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Factors Associated with Smoking Cessation Intention among Current Smokers with Diabetes: Analysis of the 2013 Community Health Survey in Korea
Original Article

Korean J Health Promot 2017;17(3):184-192.

Published online: 19 January 2017

DOI: https://doi.org/10.15384/kjhp.2017.17.3.184

Factors Associated with Smoking Cessation Intention among Current Smokers with Diabetes: Analysis of the 2013 Community Health Survey in Korea

Young-Hoon Lee1, 2, Jum Suk Ko3

1Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea

2Jeonbuk Tobacco Control Center, Iksan, Korea

3Department of Cardiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea

Corresponding author : Jum Suk Ko, MD Department of Cardiology, Wonkwang University Hospital, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 54538, Korea Tel: +82-63-859-2526, Fax: +82-63-852-8480 E-mail: nemor@hanmail.net

Received 27 March 2017       Accepted 13 July 2017

Copyright © 2017 The Korean Society of Health Promotion and Disease Prevention

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Smoking increases the risk of diabetic complications, but the prevalence of smoking in diabetes is similar to non-diabetes. We aimed to investigate factors associated with smoking cessation intentions (SCI) in current smokers with diabetes.

Methods:

In the 2013 Community Health Survey, information about current smokers has been collected among people who are over 30 years old with diabetes. Chi-squared test and logistic regression analysis were used to examine the association between socio-demographic indicators, health behaviors, comorbidities, smoking-related factors, diabetes-related factors and SCI. A total of 3,511 current smokers with diabetes were included in the final analysis.

Results:

Among current smokers with diabetes, 13.4% reported having SCI (within six months). In multivariate logistic regression analysis, gender, education, marital status and occupation were found to be significantly related to SCI. Moreover, lower amounts of smoking, previous attempts to smoking cessation (odds ratio [OR] 3.66, 95% confidence interval [CI] 2.94-4.56), experience of smoking cessation recommendations from acquaintances (OR 1.87, 95% CI 1.38-2.52), experience of smoking cessation education (OR 1.57, 95% CI 1.12-2.20), and experience of diabetic education (OR 1.33, 95% CI 1.06-1.66) were significantly associated with SCI in current smokers with diabetes.

Conclusion:

In order to lower the smoking rate of community-dwelling adults with diabetes, effective anti-smoking interventions are needed, taking into account SCI-related factors, including smoking cessation education and diabetes education.

Keywords: Smoking cessation, Intention, Community health planning, Diabetes mellitus

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Table 1.
Smoking cessation intention of study population according to general characteristics
  N Smoking cessation intention P
Never or someday (row %) Within 6 months (row %) P
Total 3,511 86.6 13.4  
Gender       0.001
Male 3,135 85.9 14.1  
Female 376 92.3 7.7  
Age, y       <0.001
30-39 139 72.7 27.3  
40-49 539 83.5 16.5  
50-59 1,124 86.5 13.5  
60-69 965 87.7 12.3  
≥70 744 90.1 9.9  
Education level       <0.001
≤Elementary school 1,117 91.9 8.1  
Middle school 644 90.2 9.8  
High school 1,161 84.7 15.3  
College or higher 589 76.2 23.8  
Marital status       0.074
Married and living with a spouse 2,635 86.6 13.4  
Divorced or separated 407 84.3 15.7  
Widowed 311 90.4 9.6  
Never married 158 83.5 16.5  
Occupation       <0.001
Manual 1,886 88.4 11.6  
Non-manual 442 75.6 24.4  
Othersa 1,183 87.7 12.3  
Monthly household income, million won       <0.001
<1.00 920 89.0 11.0  
1.00-2.99 779 90.0 10.0  
3.00-4.99 1,060 84.9 15.1  
≥5.00 752 82.3 17.7  
National basic livelihood security       0.589
Recipient 367 87.5 12.5  
Non-recipient 3,144 86.5 13.5  
Location of residence       <0.001
Rural (eup·myeon) 1,683 88.8 11.2  
Urban (dong) 1,828 84.5 15.5  
Drinking frequency       0.001
None 957 89.0 11.0  
≤1 time per month 532 85.7 14.3  
2-4 times per month 631 82.4 17.6  
2-3 times per week 725 85.4 14.6  
≥4 times per week 666 88.9 11.1  
Stress       0.094
Rare 1,134 85.0 15.0  
A little 1,583 86.7 13.3  
Much 794 88.4 11.6  
Hypertension       0.548
No 1,755 86.2 13.8  
Yes 1,756 86.9 13.1  
Dyslipidemia       0.002
No 2,630 87.6 12.4  
Yes 881 83.4 16.6  
Body mass index       0.296
Underweight 215 88.4 11.6  
Normal 2,207 87.0 13.0  
Obese 1,089 85.3 14.7  

a Job soldier, student · repeat student, housewife, unemployed.

