Abstract
Despite a decrease in incidence, smoking remains the most serious public health problem worldwide. Identification of the factors contributing to changes in willingness to quit smoking may aid the development of strategies that encourage smoking cessation. Pooled cross-sectional data from 11,924 smokers from the Korean National Health and Nutrition Examination Survey II–V were analyzed. The stages of change in smoking cessation were categorized as pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological status, and smoking-related factors were compared between groups. The smokers were grouped as follows: 32.4% pre-contemplation, 54.4% contemplation, and 13.1% preparation. The proportion of smokers in the pre-contemplation group decreased (from 37.4% to 28.4%) from 2001 to 2012, while the proportion in the preparation group increased (from 6.4% to 18.1%). Compared with the preparation group, after adjusting for confounding factors, the pre-contemplation group was older [≥65 years-old; odds ratio (OR) = 1.40], more often single (OR = 1.38), less educated (elementary school or lower; OR = 1.93), less physically active in terms of walking (OR = 1.38) or performing strengthening exercises (OR = 1.61), smoked more heavily (≥20 cigarettes per day; OR = 4.75), and had a lower prevalence of chronic disease (OR = 0.76). Moreover, smokers who had never received education on smoking cessation were less willing to quit than those who had (OR = 0.44). In Korean smokers, the stages of change for smoking cessation were associated with age, education, marital status, chronic diseases, physical activity, and participation in smoking cessation programs.
Highlights
Smoking is the leading cause of a number of preventable diseases such as chronic obstructive pulmonary disease, cardio-cerebrovascular disease, and malignancy
In the United States, estimates show that tobacco contributes to approximately 480,000 premature deaths and costing approximately 289 billion dollars annually owing to direct healthcare expenditure and loss of productivity [1, 2]
The Transtheoretical Model (TTM) proposed by DiClemente et al and Prochaska et al allows the examination of behavior associated with willingness to quit smoking with a view to developing stage-matched interventions in the United States [3,4,5]
Summary
Smoking is the leading cause of a number of preventable diseases such as chronic obstructive pulmonary disease, cardio-cerebrovascular disease, and malignancy. Despite declines in the prevalence of current smoking, the annual burden of smoking-attributable mortality in the United States has remained above 400,000 for more than a decade and currently is estimated to be about 480,000 with millions more living with smoking-related diseases [2]. Due to the slow decline in the prevalence of current smoking, the annual burden of smoking-attributable mortality can be expected to remain at high levels for decades into the future, with 5.6 million youth currently 0 to 17 years of age projected to die prematurely from a smoking-related illness [2]. Several health behaviors that have been applied by the TTM include smoking cessation, exercise adoption, dietary fat reduction, mammography compliance, and reduced sun exposure and alcohol consumption [6,7,8,9,10,11]
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