INTRODUCTION Psychological, physiological and social factors play an important role in the initiation, persistence, dependence and relapse of smoking behaviors, and coping style and smoking abstinence self-efficacy can all affect nicotine dependence. METHODS A cross-sectional sample of 568 quitters from 19 communities in Beijing in 2019 was surveyed. Demographic information and psychological characteristics of smokers were collected by an interview questionnaire, and psychological traits scales including the Smoking Abstinence Self-Efficacy (SASE) and the Trait Coping Style Questionnaire (TCSQ). We compared differences in psychological traits across demographic information and explored the relationship between nicotine dependence and coping styles and self-efficacy in refusing to smoke. RESULTS Significant differences were identified in self-efficacy in refusing to smoke and across dimensions among quitters by gender, job type, education level, and monthly income level (all p<0.05). Males had lower self-efficacy in the habitual/ addictive context than females; retirees had better overall self-efficacy and selfefficacy in the negative/emotional context than business service workers and professionals; and high-educated, high-income quitters had lower self-efficacy in the negative/emotional context. There are significant differences in positive coping styles among quitters of different ages, levels of education, and types of work (all p<0.05). The results further showed that the underage population, highly educated population, and practitioners other than those in retirement, are less likely to use positive coping styles. Interventional effects analysis showed that a higher sense of self-efficacy in addictive contexts can counteract some of the negative coping styles that induce smoking. CONCLUSIONS Self-efficacy played an indirect mediating role between negative coping style and nicotine dependence; individuals who used more negative coping styles were more likely to engage in smoking and therefore were more nicotine dependent. Hence, it is necessary to reduce the use of negative coping strategies and improve the self-efficacy of smoking abstinence in the face of addiction.
Objective To understand the reasons for failure of smoking cessation among community smokers in Beijing, and analyze the influencing factors of the reasons for failure to quit, in order to provide a reference for providing smoking cessation guidance services. Method Based on a cross-sectional study, a one-to-one questionnaire was used. The survey included basic demographic information, tobacco use, and past attempts to quit. And descriptive analysis was used to analyze the distribution of the reasons for the failure of smoking cessation. c2 test or Fisher's exact probability method were used to analyze the causes of smoking cessation failure, demographic indicators, tobacco use and other factors. Correspondence analysis was used to further explore the relationship between each factor and the reasons for smoking cessation failure. Result A total of 442 smokers who had tried to quit smoking were investigated. The top three reasons for failure to quit were difficulty in controlling addiction, insufficient self-willingness (54.3%), the effects of other smokers(35.3%), and lack of smoke-free support environment(26.0%). There were statistically significant differences in the distribution of the reasons for failure of smoking cessation among different ages, occupations, and discomforts during smoking cessation(All P<0.05). Correspondence analysis results show that the reasons for failure of smoking cessation among smokers aged 19-30 are mainly work or study stress. There are differences in the reasons why smokers in different occupations fail to quit smoking; The influence of other smokers and the lack of a smoke-free support environment are closely related to the desire to quit during the process of quitting. Conclusion Work or study pressure, the influence of other smokers and the lack of smoke-free support environment are the main reasons for the failure of smoking cessation attempts. Therefore, it is suggested to strengthen education in different occupational places and implement personalized smoking cessation education. It is recommended to provide tips on coping with smoking cessation and alleviating peer pressure in social situations, as well as help for stress coping and negative emotion relief in smoking cessation guidance. At the same time, it is essential to strengthen the shaping of a smoke-free support environment.
BackgroundThe prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown.MethodsWe conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model.ResultsA total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention.ConclusionCI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.
Objective: This study aimed to understand the perception of patient safety and the reporting system in public in China, and make further recommendations for the optimization of the reporting system of patient safety. Methods:The following data were collected through an online questionnaire from medical staffs and patients: recognition of patient safety, comments on patient participation, comments on spontaneous reports, attitudes toward the principles of spontaneous reports, and willingness to participate. This information was presented with frequency and percentage with 95% confidence intervals (CIs). Spearman rank correlation was used to evaluate the association of those data.Results: A total of 27,493 valid questionnaires were collected in this study. The participants who knew patient safety very well, regarded patients as an essential part to enhance patient safety, viewed spontaneous reports helpful, agreed on the 3 principles of voluntariness, anonymity, and nonpunishment of the reporter, and were willing to participate in reporting were accounted for 39.
