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Mediation of Smoking Consumption on the Association of Perception of Smoking Risks with Successful Spontaneous Smoking Cessation

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Abstract

Background

The perception of smoking risks has positive and smoking consumption has negative effects on successful smoking cessation, but no information is now available for what is the role of smoking consumption on the relationship between perception of smoking risks and successful smoking cessation.

Purpose

To assess the mediation of smoking amount on the association of perception of smoking risks with successful spontaneous smoking cessation.

Method

A community-based case-control study was conducted with 294 adult spontaneous successful smoking quitters who have been quitting smoking consecutively for more than 2 years as the cases, and 347 adult failed spontaneous smoking quitters who quitted but relapsed or have been quitting smoking continuously equal to or less than 2 years as the controls. The smoking amount was evaluated by pack-year that was categorized into tertiles and scored inversely. The score of perception of smoking risks was also categorized into tertiles. Propensity score as the covariate in the regression model was used to adjust the potential confounding. The total effect was decomposed into direct effect and indirect (mediating) effect by using logistic regression based on the KHB method proposed by Karlson, Holm, and Breen. The proportion of mediating effect among the total effect is calculated as the indirect effect divided by the total effect.

Results

After adjusting age, profession, education, marital status, and reasons for quitting smoking by using propensity score, the small mediating effect of smoking amount on the association of perception of smoking risks with successful spontaneous smoking cessation was observed, and the mediating effect of smoking amount was 23.75 % among the total effect. The dose-response analysis showed that the mediating effect of smoking amount in the groups with middle and high score of perception of smoking risks were 10.15 and 37.84 % among their total effect, respectively.

Conclusion

This study reveals that smoking amount has only small mediating effect among the total effect of perception of smoking risks on the successful spontaneous smoking cessation; enhancing the smokers' perception of smoking risks could promote their attempt to reduce smoking, so as to increase the probability of successful smoking cessation.

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Acknowledgments

This study is based on research of the Emory Global Health Institute-China Tobacco Control Partnership Program (GHI-CTP) funded by the Bill and Melinda Gates Foundation (no. 51437). The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation. We thank the local Health Bureau, local Center for Disease Control and Prevention, other relevant government and persons, the investigators, and respondents for their support to this research.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Shandong University, Jinan, 250012, Shandong, People’s Republic of China

    Yan Zhang, Yanxun Liu & Chongqi Jia

  2. Wenshang Center for Disease Control and Prevention, Jining, Shandong, People’s Republic of China

    Yan Zhang

  3. Center for Health Management and Policy, Shandong University, Jinan, 250012, People’s Republic of China

    Jian Wang

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  1. Yan Zhang
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  2. Yanxun Liu
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  3. Jian Wang
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  4. Chongqi Jia
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Correspondence to Chongqi Jia.

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Zhang, Y., Liu, Y., Wang, J. et al. Mediation of Smoking Consumption on the Association of Perception of Smoking Risks with Successful Spontaneous Smoking Cessation. Int.J. Behav. Med. 21, 677–681 (2014). https://doi.org/10.1007/s12529-013-9378-y

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  • DOI: https://doi.org/10.1007/s12529-013-9378-y

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