Abstract
Understanding mechanisms underlying smoking-related factors should be prioritized in establishing smoking prevention and cessation policy. The aim of this study was to identify factors significantly associated with smoking initiation and/or smoking cessation as well as the most important determinants of successful smoking cessation in a developed non-Western setting. Based on multiple logistic regression models, the odds ratios (ORs) for smoking initiation and cessation were estimated among males (N = 24,490) who had participated in the Health Examinees (HEXA) study. The Cox proportional hazards regression model was used to assess the association between selected predictors of smoking cessation and the likelihood of reaching this goal. Finally, Kaplan–Meier curves were constructed to illustrate the distribution of time from age at smoking initiation to age at smoking cessation. We found that the ORs for successfully quitting smoking increased with age, married status, educational achievement, having a non-manual job, drinking cessation and disease morbidity. Those exposed to secondhand smoking showed less likelihood of quitting smoking. A continual decrease in the ORs for successfully quitting smoking was observed according to increased smoking duration, smoking dose per day and lifetime tobacco exposure (p trend <0.001). Among the selected predictors, lifetime tobacco exposure, educational attainment, alcohol drinking status and birth cohort were the major determinants in the success of smoking cessation. Our findings suggest that lifetime tobacco exposure, educational attainment, alcohol drinking status and birth cohort can determine success in smoking cessation. Public interventions promoting a smoke-free environment are needed to reinforce discouraging the initiation of, reducing, and quitting cigarette smoking.
Highlights
Cigarette smoking, which is the second leading contributory factor to diseases worldwide, remains a potent threat to the public health [1]
This means that the latent damage caused by cigarette smoking will continue to be a threat to the public health worldwide and greater attention should be paid to the non-Western populations
To investigate which factors were significantly associated with smoking initiation and/or smoking cessation, two hierarchical multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), accounting for demographic characteristics and past disease history (Model 1) and demographic characteristics, past disease history and smoking-related history (Model 2)
Summary
Cigarette smoking, which is the second leading contributory factor to diseases worldwide, remains a potent threat to the public health [1]. Many Asian countries have faced diverse challenges regarding tobacco control and prevention: Asian men showed the highest global prevalence of smoking, and factors such as low smoking cessation rate, increasing female smoking prevalence, and aggressive marketing strategies by tobacco companies are other smoking-related challenges faced by the Asian population [5, 6]. This means that the latent damage caused by cigarette smoking will continue to be a threat to the public health worldwide and greater attention should be paid to the non-Western populations
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