Predictors Of Quitting Attempt Among Adult Smokers In The Urban Areas Of Shanghai

Background:Tobacco use has long been recognized as one of the most serious health problems. At present, there are1.1billion smokers in the world. The number of people died from diseases related to tobacco use has reached6million within which5.4million were smokers and0.6million were non-smokers exposed to environmental tobacco smoke. China is the world’s largest tobacco producer and consumer. There were350million adult smokers in the year2007. Meanwhile, about738million non-smokers were exposed to environmental tobacco smoke. The number of people died from diseases related to tobacco use was over1million. The smoking rate and passive smoking rate of Shanghai adult people was28.6%and26.5%in the year2010.Many researches have confirmed that tobacco use is one of the world’s eight leading causes of death and is also the most preventable one. Therefore, quit smoking is the most effective way to reduce the smoking-related deaths. However, smoking is a complex process of drug abuse. In China,38.8%of the smokers have the intention to quit, but only10.7%quit successfully. In Shanghai, the quit successfully rate is only12.9%. Meanwhile, offering cessation service in present China is not feasible for the expense needed is too high to afford.A professor in the University of California outlined a theory on "quit attempt". He highlighted a conceptual model for population-based cessation and cited data from the U.S. to demonstrate that a smoker could quit successfully after about14trials of quit attempts. Thus, it is more important to increase the number of smokers making quit attempts than to provide help to every smoker who is trying to quit.Since1990s, Shanghai has paid more attention on tobacco control, but few references have reported the prevalence of quit attempt rate among Shanghai adult smokers. The outcomes of this study can serve as specific evidences for the Government to set policies in the future.Objective:To identify the quit attempt rate of adult smokers in Shanghai urban areas, and to explore the predictors of making an attempt to quit among the smokers.Methods:Data from wave3(2009) of the International Tobacco Control (ITC) Policy Evaluation Project Shanghai Survey, a face-to-face survey of adult Shanghai smokers in urban areas, were analyzed.800adult smokers (aged18years and older) were sampled using a stratified multistage design. Questionnaires were used to collect information.Results:800valid individual questionnaires were collected and finally, data were obtained from737respondents. Out of737respondents, there were720male respondents and17female respondents. The quit attempt rate was13.0%(12.5%among males and31.0%among females). According to the result of single-variate analysis, the following aspects were hypothesized to be associated with making a quit attempt:(1) gender,(2) age,(3) nicotine dependence,(4) awareness of health effects of smoking,(5) overall attitude toward smoking,(6) having heard of cessation medications,(7) intention to quit (in next30days, in next6months, beyond6months, not planning to quit),(8) agreement on benefit from quitting,(9) smoking ban at home,(10) number of5closest friends who quit successfully during the last12months (P<0.05). To eliminate the interactions among these variables, multivariate logistic regression model was applied to examine the association between outcome and all predictor variables. The result showed that five variables entered the model such as age, confidence in successful quit in the next6months, intention to quit, smoking ban at home, number of5closest friends who quit successfully. Quit attempt was predicted to be more likely among smokers who (1) were at a relatively young age,(2) planned to quit in the next30days,(3) could not smoke in any indoor areas at home, and (4) reported that more than one out of five closest friends or acquaintances had quitted smoking.Conclusion:The quit attempt rate of Shanghai urban adult smokers was relatively low. The study figured out predictors that were hypothesized to be associated with quit attempts among smokers. Interventions on urging smokers to make quit attempts could be designed according to these predictors. Thus, pertinent exploration on interventions could be carried out to improve the quit attempt rate among smokers and make further efforts on improving the overall smoking cessation rate.