Article(id=1240730056956375936, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410102, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1728489600000, receivedDateStr=2024-10-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773742697228, onlineDateStr=2026-03-17, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773742697228, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773742697228, creator=13701087609, updateTime=1773742697228, updator=13701087609, issue=Issue{id=1240730050669113883, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='8', pageStart='1345', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773742695728, creator=13701087609, updateTime=1773742807836, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240730520988995837, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240730520988995838, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1455, endPage=1460, ext={EN=ArticleExt(id=1240730057270948755, articleId=1240730056956375936, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A study on the influence of individual cognition and spousal support on smoking cessation behavior among married smokers: focusing on gender differences, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effects of individual smoking cessation cognition and spousal support on married smokers’ smoking cessation behavior, and to analyse the role of gender differences on smoking cessation behavior.

Methods

A convenience sampling method was used to recruit married smokers from Jiangsu and Shandong to conduct an online questionnaire survey to collect information on demographic characteristics, smoking and cessation, individual smoking cessation cognition and spousal support. Binary logistic regression was used to analyse the relationships between smoking cessation cognition, spousal support, smoking cessation attempts, and the willingness to quit smoking with family support.

Results

715 married smokers completed the questionnaire. After controlling for potential confounders, the results showed that perceived risk of smoking-related diseases (aOR=1.29, 95% CI: 1.05–1.59) and positive outcome expectations for quitting (aOR=1.27, 95% CI: 1.06–1.51) were positively associated with smoking cessation attempts among married male smokers, whereas no statistical associationwas found between smoking cessation cognition and smoking cessation attempts among women. Regardless of gender, perceived risk of smoking-related diseases, self-efficacy, smoking cessation plan, and spousal emotional support were positively associated with the willingness to quit smoking; negative outcome expectations for quitting (aOR=0.78, 95% CI: 0.65–0.93) were negatively associated with the willingness to quit smoking among male smokers, while no statistically significant associationwas found among female smokers.

Conclusion

Perceived risk of smoking-related diseases and positive outcome expectations for quitting are protective factors for smoking cessation attempts among married male smokers, while female smokers’ smoking cessation cognition failed to translate into actual quitting behavior. Additionally, negative outcome expectations for quitting are risk factors for willingness to quit smoking among married male smokers. Therefore, individualized smoking cessation intervention strategies should be developed taking into account gender differences.

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目的

探讨个体戒烟认知和配偶支持对已婚吸烟者戒烟行为的影响,分析性别差异对戒烟行为的作用。

方法

采用方便抽样法,从江苏和山东招募已婚吸烟者进行线上问卷调查,收集人口学特征、吸烟与戒烟情况、个体戒烟认知及配偶支持等信息。采用二元logistic回归分析戒烟认知、配偶支持与戒烟尝试及家人支持下的戒烟意愿的关系。

结果

715名已婚吸烟者完成问卷调查。控制潜在混杂因素后,结果显示男性已婚吸烟者的吸烟相关疾病风险感知(aOR=1.29,95% CI:1.05~1.59)和戒烟积极结果预期(aOR=1.27,95% CI:1.06~1.51)与戒烟尝试呈正相关,而女性的戒烟认知与戒烟尝试未见统计学关联。无论性别,吸烟相关疾病风险感知、自我效能感、戒烟计划及配偶情感支持与戒烟意愿均呈正相关;戒烟消极结果预期(aOR=0.78,95% CI:0.65~0.93)与男性吸烟者的戒烟意愿呈负相关,但与女性的戒烟意愿未见统计学关联。

结论

吸烟相关疾病风险感知和戒烟积极结果预期是男性已婚吸烟者戒烟尝试的保护因素,而女性吸烟者的戒烟认知未转化为实际戒烟行为。此外,戒烟消极结果预期是男性已婚吸烟者戒烟意愿的危险因素。因此,应结合性别差异制定个性化戒烟干预策略。

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曹望楠,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=JZtY6JhwR/5rAsQf9SCtRw==, magXml=G3YuD/byS4KwUtvfZLuGyg==, pdfUrl=null, pdf=+sfcv3yHiANz2ozp7+dQHg==, pdfFileSize=711134, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=t26qNxGwLT5FaUL2wewdYw==, mapNumber=null, authorCompany=null, fund=null, authors=

