Yetişkin Türk Sigara İçicilerinde Sigara Bırakma Tetikleyicilerinde Cinsiyet ve Yaş Farklılıkları Gender and Age Differences in the Triggers for Smoking Cessation in Adult Turkish Smokers

Year 2024, Volume: 38 Issue: 1, 61 - 73, 23.07.2024

Hülya Abalı , Fatma Tokgöz Akyıl , Nurdan Şimşek Veske , Seda Tural Önür

An Erratum to this article was published on July 23, 2024. https://dergipark.org.tr/en/pub/ighd/issue/84984/1549874

Abstract

Amaç: Sigara dumanından kaynaklanan sağlık riskleri, sigarayı bırakarak belirli bir yoksunluk sürecinden sonra azaltılabilir. Sigarayı bırakmayı tetikleyen faktörlerin cinsiyet ve yaşa göre farklılıklarını tespit etmeyi amaçladık.
Gereç ve Yöntemler: Bu kesitsel çalışma Mayıs-Eylül 2022 tarihleri arasında göğüs hastalıkları polikliniğine başvuran, sigarayı bir yıldan fazla süredir bırakan ve anketi yanıtlamayı kabul eden 185 hasta üzerinde gerçekleştirildi. Ankette katılımcıların demografik özellikleri, sigara içme ve sigarayı bırakma özellikleri, bırakmaya yönelik destekler ve sigarayı bırakmayı tetikleyen bildirilmiş 25 faktör (psikososyal, ekonomik ve tıbbi faktörler) değerlendirildi. Sigarayı bırakmayı tetikleyen faktörler kadın ve erkekler arasında ve ayrıca yaş grupları (≤ 50 yaş ve > 50 yaş) arasında karşılaştırıldı.
Bulgular: Katılımcıların yaş ortalaması 58±13’dü (yıl) olup %23’ü kadındı. Katılımcıların sigarayı bırakmalarını sağlayan en önemli faktör sigaranın sağlığa zararlarının bilinmesi (%65) oldu. Kadınlar erkeklerden daha gençti ve yılda daha az paket sigara içiyordu (sırasıyla P<0.001, P=0.008). Erkeklere göre kadınlarda ortalama sigaraya başlama yaşı daha geç, ortalama sigarayı bırakma yaşı ise daha erkendi (sırasıyla P=0.036, P=0.00). Sigara içmenin sağlığa zararları konusundaki farkındalık, erken ölüm kaygısı ve Kronik Obstrüktif Akciğer Hastalığı (KOAH) tanısı erkekler üzerinde daha fazla etkiliyken (sırasıyla P=0,026, P=0,01, P=0,009) astım tanısı kadınlar üzerinde daha fazla etkiliydi (P=0.01). Ailede akciğer kanseri öyküsü genç katılımcılar için sigarayı bırakma konusunda daha cesaret vericiyken, kronik hastalıklar (KOAH ve kalp hastalıkları) yaşlılar için daha cesaret vericiydi (sırasıyla P=0.003, P=0.001).
Sonuç: Sigarayı bırakmayı tetikleyen faktörler cinsiyete ve yaşa göre değişmektedir. Hekimler bu farklı özellikleri dikkate alarak bireysel tedavi yaklaşımları geliştirebilirler. Hekimler polikliniklerde ve halka açık sigara karşıtı kampanyalarda sigara içmenin sağlık risklerini vurgulamalıdır.

Gender and Age Differences in the Triggers for Smoking Cessation in Adult Turkish Smokers
Hülya Abalı, Fatma Tokgoz Akyil, Nurdan Şimşek Veske, Seda Tural Önür
University Of Health Sciences, Yedikule Chest Diseases And Thoracic Surgery Training And Research Hospital
Objective: Health risks due to cigarette smoke can be reduced after a period of abstinence by quitting smoking. We intended to detect trigger factors and variations in triggering factors for smoking cessation regarding gender and age.
Material and Methods: This cross-sectional study was performed on 185 patients applied to the pulmonology polyclinics, who quit smoking for more than one year and who accepted to answer the questionnaire between May and Sep 2022. The questionnaire evaluated the participants’ demographic, smoking, and quitting smoking characteristics, supports for quitting, and the reported 25 trigger factors for smoking cessation (psychosocial, economic, and medical factors). The triggers for smoking cessation were compared between females and males, and also age groups (≤ 50 years and> 50 years).
Results: Of the participants, the mean age was 58±13 yrs, and 23% were female. The most seen factor enabling participants to quit smoking was awareness of smoking harms to health (65%). Females were younger and smoked fewer packs/year cigarettes than males (P<0.001, P=0.008, respectively). The mean initiation age of smoking was later, and the mean age of smoking cessation was earlier in females compared to males (P=0.036, P=0.00, respectively). The awareness of health harms of smoking, anxiety about premature death, and diagnosis of Chronic Obstructive Pulmonary Disease (COPD) had higher effects on males (P=0.026, P=0.01, P=0.009, respectively), and diagnosis of asthma had a higher impact on females (P=0.01). While a family history of lung cancer was more encouraging to younger participants for smoking cessation, chronic diseases (COPD and cardiac diseases) were more encouraging to elders (P=0.003, P=0.001, respectively).
Conclusion: The trigger factors for smoking cessation vary according to gender and age. Physicians may develop individual treatment approaches by taking these different characteristics into account. Physicians should emphasize the health risks of smoking in polyclinics and public anti-smoking campaigns.