Background: To understand the situation about quarantine of smoking cessation participants in Beijing communities during the period of COVID-19, and to explore this pandemic’s impacts on people’s smoking behaviours, relapse thoughts, and willingness to quit smoking among quitters, to provide information and guidance on quit smoking during the normalised period of epidemic prevention and control. Methods: Before the coronavirus outbreak, one-to-one interviews were used, and during the epidemic period, one-to-one question-and-answer telephone surveys were used. The contents of the survey included the hours of staying at home, psychological and emotional state, tobacco use, and willingness to quit smoking. This study adopted a 1:1 propensity score matching method, with education level, whether to take smoking cessation drugs, and whether to participate in regular follow-ups as matching conditions to control the mixed influence of the content of smoking cessation intervention services on the analysis results before the pandemic. After matching, the chi-square statistics, Fisher exact probability method, and the Spearman rank correlation test were used to analyse factors such as changes in smoking behaviour, hours of staying at home, and mental states.Results: A total of 197 pairs were successfully matched, of which 197 cases had successfully quit smoking before the epidemic, and 197 cases had not completely quit smoking. The changes in smoking volume before and during the epidemic of the incomplete quitters were affected by anxiety, calmness, mental and emotional states similar to usual, other reasons for smoking such as addiction and habits, and their willingness to quit during the epidemic (all P<0.05). The changes in daily smoking volume before and after the epidemic among the ex-smokers were statistically significant in the distribution of relapse thoughts, anxiety, depression, and other reasons for smoking, such as depression and boredom, idle pastimes, addiction and habits(P<0.05). Among the people who did not completely quit smoking before the epidemic, the idea of relapse was affected by depression, calm mental and emotional state, reasons for smoking that relieve boredom and leisure, and the willingness to quit smoking during the epidemic (P<0.05). And there is a negative correlation between the willingness to quit smoking during the epidemic and the time at home each day(rs =-0.237, P<0.05).Conclusions: During the COVID-19, the time at home of the test patients who quit smoking has a certain influence on their willingness to quit smoking. The psychological and emotional changes and idleness at home have a greater impact on the changes in their smoking behaviour and relapse thoughts. It is recommended that family members provide more support and encourage and supervise to help smokers reduce smoking. In the period of normalization of epidemic prevention and control, the smoking cessation services provided should guide the quitters on smoking cessation behavioural therapy, as well as guidance on the relief of negative emotions, and help quitters to break the relationship between existing smoking habits, negative emotions, and environmental temptation situations.Trial registration: The study was registered on the official website of the Chinese Clinical Trial Registry on August 6, 2019, with the registration number ChiCTR1900024991.