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Financial incentives for smoking cessation: status of the field and related theories[J]. Chinese Journal of Health Education, 2024, 40(1): 61-67. (In Chinese), articleTitle=Financial incentives for smoking cessation: status of the field and related theories, refAbstract=null), Reference(id=1241070730448785603, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, doi=null, pmid=null, pmcid=null, year=2017, volume=20, issue=1, pageStart=100, pageEnd=107, url=null, language=null, rfNumber=[24], rfOrder=30, authorNames=Lüscher J, Stadler G, Scholz U, journalName=Nicotine & Tobacco Research, refType=null, unstructuredReference=Lüscher J, Stadler G, Scholz U. A daily diary study of joint quit attempts by Dual-Smoker couples: the role of received and provided social support[J]. Nicotine & Tobacco Research, 2017, 20(1): 100-107., articleTitle=A daily diary study of joint quit attempts by Dual-Smoker couples: the role of received and provided social support, refAbstract=null), Reference(id=1241070730553643210, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, doi=null, pmid=null, pmcid=null, year=2019, volume=16, issue=16, pageStart=2831, pageEnd=null, url=null, language=null, rfNumber=[25], rfOrder=31, authorNames=Van den brand FA, Nagtzaam P, Nagelhout GE, journalName=International Journal of Environmental Research and Public Health, refType=null, unstructuredReference=Van den brand FA, Nagtzaam P, Nagelhout GE, et al. The association of peer smoking behavior and social support with quit success in employees who participated in a smoking cessation intervention at the workplace[J]. International Journal of Environmental Research and Public Health, 2019, 16(16): 2831., articleTitle=The association of peer smoking behavior and social support with quit success in employees who participated in a smoking cessation intervention at the workplace, refAbstract=null)], funds=[Fund(id=1241070725818274771, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, awardId=82173637, language=CN, fundingSource=国家自然科学基金面上项目(82173637), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241070720596366052, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, xref=1., ext=[AuthorCompanyExt(id=1241070720604754662, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, companyId=1241070720596366052, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Peking University School of Public Health, Beijing 100191, China), AuthorCompanyExt(id=1241070720613143271, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, companyId=1241070720596366052, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.北京大学医学部公共卫生学院,北京 100191)]), AuthorCompany(id=1241070720697029355, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, xref=2., ext=[AuthorCompanyExt(id=1241070720701223660, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, companyId=1241070720697029355, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.淄博市临淄区疾病预防控制中心慢性病预防控制科)]), AuthorCompany(id=1241070720793498351, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, xref=3., ext=[AuthorCompanyExt(id=1241070720806081264, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, companyId=1241070720793498351, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.北京大学全球健康发展研究院)])], figs=[ArticleFig(id=1241070724853584775, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=EN, label=Table 1, caption=

Basic characteristics of married smokers (n=715)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量合计n(%)男性n(%)女性n(%)χ2P
年龄(岁)10.7380.005
18~29 91(12.7) 65(11.7) 26(16.3)
30~44408(57.1)306(55.1)102(63.7)
≥45216(30.2)184(33.2) 32(20.0)
文化程度4.0780.253
初中及以下75(10.5)63(11.4)12(7.5)
高中/中专84(11.7)64(11.5)20(12.5)
本科/大专493(69.0)375(67.6)118(73.8)
研究生及以上63(8.8)53(9.5)10(6.3)
月平均收入(元)5.2850.152
<3 00058(8.1)41(7.4)17(10.6)
3 000~5 999231(32.3)172(31.0)59(36.9)
6 000~8 999201(28.1)158(28.5)43(26.9)
≥9 000225(31.5)184(33.2)41(25.6)
烟草依赖程度3.1470.076
轻度488(68.3)388(69.9)100(62.5)
中度及以上227(31.7)167(30.1)60(37.5)
戒烟尝试次数7.916 0.048
0476(66.6)363(65.4)113(70.6)
1132(18.5)98(17.7)34(21.3)
263(8.8)56(10.1)7(4.4)
≥344(6.2)38(6.8)6(3.8)
戒烟尝试方法2.435 0.487
476(66.6)363(65.4)113(70.6)
仅凭毅力125(17.5)98(17.7)27(16.9)
戒烟药物/热线/医护人员咨询44(6.2)35(6.3)9(5.6)
其他方法70(9.8)59(10.6)11(6.9)
最近一次戒烟距现在(年)6.547 0.088
无戒烟476(66.6)363(65.4)113(70.6)
<158(8.1)42(7.6)16(10.0)
1~4123(17.2)98(17.7)25(15.6)
≥558(8.1)52(9.4)6(3.8)
家人支持下的戒烟意愿17.601<0.001
147(20.6)133(24.0)14(8.8)
568(79.4)422(76.0)146(91.3)
), ArticleFig(id=1241070724937470868, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=CN, label=表1, caption=

