Sociodemographic, health-related, and external determinants of quit attempts among adult tobacco users: A cross-sectional study using a nationally representative sample in Oman

INTRODUCTIONThe aim of this study was to determine trends in receiving quit advice from healthcare professionals among current smokers in South Africa, pre- and post-adoption of Article 14 guidelines of the WHO FCTC in 2010, and to determine the association between quit advice, e-cigarette use and quit attempt.METHODSThis study was a secondary data analysis involving 2206 ever-smokers aged ≥16 years who participated in the South African Social Attitude Surveys conducted in 2007, 2010 and 2017. Data included participants’ sociodemographics, tobacco, and/or e-cigarette use (for years 2010 and 2017 only), exposure to others’ smoking at home and/or work or public places, quit advice, and quit attempts. Analyses included chi-squared test and logistic regression.RESULTSThe mean cigarettes smoked per day, the proportions of smokers offered quit advice, planning to quit and who made a quit attempt did not change significantly between 2007 and 2017 (p=0.67, p=0.70, p=0.09 and p=0.40, respectively). However, there was a marginally significant increase in e-cigarette uptake between 2010 and 2017 (p=0.05). In a bivariate analysis, quit advice was significantly associated with making a quit attempt across all survey years. In the final multivariable-adjusted regression model, having received a quit advice (OR=1.967; 95% CI: 1.255–3.083) compared to not, and being Colored/mixed race (OR=0.467; 95% CI: 0.298–0.732) compared to self-identifying as Black African, remained independently associated with making a quit attempt.CONCLUSIONSExcept for marginally increased e-cigarette use, there was no significant change in smoking or quitting behavior in South Africa post-adoption of Article 14 guidelines. The study findings highlight the importance of quit advice in promoting quitting behavior and suggest the need to scale it up in South Africa.

Given the increasing number of older adults in South Korea, it is critical to understand their attitudes toward end-of-life (EOL) care. This study examined the prevalence and factors associated with the willingness to receive hospice care and complete advance directives among 2026 middle-aged adults in South Korea. On the basis of Andersen's behavioral model and previous research, predisposing factors (age, sex, education, and religion), enabling factors (income), need factors (perceived health and depressive symptoms), and death-related factors (death of family members or friends and knowledge about EOL care planning) were included as predictors. The results showed that being older and having a higher educational level, a higher monthly income, and better knowledge of EOL care planning were associated with the willingness to use hospice services. On the other hand, a higher educational level, a higher monthly income, better knowledge of EOL care planning, and the death of a family or friend in the past year were associated with the willingness to complete advance directives. Implications for practice, policy, and research to better serve the needs related to EOL care among middle-aged adults in South Korea were discussed.

BackgroundLeft ventricular hypertrophy (LVH) is one of the risk factors for cardiovascular (CV) disease and mortality. However, the relationship between socioeconomic status (SES) and LVH in chronic kidney disease remains unclear.MethodsData were collected from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD, NCT01630486 at http://www.clinicaltrials.gov). Subjects with CKD and aged ≥50 were included. SES was characterized based on monthly income and educational attainment, each of which was divided into three strata. LVH was defined as LV mass/height2.7 ≥ 47 g/m2.7 in female and ≥ 50 g/m2.7 in male. Age, sex, diabetes, CKD stage, body mass index, blood pressure and physical activity were included as covariates.ResultsA total of 1361 patients were included. Mean age was 60.9 ± 6.9 years, and 63.2% were men. Higher education level was associated with higher monthly income (P for trend < 0.001). The lowest education level was independently associated with LVH (lower than high school, adjusted odds ratio [OR] 1.485, 95% CI 1.069–2.063, P = 0.018; completed high school, adjusted OR 1.150, 95% confidence interval [CI] 0.834–1.584, P = 0.394; highest education level as the reference). Monthly income level was marginally associated with LVH after adjusting for covariates ($1500-4500, adjusted OR 1.230, 95% CI 0.866–1.748, P = 0.247; < $1500, adjusted OR 1.471, 95% CI 1.002–2.158, P = 0.049; > $4500; reference).ConclusionsIn the CKD population, lower SES, defined by educational attainment and low income level exhibited a significant association with LVH, respectively. Longitudinal follow-up will reveal whether lower SES is associated with poor CKD outcomes.

