Survey on Smoking and Quit Smoking among Adults in the Pearl River Delta of Guangdong Province

Background: The negative effects of tobacco on health is a worldwide public health concern.Surveillance and research on smoking and smoking control have significant implications.Objective: To understand the current prevalence of smoking and smoking cessation among the residents of the Pearl River Delta in Guangdong Province, and to further explore the influencing factors of smoking cessation in adults in the region, in order to provide sufficient evidence for health-related agencies to develop effective tobacco control measures.Methods: A multistage cluster sampling was used to conduct a survey study from July 2015 to October 2016.In the first stage, three cities including Shenzhen, Zhuhai and Dongguan were selected randomly from nine cities in the Pearl River Delta in Guangdong Province.In the second stage, one urban (township) area was randomly selected as the study site from each of the cities.In the third stage, we randomly selected at least 1 500 households at each study site, and the questionnaire survey was conducted among a total of 18 102 adults.The questionnaire was composed of part of the Family Health Questionnaire developed by the National Health and Family Planning Commission, covering demographic characteristics (gender, age, household registry, marital status and education level), prevalence of chronic diseases〔hypertension, diabetes, heart disease, stroke, chronic obstructive pulmonary disease (COPD), tumour〕, smoking behavior, daily cigarette smoking amount, and the age at initiation of cigarette smoking.Results: Among 18 102 residents, 14 740 (81.43%) never smoked, 2 885 (15.94%) were currently smoking, and 477 (2.63%) were ever-smokers.The smoking rate of males was higher than that of females (P<0.05); the smoking rate of 35-64-year-old residents was higher than that of 18-34-year-old residents and residents aged 65 or over (P<0.05); the smoking rate of the local residents was lower than that of the foreign residents (P<0.05); the smoking rate of residents with junior college, college degree or above was lower than that of those with primary school or below, junior middle school, secondary specialized school or senior middle school education (P<0.05).Daily cigarette smoking amount of male smokers was higher than that of female smokers (P<0.05).The age at initiation of smoking did not vary significantly by sex (P>0.05).Smokers with hypertension, diabetes, heart disease, stroke, COPD, had a higher smoking cessation rate than those without (P<0.05); there was no significant difference in the rate of smoking cessation among smokers with cancer and those without (P>0.05).Multivariate Logistic regression analysis showed that gender 〔OR=1.823, 95%CI (1.283, 2.592)〕, age〔35-64 years old: OR=3.610, 95%CI (2.172, 6.001); ≥65 years old: OR=13.760, 95%CI (8.102, 23.367)〕, education (junior college, college degree or above)〔OR=1.846, 95%CI (1.327, 2.568)〕, hypertension〔OR=1.903, 95%CI (1.491, 2.429)〕, stroke〔OR=3.376, 95%CI (1.884, 6.048)〕, COPD〔OR=2.081, 95%CI (1.115, 3.882)〕 were influencing factors of smoking cessation behavior of residents (P<0.05).Conclusion: Residents in the Pearl River Delta of Guangdong Province have a low smoking rate accompanied by a relatively low rate of smoking cessation.Female, 35 years or over, junior college, college degree or above, and certain diseases (hypertension, stroke, COPD) were factors contributing to quitting smoking.Our study suggested an ongoing need for smoking concern and surveillance and strengthening the health education and interventional measures among high-risk subjects.One aim is to achieve the success in early detection and smoking control to prevent smoking-related diseases and improve population health.