Predictive factors for smoking initiation and quitting among a cohort of Chilean women followed for 5.5 years

Abstract

Chilean women have one of the highest smoking prevalence in the world. Aim To estimate the main factors associated with smoking initiation and quitting among a cohort of adult women living in a low socioeconomic status area of Santiago, Chile. A random population-based sample of 1,100 women, 18 years and older, were selected from a community located in the South East area of Santiago. Sociodemographic, as well as smoking, beliefs, behaviors, stages of change and nicotine addiction level were recorded during a personal interview. After an average follow-up period of 5.5 years, women were re-evaluated. Seventy-three percent of women completed the study. At baseline, 39% of women were smokers. At the end of the study, there was an absolute smoking rate reduction of 7.1% (p <0.001). The main variables associated with smoking initiation were younger age (Odds ratio (OR): 1.08, 95% confidence intervals (CI): 1.05-1.12), higher education level (OR: 1.2, 95% CI: 1.07-1.35), and having fewer children (OR: 1.3 95% CI: 1.01-1.66). Factors related with quitting were younger age of onset (OR: 1.06 95% CI: 1.02-1.1), higher level of nicotine dependence (OR: 4.22, 95% CI: 1.74-10.27), and higher perception of smoking addiction (OR: 4.34, 95% CI: 2-9.09). Stage of change was associated with smoking cessation but its effect was diluted after adjusting for the level of nicotine addiction. Sociodemographic and family factors were the main variables related with initiation, whereas age of onset, belief of addiction, and nicotine dependence were the main factors related with cessation. Women with a high motivation for quitting should be evaluated for nicotine addiction level to define the best strategy for intervention.