Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA 92122, USA.
Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA.
Int J Environ Res Public Health. 2021 Jun 23;18(13):6731. doi: 10.3390/ijerph18136731.
Tobacco use, which is directly responsible for 10% of total deaths per year globally, remains consistently high, with approximately 20% of the population reporting regular consumption globally. Moreover, health disparities regarding tobacco consumption and smoking cessation are growing between rural and urban populations worldwide. Social media interventions for tobacco cessation may effectively reach both groups. The objective of this study was to evaluate the efficacy of a WeChat-delivered smoking cessation intervention among rural and urban Chinese smokers, and to assess moderating variables that may contribute to differential intervention efficacy.
WeChat was used to recruit smokers into this intervention study between 1 July and 5 August 2019. Participants were randomized to one of three intervention schedules: participants in the Standard Group and the Enhanced Group received 20 smoking-related messages over 2 weeks, whereas participants in the Enhanced Group received an extra 6 oral health-related messages for one week. Participants in the control group received 20 smoking-related messages after the post-intervention assessment. Participants completed questionnaires at baseline and at 4 weeks follow-up. Our primary outcome was smoking cessation stage of change and secondary outcome was 24-h point prevalence abstinence (PPA). Urban and rural areas were based on self-reported living areas. Chi-squared test, Fisher's exact test, ANOVA test, linear regression, and logistic regression were used for analysis.
Overall, 403 participants completed the intervention (233 rural, 107 suburban, 63 urban). Compared to urban participants, rural participants were more likely to have progressed to a later stage of change (β = 0.40, 95% CI: 0.13, 0.67) and to report higher 24-h PPA rates at follow-up (aOR = 3.23, 95% CI: 1.36, 7.68). After stratification by living area, the intervention effects in stage of change and 24-h PPA rate at follow-up were only found in the urban subgroup.
Smokers who lived in rural areas reported better smoking cessation outcomes compared with urban smokers; however, the efficacy of a WeChat-based smoking cessation intervention was only found for participants living in an urban area. WeChat based smoking cessation interventions should be used to promote smoking cessation in urban, suburban, and rural areas.
烟草使用每年直接导致全球 10%的总死亡人数，其使用率仍然居高不下，在全球范围内，约有 20%的人口报告有规律地消费烟草。此外，全球农村和城市人口在烟草消费和戒烟方面的健康差距正在扩大。针对烟草使用的社交媒体干预措施可能会有效地覆盖到这两个群体。本研究的目的是评估微信戒烟干预措施对中国农村和城市吸烟者的疗效，并评估可能导致干预效果差异的调节变量。
我们于 2019 年 7 月 1 日至 8 月 5 日期间通过微信招募吸烟者参与这项干预研究。参与者被随机分配到以下三个干预方案之一：标准组和增强组各接受 20 条与吸烟相关的信息，为期 2 周，而增强组额外在第一周再接受 6 条与口腔健康相关的信息。对照组在干预后评估后收到 20 条与吸烟相关的信息。参与者在基线和 4 周随访时完成问卷调查。我们的主要结果是吸烟阶段变化的戒烟状态，次要结果是 24 小时点流行率戒烟（PPA）。城乡地区基于自我报告的居住地区。使用卡方检验、Fisher 确切检验、方差分析、线性回归和逻辑回归进行分析。
共有 403 名参与者完成了干预（233 名农村，107 名郊区，63 名城市）。与城市参与者相比，农村参与者更有可能进入到较后的戒烟阶段（β=0.40，95%CI：0.13，0.67），并在随访时报告更高的 24 小时 PPA 率（aOR=3.23，95%CI：1.36，7.68）。按居住地区分层后，仅在城市亚组中发现了干预对阶段变化和 24 小时 PPA 率的影响。
居住在农村地区的吸烟者报告的戒烟结果优于城市吸烟者；然而，基于微信的戒烟干预措施的疗效仅在居住在城市地区的参与者中发现。基于微信的戒烟干预措施应该用于促进城市、郊区和农村地区的戒烟。
