title: Stages of change, determinants, and mortality for smoking cessation in adult Taiwanese screenees.
abstract: We aimed to investigate the associations between three smoking-related constructs (pros and cons of smoking, temptation to smoke, and self-efficacy of resisting smoking) and stage of change (precontemplation, contemplation, preparation, and action) based on the transtheoretical model among smokers attending a community-based screening program. We also assessed their effects on long-term all-cause mortality. A prospective cohort study, with an average of 7 years of follow-up, was conducted by enrolling 454 male smoking screenees. The comparisons of the mean score of each variable pertaining to three smoking-related constructs across four stages of smoking cessation were assessed by analysis of variance. The impacts of both smoking-related constructs and smoking cessation stage measured at baseline on 7-year mortality were assessed by using proportional hazards regression model. The differences in the mean scores of pros and cons of smoking, temptation to smoke, and self-efficacy of resisting smoking across four stages of smoking cessation were statistically significant (P < 0.01). The precontemplation group and the contemplation group as opposed to the action group increased the risk for all-cause mortality, but the size of effect was not statistically significant (P = 0.39) when age, duration of smoking, and three smoking- related constructs were controlled. Those with a lower social aspect of self-efficacy were approximately threefold [adjusted hazard ratio = 3.22 (95 % CI 1.26-8.21)] risk for all-cause death compared with those with a higher one. Three smoking-related constructs were highly associated with smoking cessation stage, and low self-efficacy was independently predictive of long-term mortality among male smokers attending a community-based screening program.
authors: Department of Public Health, Chung Shan Medical University, No.110, Sec. 1,Chien-Kuo N. Road, Taichung, 40201, Taiwan, luh@csmu.edu.tw.
authors: Dih-Ling
authors: DL
authors: Luh
authors: Hsiu-Hsi
authors: HH
authors: Chen
authors: Long-Ren
authors: LR
authors: Liao
authors: Sam Li-Sheng
authors: SL
authors: Chen
authors: Amy Ming-Fang
authors: AM
authors: Yen
authors: Ting-Ting
authors: TT
authors: Wang
authors: Sherry Yueh-Hsia
authors: SY
authors: Chiu
authors: Ching-Yuan
authors: CY
authors: Fann
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011446:Prospective Studies; D016540:Smoking Cessation / Q000523:psychology*; D013624:Taiwan