title: Urban Chinese smokers from lower socioeconomic backgrounds face more barriers to quitting: results from the international tobacco control-China survey.
abstract: BACKGROUND
  Research findings on social disparities in barriers to quitting faced by smokers from mainly Western English-language countries may or may not generalize to smokers in China. This paper sought to determine whether nicotine dependence, quitting self-efficacy, quitting interest differ by socio-economic status (SES), and whether they mediate the relationship between SES and quitting behavior of urban Chinese smokers.
  
  
  METHODS
  Data come from 7,309 adult smokers who participated in the first 3 waves of the International Tobacco Control-China survey conducted in 7 cities across China. The association of socio-economic indicators with nicotine dependence, quitting self-efficacy, quitting interest, and behavior was evaluated using generalized estimating equations models along with a formal test of mediational effects.
  
  
  RESULTS
  The SES index indicated that those from lower SES were significantly more addicted (p < .001), less confident (p < .001), and less interested in quitting (p < .05). This finding was replicated by education and employment status, but it was not clearly related to income. Mediational analyses revealed that the effects of SES on making quit attempts and quit success among those who tried were indirect. For quit attempts, self-efficacy, interest to quit, and heaviness of smoking index (HSI) were all significant mediators of the SES effect (p < .001), but for maintenance, only HSI was a significant mediator (p < .001).
  
  
  CONCLUSIONS
  Urban Chinese smokers from lower socio- economic backgrounds experience greater levels of psychological and behavioral barriers to quitting than their counterparts from higher socio-economic backgrounds and as such, they need more help to quit and do so successfully.
authors.affiliation: VicHealth Centre for Tobacco Control, The Cancer Council Victoria, Carlton, VIC, Australia. hua.yong@cancervic.org.au
authors.forename: Hua-Hie
authors.initials: HH
authors.lastname: Yong
authors.forename: Mohammad
authors.initials: M
authors.lastname: Siahpush
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
authors.forename: Jilan
authors.initials: J
authors.lastname: Yang
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fong
authors.forename: Jiang
authors.initials: J
authors.lastname: Yuan
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D020377:Self Efficacy; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control*; D014504:Urban Health; D055815:Young Adult