Motivation for Cessation of Smoking and Its Associated Factors Among Patients Who Smoke Admitted to A Tertiary Hospital in North Kerala
Science Journal of Public Health
Volume 5, Issue 1, January 2017, Pages: 35-40
Received: Nov. 21, 2016;
Accepted: Dec. 6, 2016;
Published: Jan. 12, 2017
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Usha Karunakaran, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, India
Binoo Divakaran, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, India
Suma Harindramohan, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, India
Ganesh Mallar, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, India
Jayasree Anandabhavan Kumaran, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, India
Use of tobacco is associated with significant morbidity and mortality globally. It is one of the leading risk factors of several diseases including cardiovascular pulmonary diseases and cancers. Stopping smoking has immediate and major health benefits. A major opportunity to promote health and well being exists in hospitals when smokers get admitted as patients. Doctors and paramedical staff have the authoritative power to ask patients to stop smoking. Thus this study was conducted to find out the percentage of smoker patients who were motivated by doctors to quit smoking. In addition the socio demographic characteristics and smoking habits were studied and also factors that were associated with attitude for quitting smoking were assessed. A hospital based cross sectional study with quantitative method of data collection was done among patients who are smokers admitted to this hospital for smoking related diseases like coronary vascular disease (CVD), lung and any other diseases apparently not related to smoking. Quantitative data was collected through face to face interview using a pre tested questionnaire. Analysis was done with descriptive statistics and chi square using epi info. Out of 179 patients who participated 177 were males. The mean age of patients was 54.8 with a standard deviation of 14.6 years. More than 85% belonged to the lower and lower middle class. More than 50% of patients smoked cigarettes. The mean age of initiation of smoking was 16 years and peer pressure was the most common reason for initiation. In this study 64% of the total smoker patients were motivated by doctors to quit smoking while only 26% of smoker patients admitted for non related diseases were motivated by doctors Brief advice by doctors and the smoking related diseases namely lung and CVD’s were factors associated with motivation to stop smoking while social class was not associated with motivation for cessation. Simply addressing the topic of smoking is a crucial first step in a medical consultation. Patients with tobacco-related complaints should be told that their problem is related to tobacco use and they should consider quitting. With patients who do not have tobacco related diseases the subject of tobacco usage will have to be addressed in a general way. Introducing the smoking topic can initiate a structured intervention tailored to the patient's needs.
Jayasree Anandabhavan Kumaran,
Motivation for Cessation of Smoking and Its Associated Factors Among Patients Who Smoke Admitted to A Tertiary Hospital in North Kerala, Science Journal of Public Health.
Vol. 5, No. 1,
2017, pp. 35-40.
Report On The Global Tobacco Epidemic 2008, The MPOWER Package, World Health Organization.
K Srinath Reddy, Prakash C Gupta Editors, Report on Tobacco Control in India, Ministry Of Health and Family Welfare, CDC –USA, WHO, 2004.
(IIPS), Mumbai and Ministry of Health and Family welfare, GOI, New Delhi; 2010.
Jha P, Jacob B, Gajalakshmi V, Gupta PC, Dhingra N, Kumar R, et al. A nationally representative case-control study of smoking and death in India. N Engl J Med. 2008; 358:1137-4.
Tobacco fact sheet, World Health Organization June 2016.
Kishore Chaudhry, Tobacco Control in India,50 Years of Cancer Control in India, SP Agarwal Editor, Ministry Of Health and Family Welfare, Nov 2002.
Encouraging people to stop smoking. Department of Mental health and substance dependence. World Health Organization, 2001.
Helping Patients stop – The Role of Hospitals in Smoking Cessation. Conference Report, Action on Smoking and Health, Wales, Cardiff, March 2002.
John R Hughes, Motivating and helping smokers to stop smoking. J Gen Intern Med. 2003 Dec; 18(12): 1053–1057.
The World Bank, Smoking prevalence, males (% of adults), WHO, Global Health Observatory Data Repository.2000.
