Hirko Kelly A, Moore Patti, An Lawrence C, Hawley Sarah T
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan.
Munson Medical Center, Munson Healthcare, Traverse City, Michigan.
AJPM Focus. 2022 Dec 15;2(1):100057. doi: 10.1016/j.focus.2022.100057. eCollection 2023 Mar.
Rural‒urban smoking disparities have widened in recent years because smoking prevalence reductions have been experienced disproportionately among urban adults. Tobacco cessation programs that work in urban settings may not be reaching rural smokers or may need tailoring to be effective. Identifying smoking cessation preferences and barriers among rural smokers can facilitate the implementation of acceptable programs to address rural smoking-related disparities. Thus, the aim of this study was to examine tobacco cessation motivations, preferences, and barriers among rural smokers and to assess smokers' likelihood to use various types of tobacco cessation programs.
Using a cross-sectional study design, we distributed a self-administered survey to 100 smokers during regularly scheduled healthcare appointments at 3 rural Michigan practices from June to August 2019. We examined differences in participant characteristics by the readiness to quit using chi-square/Fisher's exact tests and described cessation motivations, preferences, and barriers to tobacco cessation among rural smokers.
Participants reporting readiness to quit were less likely to have smoking allowed in their home (31.7% vs. 75.0%; =0.003) and had a higher prevalence of anxiety (62.1% vs. 6.3%; =0.0001) and depression (49.2% vs. 18.8%; =0.04) than those not ready to quit. Preferences were higher for nicotine replacement medications and reward-based approaches, with only 10% of participants being likely to use telephone-based quitlines.
These findings suggest that provider referrals to nicotine replacement medications and reward-based approaches can be used to enhance tobacco cessation among rural smokers.
近年来，城乡吸烟差异不断扩大，因为城市成年人吸烟率的下降幅度不成比例。在城市环境中有效的戒烟项目可能无法惠及农村吸烟者，或者可能需要进行调整才能有效。识别农村吸烟者的戒烟偏好和障碍有助于实施可接受的项目，以解决农村与吸烟相关的差异。因此，本研究的目的是调查农村吸烟者的戒烟动机、偏好和障碍，并评估吸烟者使用各种类型戒烟项目的可能性。
采用横断面研究设计，在2019年6月至8月期间，我们在密歇根州农村的3家医疗机构定期安排的医疗预约中，向100名吸烟者发放了一份自填式调查问卷。我们使用卡方检验/费舍尔精确检验，根据戒烟意愿检查参与者特征的差异，并描述农村吸烟者的戒烟动机、偏好和戒烟障碍。
报告有戒烟意愿的参与者家中允许吸烟的可能性较小（31.7%对75.0%；P = 0.003），焦虑症患病率较高（62.1%对6.3%；P = 0.0001），抑郁症患病率也较高（49.2%对18.8%；P = 0.04），高于那些没有戒烟意愿的参与者。对尼古丁替代药物和基于奖励的方法的偏好较高，只有10%的参与者可能会使用基于电话的戒烟热线。
这些发现表明，医疗服务提供者推荐尼古丁替代药物和基于奖励的方法可用于提高农村吸烟者的戒烟率。