已婚吸烟者基本特征(n=715)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量合计n(%)男性n(%)女性n(%)χ2P
年龄(岁)10.7380.005
18~29 91(12.7) 65(11.7) 26(16.3)
30~44408(57.1)306(55.1)102(63.7)
≥45216(30.2)184(33.2) 32(20.0)
文化程度4.0780.253
初中及以下75(10.5)63(11.4)12(7.5)
高中/中专84(11.7)64(11.5)20(12.5)
本科/大专493(69.0)375(67.6)118(73.8)
研究生及以上63(8.8)53(9.5)10(6.3)
月平均收入(元)5.2850.152
<3 00058(8.1)41(7.4)17(10.6)
3 000~5 999231(32.3)172(31.0)59(36.9)
6 000~8 999201(28.1)158(28.5)43(26.9)
≥9 000225(31.5)184(33.2)41(25.6)
烟草依赖程度3.1470.076
轻度488(68.3)388(69.9)100(62.5)
中度及以上227(31.7)167(30.1)60(37.5)
戒烟尝试次数7.916 0.048
0476(66.6)363(65.4)113(70.6)
1132(18.5)98(17.7)34(21.3)
263(8.8)56(10.1)7(4.4)
≥344(6.2)38(6.8)6(3.8)
戒烟尝试方法2.435 0.487
476(66.6)363(65.4)113(70.6)
仅凭毅力125(17.5)98(17.7)27(16.9)
戒烟药物/热线/医护人员咨询44(6.2)35(6.3)9(5.6)
其他方法70(9.8)59(10.6)11(6.9)
最近一次戒烟距现在(年)6.547 0.088
无戒烟476(66.6)363(65.4)113(70.6)
<158(8.1)42(7.6)16(10.0)
1~4123(17.2)98(17.7)25(15.6)
≥558(8.1)52(9.4)6(3.8)
家人支持下的戒烟意愿17.601<0.001
147(20.6)133(24.0)14(8.8)
568(79.4)422(76.0)146(91.3)
), ArticleFig(id=1241070725025551259, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=EN, label=Table 2, caption=

Individual smoking cessation cognition and spousal support among married smokers

, figureFileSmall=null, figureFileBig=null, tableContent=
类型特征[得分,M(Q1,Q3)]合计(n=715)男性(n=555)女性(n=160)P
个体戒烟认知吸烟相关疾病风险感知5.0(3.8,5.0)4.7(3.8,5.0)5.0(4.0,5.0)0.001
戒烟积极结果预期4.3(3.7,5.0)4.3(3.7,5.0)5.0(3.4,5.0)0.011
戒烟消极结果预期3.0(2.0,3.7)3.0(2.0,3.7)2.3(1.0,3.7)<0.001
启动戒烟自我效能4.0(3.0,5.0)3.7(3.0,4.7)4.8(3.0,5.0)<0.001
维持戒烟自我效能4.0(3.0,5.0)3.7(3.0,4.7)4.5(3.0,5.0)<0.001
恢复戒烟自我效能4.0(3.0,5.0)4.0(3.0,5.0)5.0(3.0,5.0)<0.001
启动戒烟行动计划4.0(3.0,5.0)3.0(3.0,4.5)5.0(3.5,5.0)<0.001
维持戒烟行动计划4.0(3.0,5.0)3.3(3.0,4.3)5.0(3.5,5.0)<0.001
配偶支持现状共同居住配偶吸烟(%)<0.001
604(84.5)520(93.7)84(52.5)
111(15.5)35(6.3)76(47.5)
配偶支持
情感支持10.0(6.0,10.0)10.0(7.0,10.0)9.0(5.0,10.0)0.142
物质支持9.0(6.0,10.0)9.0(6.0,10.0)9.0(6.0,10.0)0.922
), ArticleFig(id=1241070725130408868, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=CN, label=表2, caption=

