Droomers Mariël, Huang Xinyuan, Fu Wenjie, Yang Yong, Li Hong, Zheng Pinpin
Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
Center of Disease Control, Pudong District, Shanghai, China.
BMJ Open. 2016 Oct 7;6(10):e011058. doi: 10.1136/bmjopen-2016-011058.
We aim to describe the intention to quit smoking among Chinese male smokers from different educational backgrounds and to explain this intention from their attitude, perceived social norms and self-efficacy regarding smoking cessation.
Participants were recruited from workplaces and communities to reflect the occupational distribution in three cities (Shanghai, Nanning and Mudanjiang) in China.
In 2013 interviews were conducted with 3676 male smokers aged 18 years and older.
Multivariate logistic regression analyses calculated educational differences in the intention to quit smoking as well as the association between the intention to quit smoking and attitude, subjective norms, and self-efficacy. Bootstrapping estimated to what extent the educational disparities in the intention to quit smoking were mediated by these three determinants.
No educational disparities in the intention to quit smoking within 1 or 6 months were observed among male Chinese smokers (p=0.623 and p=0.153, respectively). A less negative attitude, a higher perceived subjective norm towards smoking cessation, and a higher perceived self-efficacy to quit smoking were all associated with intention to quit (all p values <0.001). Perceived subjective norms were the only component of the theory of planned behaviour that statistically significantly mediated the differences in the intention to quit smoking (within 1 or 6 months) between the lowest educated Chinese men and the groups with lower (β=0.039, 95% CI 0.017 to 0.071 and β=0.043, 95% CI 0.019 to 0.073), higher (β=0.041, 95% CI 0.017 to 0.075 and β=0.045, 95% CI 0.019 to 0.077) and the highest education (β=0.045, 95% CI 0.019 to 0.080 and β=0.050, 95% CI 0.023 to 0.083).
In order to prevent future socioeconomic disparities in smoking cessation, investment in a more stimulating social environment and norms towards smoking cessation among particularly the lowest educated Chinese men is warranted.
我们旨在描述不同教育背景的中国男性吸烟者的戒烟意愿，并从他们对戒烟的态度、感知到的社会规范和自我效能方面来解释这种意愿。
参与者从工作场所和社区招募，以反映中国三个城市（上海、南宁和牡丹江）的职业分布情况。
2013年，对3676名18岁及以上的男性吸烟者进行了访谈。
多因素逻辑回归分析计算戒烟意愿的教育差异，以及戒烟意愿与态度、主观规范和自我效能之间的关联。采用自抽样法估计这三个决定因素在多大程度上介导了戒烟意愿的教育差异。
中国男性吸烟者在1个月或6个月内戒烟意愿无教育差异（p值分别为0.623和0.153）。对吸烟持较不消极的态度、对戒烟有更高的感知主观规范以及更高的戒烟自我效能均与戒烟意愿相关（所有p值<0.001）。感知主观规范是计划行为理论中唯一在统计学上显著介导受教育程度最低的中国男性与较低（β=0.039，95%CI 0.017至0.071和β=0.043，95%CI 0.019至0.073）、较高（β=0.041，95%CI 0.017至0.075和β=0.045，95%CI 0.019至0.077）和最高教育程度组（β=0.045，95%CI 0.019至0.080和β=0.050，95%CI 0.023至0.083）之间（1个月或6个月内）戒烟意愿差异的因素。
为防止未来戒烟方面出现社会经济差异，有必要对特别是受教育程度最低的中国男性投入更多资源，营造更具激励性的社会环境和戒烟规范。