Sexual minority (SM) tobacco users are less likely to successfully quit than heterosexuals, yet little evidence describes cessation behaviors in this population over time. Our study investigated quit motivations, attempts, and methods in a longitudinal cohort of adult tobacco users by sexual orientation. Participants (N = 1177) completed interviews every 6 months through 48 months and reported quit attempts (24-hour tobacco free), successful quits (7-day point prevalence abstinence), motivations, and methods. Chi-squared and Fisher's exact tests assessed differences by heterosexual and SM orientation, gender, and quit outcome (attempt-only vs. successful quit). Quit rates were similar for heterosexual and SM adults. Over half attempted to quit at least once over 48 months, but few remained abstinent (SM: 16.9%; heterosexual: 12.1%). Most used nicotine replacement therapy (SM: 31.9%; heterosexual: 26.1%) or tobacco product substitution (SM: 27.7%; heterosexual: 21.2%). Few used quitlines (SM: 4.3%; heterosexual: 1.3%) or Internet-based programs (SM: 6.4%; heterosexual: 1.3%). Quit motivations included health concerns, family, and physical fitness. Participants reporting a successful quit were more likely to report a household member quit smoking than 24-hour quit attempters. Among participants reporting a successful quit, more SM than heterosexual participants reported that a coworker quit smoking (55.6% vs. 33.1%, p = .009). We found few differences between heterosexual and SM tobacco users in our sample. Many repeatedly attempt to quit, yet few used evidence-based methods. Leveraging online quit programs, health messages, and family members in tailored cessation interventions may help SM and heterosexual tobacco users successfully quit. SM and heterosexual tobacco users evidenced few differences in quit behaviors. Over 4 years, a majority attempted to quit, with over a third making repeated quit attempts. Nicotine replacement therapy and tobacco product substitution were mostly used during quit attempts; however, more SM than heterosexual men reported using web-based quit programs. Personal health and family concerns were universal motivations to quit, yet SM women also cited physical fitness as a primary motivation. Tobacco users reporting that a household member stopped smoking were more likely to successfully quit. More SM than heterosexual men reported that a coworker quit smoking.

Correlates of tobacco quit attempts and missed opportunity for tobacco cessation among the adult population in India

Objective: To evaluate the characteristics of men who support their partners in getting the HPV vaccine. Material And Methods: All married women (&lt; 26 years) who were admitted to the gynecology outpatient clinic and their husbands were evaluated for participation in the study. Patients’ and all characteristics of male partners were recorded. All male participants answered a survey form including ten statements about HPV and HPV vaccination. Male participants were divided into two groups according to their support or lack of support for HPV vaccination of their wife. Results: In total, 92 men supported HPV vaccination for their partners and 144 men opposed HPV vaccination (support rate: 39%). The mean marriage age, education status and monthly income were significantly higher in favor of men who support HPV vaccination for their wives. The rate of those who stated they were religious was significantly higher in the anti-vaccine group. Safety concerns about vaccine (27.8%), cost of vaccine (26.4%) and belief about HPV vaccine effectiveness (26.4%) were most common reasons for opposing HPV vaccination. Multivariate regression analysis revealed marriage age ≥25 years, education level of high school and university, higher monthly income and not self-identification as religious increased the HPV vaccine support rate. Conclusion: The present study found that men with higher marriage age, higher educational level, higher monthly income, and higher score on the HPV survey were significantly more supportive of their spouses getting the HPV vaccination. In contrast, men who identified themselves as religious had significantly less support for their wife being vaccinated. Keywords: vaccine, immunity, genital wart, human papilloma virus, cervical cancer

BackgroundThe prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip.MethodsA cross-sectional study was conducted to recruit a total of 357 mothers aged 18–50 years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity.ResultsThe combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged > 33.0 years (OR = 2.7, 95% CI: (1.06,6.86)), and (OR = 5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged < 33.0 years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR = 0.31, 95% CI: (0.15,0.64)), and (OR = 0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR = 2.64, 95% CI: (1.20, 5.83)), and (OR = 3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR = 1.20, 95% CI: (1.03,1.38)).ConclusionsThis study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.

