Korean Journal of Health Promotion

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

Original Article

Published online: January 19, 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 Lee^1,², 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 March 27, 2017 Accepted July 13, 2017

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.

Key words: Smoking cessation; Intention; Community health planning; Diabetes mellitus

Table 1.

Smoking cessation intention of study population according to general characteristics

	N	Smoking cessation intention		P
Never or someday (row %)	N	Within 6 months (row %)	P	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
Others^a	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

^aJob 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
	N	Never or someday (row %)	Within 6 months (row %)	P
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

^a27 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)
Others^a	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).

^aJob soldier, student · repeat student, housewife, unemployed.

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