Keywords

Sigara bırakma, sağlık bilgisi, kronik hastalık, cinsiyet, yaş

Ethical Statement

var

References

• 1. Center For Disease Control and Prevention, 2022. Global Tobacco Control. Available at: https://www.cdc.gov/tobacco/global/index.htm. Accessed April 26, 2023.
• 2. World Health Organization Report on the Global Tobacco Epidemic 2021b:69.
• 3. World Health Organization Report on the Global Tobacco Epidemic 2021a:148.
• 4. Wang L, Kong L, Wu F, et al. Preventing chronic diseases in China. Lancet 2005;366: 1821–4.
• 5. US Department of Health and Human Services. The health benefits of smoking cessation. US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990 (DHHS Publication No. (CDC) 90–8516.
• 6. Bilir N. Tütün Kontrolü Çerçeve Sözleşmesi ve Türkiye: Bir Başarı Örneği. Güncel Göğüs Hastalıkları Serisi 2016;4: 7–12.
• 7. T. C. Sağlık Bakanlığı Tütün ve Madde Bağımlılığı ile Mücadele Dairesi Başkanlığı, 2019.
• 8. Türkiye health research, 2022-Türkiye statistical agency-data portal. Available at: https.//data.tuik.gov.tr. Accessed June 1, 2023.
• 9. Fiore MC, Bailey WC, Cohen SJ, Dorfman SF, Goldstein MG, Gritz EF, et al. Treating tobacco use and dependence: clinical practice guidelines. U.S. Department of Health and Human Services. Public Health Service, Rockville, MD2000.
• 10. Pogun S, Yararbas G, Nesil T, Kanit L. Sex differences in nicotine preference. J Neurosci Res. 2017;95: 148–162.
• 11. Chen D and Wu LT. Smoking Cessation Interventions for Adults Aged 50 or Older: A Systematic Review and Meta-analysis. Drug Alcohol Depend 2015;154: 14–24.
• 12. Argüder E, Hasanoğlu H C, Karalezli A, Kılıç H. [Factors that increasing tendency to smoking cessation] [Article in Turkish]. Tuberk Toraks 2012;60: 129–35.
• 13. Bui TC, Xangsayarath P, Douangvichith D, Siengsounthone L, Phandouangsy K, Tran LT, et al. Factors Associated with Cigarette Smoking Cessation in Lao People’s Democratic Republic: Results from the 2015 National Adult Tobacco Survey. International Journal of Environmental Research and Public Health 2020;17: 4953.
• 14. Vangeli E, West E. Sociodemographic differences in triggers to quit smoking: findings from a national survey. Tob Control 2008;17: 410–5
• 15. Shang C, Huang J, Cheng KW, He Y, Chaloupka F J. The association between warning label requirements and cigarette smoking prevalence by education-findings from the Global Adult Tobacco Survey (GATS). Int J Environ Res Public Health 2017;14.
• 16. Levy DT, Li Y, Yuan Z. Impact of nations meeting the MPOWER targets between 2014 and 2016: An update. Tob Control 2020;29: 231–3.
• 17. Wang R, Jiang Y, Yao C, Zhu M, Zhao Q, Huang L, et al. Prevalence of tobacco related chronic diseases and its role in smoking cessation among smokers in a rural area of Shanghai, China: a cross sectional study. BMC Public Health 2019;19: 753.
• 18. Holm M, Schiöler L, Andersson E, Forsberg B, Gislason T, Janson C, et al. Predictors of smoking cessation: A longitudinal study in a large cohort of smokers. Respir Med 2017;132: 164–9.
• 19. Patel K, Schlundt D, Larson C, Wang H, Brown A, Hargreaves M. Chronic illness and smoking cessation. Nicotine Tob Res 2009;11: 933–9.
• 20. Gallus S, Muttarak R, Franchi M, Pacifici R, Colombo P, Boffetta P, et al. Why do smokers quit? Eur J Cancer Prev 2013;22: 96–101. 21. Curry SJ, Grothaus L, McBride C. Reasons for quitting: intrinsic and extrinsic motivation for smoking cessation in a population-based sample of smokers. Addict Behav 1997;22: 727–39.
• 22. McKee SA, Maciejewski PK, Falba T, Mazure CM. Sex differences in the effects of stressful life events on changes in smoking status. Addiction 2003;98: 847–55.
• 23. Grøtvedt L, Stavem K. Association between age, gender and reasons for smoking cessation. Scand J Public Health 2005;33: 72–76.
• 24. Chinwong D, Mookmanee N, Chongpornchai J, Chinwong S. A Comparison of Gender Differences in Smoking Behaviors, Intention to Quit, and Nicotine Dependence among Thai University Students. J Addict 2018: 8081670.
• 25. Lindsay H G, Wamboldt F S, Holm K E, Make B J, Hokanson J, Crapo J D, et al. Impact of a Medical Diagnosis on Decision to Stop Smoking and Successful Smoking Cessation. Chronic Obstr Pulm Dis 2021;8: 360–70.
• 26. Danielsen S E, Løchen M-L, Medbø E, Vold M L, Melbye H. A new diagnosis of asthma or COPD is linked to smoking cessation- the Tromsø study. Int J Chronic Obstr Pulm Dis 2016;11: 1453–8.
• 27. Chen Z, Wasti B, Shang Y, Ouyang R, Yuan Y, He Y, et al. Different clinical characteristics of current smokers and former smokers with asthma: a cross-sectional study of adult asthma patients in China. Sci Rep 2023;13: 1035.