COVID-19 and tobacco cessation: lessons from India

Objective:India has the highest number of smokeless tobacco (SLT) products available in different forms, consumed in various ways. The current study aimed to understand the pattern of daily SLT use according to different product categories and whether Quit intention and Quit attempts vary by SLT type and exposure to media messages. Methods:Data from Global Adult Tobacco Surveys (GATS), 2016-17, was used to find access to media messages and warning labels by SLT type. Quit attempt and Quit intention were calculated for each of the SLT types. Logistic regression analyses were employed to identify whether access to media messages, warning labels influenced, quit intention and attempts vary by SLT type. Results:Khaini or tobacco lime mixture was the most common SLT type consumed by 37% of SLT users, whereas SLT users consuming more than one product accounted for 23% of SLT users. Exposure to media messages and warning labels was high among Gutkha/ paan masala tobacco users (74.7% and 81.2%) and low among oral tobacco (Mishri, Gul, Gudakhu) users (56.1% and 60.0%). Quit attempts and quit intention were high among Gutkha/ paan masala tobacco users (38.3% and 22.3%) and low among oral tobacco (Mishri, Gul, Gudakhu) users (25.3% and 13.6%). Users of Oral tobacco and khaini or tobacco-lime mixture were significantly less likely to attempt quitting (AOR 0.806(95%CI: 0.676-0.962), 0.839(95%CI: 0.736-0.956), and have quit intention (AOR 0.681(95%CI: 0.702-0.976), 0.733(95%CI: 0.627-0.857) compared to Gutkha/ paan masala with tobacco users. Conclusion:The reach of media messages and warning labels varies by SLT type. Quit intention and attempts vary by SLT type and access to media messages and warning labels. There is a need to re-strategise the tobacco control Information, Education and Communication (IEC) to reach out with effective messaging to the most unreached.

Background:In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018.Methods:A cross-sectional study was conducted at Sigatoka Sub-divisional Hospital (SSH) in Fiji in July-August, 2018 using a self-structured questionnaire to test KAP of 225 patients. The inclusion criteria were confirmed T2DM patients (Fijian citizens) with CKD, aged 30 years or above and attending Special Out-Patient's Department (SOPD) at SSH. Independent t-test and ANOVA was used to test differences between demographic variable and practice score while non-parametric tests were used for knowledge and attitude. Spearman correlation and multiple linear regressions were also done. All the tests were set at 5% level of significance.Results:The mean KAP level was high: knowledge, 23.3 (SD±3.25); attitude, 23.1 (SD±2.73) and practice, 7.1 (SD±2.04). A high level of knowledge was seen in those with university-level education (p&lt;0.001), unemployed (p=0.05) and high average monthly income (p=0.03). Those aged 61-70 years had a 0.53-point lower attitude score (p=0.05) than other age categories, while those &gt;70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Fijians of Indian descent (FID) had lower attitude (p=0.002) and higher practice (p=0.001) scores.Conclusion:Patients with both T2DM and CKD at SSH have high levels of KAP. Those with higher levels of education, the unemployed and those with high monthly income had higher knowledge, FID had low attitude but high practice scores, and the higher age category had lower attitude scores. The study identified high-risk groups for low KAP, which can become the focus of future public health intervention.