Glossary of terms used in the Tobacco Atlas, http://www.who.int/tobacco/en/atlas42.pdf.
National Health Interview Survey, National Centre for Health Statistics, CDC 24X 7 saving lives, protecting people. 2009.
Sarasota Demonstration Project, USF Tobacco Strategy Workbook – USF Health, Florida Prevention Research Center. Available from:http://health.usf.edu/nocms/publichealth/cbpm/tobacco_workbook.pdf.
M Rani, S Bonu, P Jha, SN Nguyen, L Jamjoum. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey; Tobacco Control. 2003; 12:e4.
Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D'Souza GA, Gupta D et al; Asthma Epidemiology Study Group. Tobacco smoking in India: prevalence, quit-rates and respiratory morbidity. Indian J Chest Dis Allied Sci. 2006 Jan-Mar; 48 (1):37-42.
A Ghosh. Modification of Kuppuswamy’s socioeconomic status scale in context to Nepal: Indian Paediatrics, Vol 46, Dec 17, 2009: 1104-1105.
Current Cigarette Smoking Among Adults in the United States; Centers for Disease Control and Prevention, 2014.
Global Adult Tobacco Survey (GATS), Fact sheet, India 2009–2010.
Cheangaivendan Chezhian, Shruti Murthy, Satish Prasad, Jyoti Bala Kasav, Surapaneni Krishna Mohan, Sangeeta Sharma et al. Exploring Factors that Influence Smoking Initiation and Cessation among Current Smokers J Clin Diagn Res. 2015 May; 9(5): LC08–LC12.
Mythily Subramaniam, Shazana Shahwan, Restria Fauziana, Pratika Satghare, Louisa Picco, Janhavi Ajit Vaingankar et al. Perspectives on Smoking Initiation and Maintenance: A Qualitative Exploration among Singapore Youth, Int. J. Environ. Res. Public Health 2015, 12(8), 8956-8970.
Raj Narain, Sarita Sardana, Sanjay Gupta, Ashok Sehgal. Age at initiation & prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey: Indian J Med Res. 2011 Mar; 133(3): 300–307.
Bhat VM, Cole JW, Sorkin JD, Wozniak MA, Malarcher AM, Giles WH et al. Dose-response relationship between cigarette smoking and risk of ischemic stroke in young women. Stroke. 2008 Sep; 39(9):2439-43.
Smoking, the heart and circulation, Action on smoking health – Fact sheet: The Information Standard, Nov 2013.
Tobacco: totally avoidable risk factor of CVD, World Heart Federation, 2016.
Staying tobacco free, Partnership for a free tobacco Maine, Partnership for a Tobacco-Free Maine, Maine CDC, Maine Department of Health and Human Services, 2016.
Rajmohan Panda, Divya Persai, Sudhir Venkatesan, Missed opportunities for brief intervention in tobacco control in primary care: patients’ perspectives from primary health care settings in India: BMC Health Serv Res. 2015; 15: 50.
General Practice and Ethics: Uncertainity and Responsibility, Editors - Christopher Dowrick, Lucy Frith, London, Routledge, 1999.
Raj Kumar, Suraj Prakash, Alka Singh Khushwah, Harsh Kumar, Smoking cessation – control measures, Lung India,2005; 22(2): 68-73.
Allan. V. Prochazka, Edward. J.Boyko, How physicians can help their patients quit smoking- A practical guide, West J Med 1988 Aug; 149: 188-194.
Helping people quit tobacco, A manual for doctors and dentists, WHO, Regional office for South East Asia; 2010.
Abu. S. Abdullah, Frances. A. Stillman et al, Tobacco use and smoking cessation practices among physicians in developing countries: A literature review (1987-2010). Int. J Environ Res Public Health, v 11(1).
Donald T Fredrickson, Helping smokers quit: The Physicians Role. CA: A cancer journal for Physicians, Vol 26, Issue 4, Version of record online; 31 Dec 2008.
Toolkit for delivering the 5A’s and 5R’s brief tobacco interventions to TB patients in primary care, World Health Organization, 2014.