Tobacco Smoking, Quitting, and Relapsing Among Adult Males in Mainland China: The China Seven Cities Study

Introduction: Despite an estimated 1 million tobacco-related deaths annually in China, public health officials face overwhelming barriers to implementing effective tobacco control policies and programs. Models of effective tobacco control can be adapted for Chinese tobacco use and culture based on reliable and valid data regarding predictors of smoking and abstaining. Methods: As part of the China Seven Cities Study to assess the role of rapid social, economic, and cultural change on tobacco use and related health practices and outcomes, 4,072 adult male smokers provided data in 3 annual waves. Measures included current smoking, nicotine dependence, readiness for quitting, perceived stress, hostility, depressive symptoms, as well as covariates (e.g., age, marital status, educational attainment, and family income). Results: Odds of being abstinent at Wave 3 were increased by: lower nicotine dependence at Wave 1 and becoming less dependent between Waves 1 and 3; progressing beyond the contemplation stage between Waves 1 and 3; perceiving less stress, whether initially at Wave 1 or over time from Wave 1 to Wave 3; and lower hostility scores at Wave 1 and decreased hostility from Wave 1 to Wave 3. Among those who quit, odds of remaining abstinent rather than relapsing by Wave 3 were higher among those who were less dependent at Wave 1 and who became less dependent from Wave 1 to Wave 3; and those who showed decreases in hostility from Wave 1 to Wave 3. Conclusions: The public health challenge posed by very high prevalence of male smoking in China can be met by policies and programs that lead to successful long-term cessation. This can only be done successfully by designing interventions based on knowledge of the country’s smokers and the current study suggests several elements

Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California

OBJECTIVES: The current study examined disparities in smoking trends across African Americans and non-Hispanic whites in California. METHODS: Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across African Americans and non-Hispanic whites. RESULTS: A decrease in overall ever and current smoking was observed for both African American and non-Hispanic whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both African American and non-Hispanic whites were observed. Proportions of light and intermittent smokers (LITS) and moderate daily smokers displayed modest increases for African Americans but large increases for non-Hispanic whites. Increases in successful cessation were also observed for African Americans and, to a lesser extent, for non-Hispanic whites. DISCUSSION: Smoking behavior and cessation trends across African Americans and non-Hispanic whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of LITS and moderate daily smokers for both African Americans and non-Hispanic whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by the author(s) and published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. It can be found at: http://ntr.oxfordjournals.org/Keywords: Public health, LITS, African American, Special populations, Disparities, Tobacco contro