Objectives: To explore the quality of life (QOL) status and related factors in young human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) aged 16 to 24 years in Zhejiang province. Methods: A cross-sectional study was conducted in 22 counties of Zhejiang province, and 395 subjects took part in our research. A t-test, one-way Analysis of variance (ANOVA), and multivariate stepwise linear regression analysis were used to investigate the factors associated with QOL in young HIV-infected MSM. Results: The total score on the QOL was 86.86 ± 14.01. The multivariate stepwise linear regression analysis revealed that self-efficacy and discrimination were associated with all domains on the QOL assessment, monthly income was associated with QOL for all domains except spirituality and consistent condom use during oral sex with men in the past three months was associated with QOL for all domains except the relationship domain. Those individuals within the group of young HIV-infected MSM who have higher self-efficacy, a higher monthly income, greater social support, safer sexual behaviors, a higher level of education, and a higher cluster of differentiation 4 (CD4) count have a better QOL. Conclusions: These findings suggest that to improve the QOL of this population, greater emphasis should be placed on improving social support, self-efficacy, and antiviral therapy adherence and on reducing discrimination, disease progression, and high-risk behaviors.

Background/Objectives: Weight loss and its subsequent regain pose significant challenges for those dealing with overweight and obesity. This study explores weight loss strategies among adults in Saudi Arabia and evaluates factors linked to weight regain. Methods: This cross-sectional study focused on adults residing in Jazan, located in southwest Saudi Arabia. Data collection was conducted using a self-administered questionnaire that assessed participants’ demographics, medical history, perceptions of body weight, weight loss methods, and the incidence of weight regain. Logistic regression was used to determine whether there were statistically significant differences related to the occurrence of weight regain. Results: A total of 368 participants reported efforts to lose weight over the past 3 years. The average age of these participants was 32.7 years (standard deviation: 11.3), and the gender distribution was almost equal. The majority of the sample (65%) voiced dissatisfaction with their body weight. Some participants employed a combination of weight loss methods, with exercise, reduced food intake, and intermittent fasting being the most frequently mentioned. The findings also indicate that a minority sought professional help, whether from a physician or a nutritionist. Over 90% claimed to have successfully lost weight at least once during their attempts, but more than half (139 individuals) experienced weight regain following their weight loss efforts. Within the univariate logistic regression, higher odds ratios of weight regain were detected among men, older participants, those living in rural areas, individuals with higher levels of education, employed persons or business owners, those with higher monthly incomes, smokers, khat chewers, and those diagnosed with a chronic condition (p values < 0.05). However, the multivariate logistic regression revealed that only residence, monthly income, smoking status, and being diagnosed with a chronic disease remained statistically significant as predictors of weight regain after adjusting for other variables (p values < 0.05). Conclusions: These findings highlight the significance of incorporating weight regain prevention into body weight management for individuals dealing with overweight and obesity. Further research is needed to evaluate specific dietary, physical activity, and psychological factors that may increase the risk of weight regain in certain participants.

BackgroundAdherence to COVID-19 prevention and control measures is related to people’s knowledge, attitudes and practices.SettingIn Thabo Mofutsanyana District, the proportion of reported community COVID-19-related deaths was higher than in-facility reported deaths.AimTo assess knowledge, attitudes and practices of the community towards COVID-19.MethodsA survey was conducted among consenting adults from 28 February 2022 to 4 March 2022. An interviewer-administered questionnaire was used for data collection. Descriptive statistics was used to describe the responses and logistic regression used to assess factors associated with poor knowledge towards COVID-19.ResultsA total of 551 participants’ data were analysed, most of whom were < 40 years (63%) and female (68%). Despite 43.4% having education levels below high school, 89% knew that anyone could contract COVID-19, mainly through television and/or radio (74%) and social media (53%). The majority practiced mask-wearing (84%) and social distancing (80%), while 65% indicated they will use home remedies if there was severe COVID-19 infection. Older age group (OR = 2.40; 95% CI 1.17-4.89; p = 0.015), higher education level (OR = 0.59; 95% CI 0.39–0.87; p = 0.009) and higher monthly income were each associated with poor knowledge towards COVID-19 but the significance did not remain in multivariate model.ConclusionParticipants had good knowledge of COVID-19; however, a high proportion supported the use of home remedies in severe COVID-19 infections. This underscores the need to enhance the health-seeking behaviour of communities through health education and community engagement, using television and/or radio and social media.ContributionStudy findings are useful to inform preparedness and response strategies in communities.

