Zarghami Fatemeh, Rajabi Abdolhalim, Abed-Tazehabadi Reza, Charkazi Abdurrahman, Shahryari Ali
University of Limerick, Castletroy, Co. Limerick. V94 T9PX, Limerick, Ireland.
Department of Public Health & Gerontology, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Public Health. 2025 Jan 17;25(1):198. doi: 10.1186/s12889-025-21444-w.
Studies have consistently demonstrated a strong link between cigarette smoking and an increased risk of cardiovascular diseases (CVD). On the other hand, studies have shown that most smokers do not have a real understanding of the cardiovascular health hazards of smoking. Therefore, the study aimed to determine the perceived risk of Myocardial Infarction (MI), Hypertension (HTN), and Stroke among current smokers in Iran.
This cross-sectional study was conducted between January and May 2023, and recruited 380 smokers by convenience sampling who smoked at least 100 cigarettes in their lifetime. The data were collected using three questionnaires (1) the questionnaire to assess the risk perception for MI, HTN, and Stroke, (2) the smoking stage of change questionnaire, and (3) the Fagerström Test for nicotine dependence (FTND). The CVD risk perception consisted of two parts, perceived susceptibility and perceived severity. Each part scores between 0 and 10 and finally gets a total score of 0-20. A score of zero indicated the lowest risk perception while a score of 20 indicated the highest risk perception. We examined the relationship between the demographic and smoking-related variables and the smokers' perceived risk of MI, stroke, and HTN by using multiple linear regression.
The mean age of participants was 35.57 ± 12.05 years, and 77.1% were male. The perceived risk score of MI was 10.68 ± 4.69 out of 20. The scores related to stroke and HTN were 10.00 ± 4.65 and 10.89 ± 4.73, respectively. Identified variables collectively contributed significantly to predicting the perceived risk of MI (p <.0001, Adj R-squared = 0.05%), stroke ( p <.0001, Adj R-squared = 0.08%), and HTN (p <.0001, Adj R-squared = 0.06%). We found that longer smoking duration [coefficient=-1.96 (95% CI= -3.91, - 0.09)] for 20-29 years and - 4.08 ( 95% CI= -6.70, -1.46 ) for 30 + years), older smoking age onset [coefficient=-2.10 ( 95% CI= -3.24, - 0.96 )] for 20 + years), and dual tobacco users [coefficient= -1. 04 (95% CI= -2.08, - 0.06)] were significantly associated with lower perceived risk for MI. We also found that longer smoking duration [coefficient=-2.23 (95% CI= -4.13, - 0.32)] for 20-29 years and - 5.01 (95% CI= -7.565734, -2.462361 ) for 30 + years), older smoking age onset [coefficient=-1.86 (95% CI= -2.970021, - 0.75 ] for 20 + years), and being male [coefficient= -2. 00, (95% CI= -3.53, - 0.47)] were significantly associated with lower perceived risk for stroke. We found that longer smoking duration (coefficient=-4.40 for 30 + years), older smoking age onset [coefficient=-2.02 (95% CI= -3.14, - 0.87,)] for 20 + years), and being dual users [coefficient=-1.36, 95% CI= -2.40, - 0.3241238)] were significantly associated with lower perceived risk for HTN.
The results of this study demonstrated a moderate perceived risk of participants to CVD. Also, the perceived risk decreases as the duration of smoking and the age for the smoking onset increases to 20 years and above. It seems necessary to carry out interventions to inform the public about the harms of smoking, especially for adolescents and young adults, and its risks in causing cardiovascular disease.
研究一直表明吸烟与心血管疾病（CVD）风险增加之间存在紧密联系。另一方面，研究表明大多数吸烟者并未真正了解吸烟对心血管健康的危害。因此，本研究旨在确定伊朗当前吸烟者对心肌梗死（MI）、高血压（HTN）和中风的感知风险。
本横断面研究于2023年1月至5月进行，通过便利抽样招募了380名终身吸烟至少100支的吸烟者。使用三份问卷收集数据：（1）评估对MI、HTN和中风风险感知的问卷；（2）吸烟改变阶段问卷；（3）尼古丁依赖的法格斯特龙测试（FTND）。心血管疾病风险感知由两部分组成，即感知易感性和感知严重性。每部分得分在0到10之间，最终总分为0 - 20分。得分为零表示最低风险感知，得分为20表示最高风险感知。我们使用多元线性回归研究人口统计学和吸烟相关变量与吸烟者对MI、中风和HTN的感知风险之间的关系。
参与者的平均年龄为35.57±12.05岁，77.1%为男性。MI的感知风险得分在20分制中为10.68±4.69。与中风和HTN相关的得分分别为10.00±4.65和10.89±4.73。确定的变量共同对预测MI（p <.0001，调整后R平方 = 0.05%）、中风（p <.0001，调整后R平方 = 0.08%）和HTN（p <.0001，调整后R平方 = 0.06%）的感知风险有显著贡献。我们发现，吸烟持续时间较长[系数 = -1.96（95%置信区间 = -3.91，-0.09），20 - 29岁]和 -4.08（95%置信区间 = -6.70，-1.46），30岁及以上）、吸烟起始年龄较大[系数 = -2.10（95%置信区间 = -3.24，-0.96），20岁及以上）以及双重烟草使用者[系数 = -1.04（95%置信区间 = -2.08，-0.06）]与较低的MI感知风险显著相关。我们还发现，吸烟持续时间较长[系数 = -2.23（95%置信区间 = -4.13，-0.32），20 - 29岁]和 -5.01（95%置信区间 = -7.565734，-2.462361），30岁及以上）、吸烟起始年龄较大[系数 = -1.86（95%置信区间 = -2.970021，-0.75），20岁及以上）以及男性[系数 = -2.00，（95%置信区间 = -3.53，-0.47）]与较低的中风感知风险显著相关。我们发现，吸烟持续时间较长（30岁及以上系数 = -4.40）、吸烟起始年龄较大[系数 = -2.02（95%置信区间 = -3.14，-0.87），20岁及以上）以及双重使用者[系数 = -1.36，95%置信区间 = -2.40，-0.3241238）]与较低的HTN感知风险显著相关。
本研究结果表明参与者对心血管疾病有中等程度的感知风险。此外，随着吸烟持续时间和吸烟起始年龄增加到20岁及以上，感知风险降低。似乎有必要开展干预措施，向公众宣传吸烟的危害，特别是对青少年和年轻人，以及吸烟导致心血管疾病的风险。