Table 2.
Smoking cessation intention of study population according to smoking-relating factors and diabetes-relating factors
  N Smoking cessation intention P
  Never or someday (row %) Within 6 months (row %)
Amounts of smoking, numbers of cigarettes       <0.001
Sometimes (not daily smoking) 220 66.8 33.2  
1-9 per day 421 83.6 16.4  
10-19 per day 979 85.9 14.1  
≥20 per day 1,891 89.8 10.2  
Experience of past quit attempts       <0.001
No 2,790 91.3 8.7  
Yes 721 68.2 31.8  
Experience of smoking cessation recommendations from acquaintances       0.001
Never or seldom 828 89.0 11.0  
Frequently 1,211 87.9 12.1  
Always 1,472 84.0 16.0  
Experience of smoking cessation public advertising       <0.001
No 607 91.4 8.6  
Yes 2,904 85.5 14.5  
Experience of smoking cessation education       <0.001
No 3,264 87.7 12.3  
Yes 247 72.1 27.9  
Self-awareness of blood glucose control (n=3,484)a       0.921
No 488 86.7 13.3  
Yes 2,996 86.5 13.5  
Current treatment for diabetes       0.499
No 392 85.5 14.5  
Yes 3,119 86.7 13.3  
Experience of diabetic education       <0.001
No 2,393 88.5 11.5  
Yes 1,118 82.5 17.5  
Examination of diabetic retinopathy       <0.001
No 2,597 88.2 11.8  
Yes 914 81.9 18.1  
Examination of diabetic nephropathy       <0.001
No 2,523 88.3 11.7  
Yes 988 82.1 17.9  

a 27 people without data are excluded.

Table 3.
Associating factors for smoking cessation intention using multivariate logistic regression analysis
  Unadjusted Fully adjusted
Male (ref: female) 1.97 (1.33-2.91) 1.91 (1.18-3.09)
Age (ref: ≥70), y        
60-69 1.27 (0.94-1.73) 1.00 (0.70-1.43)
50-59 1.42 (1.05-1.90) 0.98 (0.67-1.45)
40-49 1.79 (1.29-2.49) 0.98 (0.62-1.54)
30-39 3.41 (2.19-5.31) 1.66 (0.92-2.97)
Education level (ref: ≤elementary school)        
Middle school 1.22 (0.87-1.71) 1.03 (0.71-1.50)
High school 2.04 (1.56-2.67) 1.58 (1.15-2.19)
College or higher 3.52 (2.64-4.68) 1.97 (1.33-2.91)
Marital status (ref: married and living with a spouse)
Divorced or separated 1.21 (0.91-1.62) 1.49 (1.05-2.10)
Widowed 0.69 (0.47-1.03) 1.35 (0.83-2.18)
Never married 1.28 (0.83-1.97) 1.13 (0.68-1.90)
Occupation (ref: manual)        
Non-manual 2.46 (1.90-3.19) 1.45 (1.05-1.99)
Othersa 1.06 (0.85-1.33) 1.02 (0.77-1.36)
Monthly household income (ref: <1.00 million won)        
1.00-2.99 million won 0.90 (0.66-1.23) 0.90 (0.63-1.28)
3.00-4.99 million won 1.44 (1.10-1.88) 1.06 (0.75-1.49)
≥5.00 million won 1.74 (1.32-2.30) 0.99 (0.67-1.46)
Urban (ref: rural) 1.46 (1.20-1.78) 1.05 (0.84-1.32)
Drinking frequency (ref: none)
≤1 time per month 1.35 (0.99-1.86) 1.01 (0.71-1.43)
2-4 times per month 1.73 (1.30-2.31) 1.20 (0.86-1.67)
2-3 times per week 1.39 (1.04-1.86) 1.02 (0.73-1.43)
≥4 times per week 1.01 (0.74-1.39) 1.06 (0.75-1.51)
Stress (ref: rare)        
A little 0.87 (0.70-1.08) 0.93 (0.73-1.18)
Much 0.74 (0.57-0.98) 0.87 (0.64-1.18)
Dyslipidemia (ref: no) 1.40 (1.14-1.74) 1.15 (0.91-1.46)
Amounts of smoking (ref: ≥20 per day)        
10-19 per day 1.45 (1.15-1.84) 1.47 (1.14-1.90)
1-9 per day 1.74 (1.29-2.34) 2.30 (1.64-3.23)
Sometimes (not daily) 4.39 (3.20-6.04) 4.33 (2.99-6.27)
Experience of past quit attempts (ref: no) 4.88 (3.98-5.99) 3.66 (2.94-4.56)
Experience of smoking cessation recommendations from acquaintances (ref: never or seldom)
Frequently 1.11 (0.84-1.47) 1.25 (0.92-1.71)
Always 1.54 (1.19-1.99) 1.87 (1.38-2.52)
Experience of smoking cessation public advertising (ref: no) 1.81 (1.33-2.44) 1.30 (0.94-1.81)
Experience of smoking cessation education (ref: no) 2.75 (2.05-3.70) 1.57 (1.12-2.20)
Experience of diabetic education (ref: no) 1.63 (1.34-1.99) 1.33 (1.06-1.66)
Examination of diabetic retinopathy (ref: no) 1.64 (1.34-2.02) 1.28 (0.97-1.69)
Examination of diabetic nephropathy (ref: no) 1.65 (1.35-2.02) 1.05 (0.80-1.38)

Abbreviation: ref, reference. Values are presented as odds ratio (95% confidence interval).

a Job soldier, student · repeat student, housewife, unemployed.

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