was influenced by age. The proportion of heavy smokers was most among patients over40years old.2. The onset age and period of smoking were statistically different among patients of different age.3. The number of cigarettes per day was associated with age, educational level and occupation, and there were statistical significances.4.152and140patients respectively finished the3-month and6-month follow-up. There were no significant differences between patients of quitting smoking at3-month and6-month follow-up.The number of smokers continuing to smoke at different follow-ups were different, but significant differences were not found.5. In univariable analysis, quitting smokers were likely to be younger, non-manual workers, have less number of cigarettes per day, more confidences in quitting, and more home restriction in smoking; and the patients who were more depression on admission and with worse function status after discharge tended to quit smoking.6. By logistic regression analysis, Rankin score (OR=2.556,95%CI=2.466-23.153), confidence in quitting smoking (OR=2.475,95%CI=1.063-5.760), FTND score (OR=0.245,95%CI=0.100-0.601), occupation (OR=0.328,95%CI=0.139-0.770) retained as factors that contributed to quitting smoking among young smokers after first-ever stroke.ConclusionsPatients over40years’ old among the young smokers with stroke should be focused in the future intervention program. The stroke deeply motivates young patients to quit smoking after discharge; so the hospital time is perfect time for intervention of smoking cessation. The factors, occupation, confidence in quitting smoking, FTND score and Rankin score, which were associated with continuing smoking after discharge, should be assessed mainly prior to the pointed and consecutive interventions.