[Objectives] The current study set out to examine the effects of unintended exposure to anti-smoking-related information during the routine of social media use on actual anti-smoking behaviors based on the health belief model. And it aims to determine the smoking characteristics of the social media users as well as ascertaining the choice of social media platforms of smokers. In addition, this research was conducted to identify the differences in path coefficients among different subgroups. [Methods] An online survey provided quantitative data from 921 social media users, including 466 smokers and 455 non-smokers. Chi-square tests were utilized to identify the differences in smoking characteristics and the choice of social media platforms. Then, partial least squares structural modeling (PLS-SEM) was employed using Smart PLS 3.3.5 to test hypotheses and the multi-group analysis (MGA) was conducted to quantitively describe the differences in path coefficients. [Results] Firstly, social media users who are male, or elder, or with higher monthly income are more likely to be addicted smokers and reported using regular cigarette more frequently, while the female smokers tend to use e-cigarette. Second, smokers who reported higher monthly income or higher education level or using e-cigarette rely on Sina microblog to obtain anti-smoking information. And the smokers who reported using regular cigarette prefer TikTok. Thirdly, there was empirical evidence that anti-smoking information scanning via social media platforms exerts a positive effect on smokers’ anti-smoking behaviors (by directly influencing their perceived barriers (, perceived severity ( and self-efficacy . And the anti-smoking information scanning via social media platforms is positively associated with non-smokers’ self-efficacy, thereby promoting their anti-smoking behaviors . Finally, there was no significant difference in the direct and total effect of anti-smoking information scanning on smokers’ perceptions and actual behaviors among subgroups (age, gender, income, CPD, TTF). And anti-smoking information scanning exerts a more decisive influence on perceived barriers of female non-smokers than male non-smokers (Diff.= 0.219, &lt;.001). [Conclusion] The present results highlight the effectiveness of anti-smoking information dissemination via social media on public anti-smoking behaviors and put forward the segmentation strategies targeted to various users and tailored to three social media platforms.

Aim: To investigate the knowledge of and attitudes towards herpes zoster (HZ) and its vaccination, as well as the vaccination status of Chinese patients with rheumatic disease. Method: A face-to-face questionnaire survey was conducted among patients visiting the Department of Rheumatology and Clinical Immunology, Peking University First Hospital from 1 March to 30 April 2024. Information on HZ infection and vaccination status was recorded. The questionnaire assessed their knowledge of HZ and the HZ vaccine with nine questions, scoring one point for each correct answer, resulting in a total score ranging from zero to nine. Attitudes toward HZ and vaccines were measured by a five-point Likert scale, with scores ranging from one (“strongly disagree”) to five (“strongly agree”). Factors associated with knowledge and attitude scores were analyzed using an ordinal logistic regression. Results: A total of 1036 patients completed the questionnaire, with a mean age of 47.1 years, and 79.3% were females. The three most prevalent diseases were systemic lupus erythematosus (32.4%), rheumatoid arthritis (26.3%) and Sjögren’s syndrome (9.9%). A total of 243 patients (23.5%) reported a history of HZ or current HZ infection. Only 2.0% of the patients had been vaccinated, while 51.0% expressed willingness to be vaccinated in the future. The median knowledge score was four (2, 5) (ranging from zero to nine), and the median attitude score was 19 (17, 20) (ranging from 5 to 25). Factors associated with higher knowledge scores included being female (β = 0.448, p = 0.001), having a higher educational level (β = 0.355, p < 0.001), having a higher monthly income (β = 0.191, p = 0.008) and having comorbidities (β = 0.275, p = 0.023). Factors associated with higher attitude scores included being female (β = 0.279, p = 0.035), having a higher monthly income (β = 0.196, p = 0.037) and possessing a higher education level (β = 0.310, p = 0.045). Conclusions: Patients with rheumatic disease in China exhibit a low level of cognition regarding HZ as well as its vaccine, and the vaccination rate is very low. To improve the understanding and prevention awareness of HZ, health education should be intensified, particularly targeting males, those with lower levels of education and lower-income patients.