Background: To understand the quit smoking status of people trying to quit smoking in Beijing communities during the epidemic of COVID-19 period, analyze their changes in smoking behavior, relapse thought, nicotine dependence, willingness to quit smoking compared with before the epidemic, and correlation with home stay time, change in psychological mood and smoking status during independent home quarantine so as to provide reference for tobacco control and optimization of quitting smoking guidance service during normalization of epidemic prevention and control. Methods: To interview 388 people who are trying to quit smoking and involved in quitting smoking intervention service by one-to-one face interview before outbreak and one-to-one telephone survey during the epidemic period. The survey covers daily home stay time, psychological mood, tobacco use, nicotine dependence, and willingness to quit smoking. Adopt 1:2 propensity score matching, and take whether to consume quit smoking drugs and whether to participate in regular follow-ups as the matching conditions to control confounder. After matching, the c2 test, t test, and rank sum test were used to compare correlative factors such as smoking behavior change, relapse thought, nicotine dependence, and change in willingness to quit smoking between people who have quit and those who have not quit. Results: A total of 348 cases were successfully matched, including 137 who have quit smoking and 211 who have not quit smoking. The difference in two groups of baseline data after matching was no statistically significant (P>0.05). During the epidemic period, the quit smoking rate (39.9%) was higher than that (25.0%) before the outbreak. The average daily smoking (7.10±8.473) was lower than that (7.77±8.405) before the outbreak. The score of Fagerstrom Test of Nicotine Dependence (1.91±2.449) was lower than that (4.35±2.518) before the outbreak; the score of the assessment scale of willingness to quit smoking (38.17±12.377) was higher than that (19.78±9.103) before the outbreak; the smoking change of non-smokers before and after outbreak was related to distress, calm psychological mood, relief of sorrow and boredom, smoking addiction and habit (P<0.05); nicotine dependence was related to the psychological mood of distress (P<0.05), and the willingness to quit smoking was related to the daily home stay time (P<0.05); For those who had quit smoking successfully, the smoking change was related to the psychological mood of distress, relief of sorrow and boredom, alleviation of stress, smoking addiction and habit (P<0.05); relapse thought was related to the psychological mood of distress, relief of sorrow and boredom, recreation and alleviation of stress (P<0.05); nicotine dependence was related to the daily home stay time, calm psychological mood and smoking addition (P<0.05), and the willingness to quit smoking related to recreation and smoking addition(P<0.05). Conclusions: During the epidemic period, people who tried to quit smoking reduced their smoking, nicotine dependence, and their willingness to quit smoking increased. During normalization of epidemic prevention and control, social activities decrease and home stay time increased, which created favorable conditions for quitting smoking and tobacco control. However, negative emotions during home stay, relief of sorrow and boredom and smoking addition may restore smoking behavior and relapse thought. It is recommended that family members provide more support and encouragement to smoke quitters, and supervise and help them reduce smoking. During normalization of epidemic prevention and control, the quit smoking service center should alleviate negative emotion of quitters and break connection between existing smoking habit and negative emotion and environmental temptation.
Background:The reason for smoking causes people to smoke in their daily life. It is the main factor hindering the success of quitting smoking. This study analyzed the differences and characteristics of tobacco dependence patients with different smoking causes in their past smoking cessation behaviors, to understand the relationship between smoking cessation behaviors and smoking causes, and provide a reference for the innovation of the tobacco dependence management model.Methods:Based on a cross-sectional epidemiological study, a total of tobacco dependence patients over 18 years old to quit smoking were recruited from various communities in Beijing. The survey included basic demographic information, tobacco use, attempts to quit, reasons for smoking, etc. Analysis of variance and dichotomous Logistic Regression was used to investigate the relationship between smoking causes and smoking cessation behaviors and their duration.Results:A total of 673 participants were recruited, including 611 males (90.8%), 428 smokers (63.6%) and 245 males (36.4%) who tried to quit smoking. ANOVA was used to find that the attempts to quit smoking were statistically correlated with scores of sedation, stimulation, smoking addiction, and automatism (all p<0.05). Sedation (OR=1.111, 95%CI: 1.011-1.220), smoking addiction, (OR=1.152, 95%CI: 1.034-1.282) and automatism (OR=1.119, 95%CI: 1.000~1.251) were found statistically related the attempts to quit smoking by the Logistic regression model. The mean scores of hand and mouth activity, hedonic sedation, stimulation, smoking addiction, and auxiliary factors were statistically significant in different smoking cessation duration groups (all p<0.05), and sedative factors were negatively related factors for smoking cessation duration (OR=0.911, 95%CI: 0.827-1.002).Conclusion:Most residents try to quit smoking only when they are heavily physiologically dependent or even physically unwell. The success or failure of smoking cessation is closely related to social psychology and physical dependence. Most smokers only try to quit by their own will without professional help. Lack of a supportive environment and other people's understanding is a major cause of smoking cessation failure. Creating a smoke-free supportive environment should be an important part of community tobacco control and smoking cessation efforts.Fund program: Supported by the Foundation of National Key R&D Program of China (2017YFC1309400)
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