已婚吸烟者个体戒烟认知及配偶支持情况

, figureFileSmall=null, figureFileBig=null, tableContent=
类型特征[得分,M(Q1,Q3)]合计(n=715)男性(n=555)女性(n=160)P
个体戒烟认知吸烟相关疾病风险感知5.0(3.8,5.0)4.7(3.8,5.0)5.0(4.0,5.0)0.001
戒烟积极结果预期4.3(3.7,5.0)4.3(3.7,5.0)5.0(3.4,5.0)0.011
戒烟消极结果预期3.0(2.0,3.7)3.0(2.0,3.7)2.3(1.0,3.7)<0.001
启动戒烟自我效能4.0(3.0,5.0)3.7(3.0,4.7)4.8(3.0,5.0)<0.001
维持戒烟自我效能4.0(3.0,5.0)3.7(3.0,4.7)4.5(3.0,5.0)<0.001
恢复戒烟自我效能4.0(3.0,5.0)4.0(3.0,5.0)5.0(3.0,5.0)<0.001
启动戒烟行动计划4.0(3.0,5.0)3.0(3.0,4.5)5.0(3.5,5.0)<0.001
维持戒烟行动计划4.0(3.0,5.0)3.3(3.0,4.3)5.0(3.5,5.0)<0.001
配偶支持现状共同居住配偶吸烟(%)<0.001
604(84.5)520(93.7)84(52.5)
111(15.5)35(6.3)76(47.5)
配偶支持
情感支持10.0(6.0,10.0)10.0(7.0,10.0)9.0(5.0,10.0)0.142
物质支持9.0(6.0,10.0)9.0(6.0,10.0)9.0(6.0,10.0)0.922
), ArticleFig(id=1241070725222683566, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=EN, label=Table 3, caption=

Analysis of the association between basic characteristics of married smokers and smoking cessation attempts and willingness to quit smoking

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(参照组)戒烟尝试家人支持下的戒烟意愿
男性女性男性女性
年龄(23~29岁)
30~44岁1.00(0.56~1.78)1.08(0.41~2.84)1.37(0.73~2.57)0.41(0.05~3.42)
≥45岁1.66(0.91~3.02)1.42(0.46~4.41)0.71(0.37~1.35)0.28(0.03~2.67)
文化程度(初中及以下)
高中/中专0.80(0.40~1.62)0.86(0.19~3.98)0.78(0.38~1.61)1.80(0.22~14.80)
本科/大专0.64(0.37~1.10)0.84(0.24~2.98)2.10(1.17~3.77)a2.42(0.46~12.78)
研究生及以上0.37(0.16~0.83)a0.50(0.07~3.55)1.27(0.57~2.80)1.80(0.14~23.37)
月平均收入(<3 000岁)
3 000~5 999岁1.01(0.49~2.07)0.75(0.22~2.49)1.10(0.51~2.38)0.68(0.07~6.21)
6 000~8 999岁1.09(0.53~2.24)1.16(0.34~3.94)1.34(0.61~2.94)0.39(0.04~3.47)
≥9 000岁0.98(0.48~2.00)1.24(0.37~4.24)1.13(0.53~2.44)1.22(0.10~14.41)
), ArticleFig(id=1241070725331735481, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=CN, label=表3, caption=

已婚吸烟者基本特征与戒烟尝试及戒烟意愿的关联性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(参照组)戒烟尝试家人支持下的戒烟意愿
男性女性男性女性
年龄(23~29岁)
30~44岁1.00(0.56~1.78)1.08(0.41~2.84)1.37(0.73~2.57)0.41(0.05~3.42)
≥45岁1.66(0.91~3.02)1.42(0.46~4.41)0.71(0.37~1.35)0.28(0.03~2.67)
文化程度(初中及以下)
高中/中专0.80(0.40~1.62)0.86(0.19~3.98)0.78(0.38~1.61)1.80(0.22~14.80)
本科/大专0.64(0.37~1.10)0.84(0.24~2.98)2.10(1.17~3.77)a2.42(0.46~12.78)
研究生及以上0.37(0.16~0.83)a0.50(0.07~3.55)1.27(0.57~2.80)1.80(0.14~23.37)
月平均收入(<3 000岁)
3 000~5 999岁1.01(0.49~2.07)0.75(0.22~2.49)1.10(0.51~2.38)0.68(0.07~6.21)
6 000~8 999岁1.09(0.53~2.24)1.16(0.34~3.94)1.34(0.61~2.94)0.39(0.04~3.47)
≥9 000岁0.98(0.48~2.00)1.24(0.37~4.24)1.13(0.53~2.44)1.22(0.10~14.41)
), ArticleFig(id=1241070725419815871, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=EN, label=Table 4, caption=

Analysis of the association between smoking cessation cognition, spousal support, and smoking cessation attempts and willingness to quit smoking among married smokers

, figureFileSmall=null, figureFileBig=null, tableContent=
变型变量戒烟尝试家人支持下的戒烟意愿
男性女性男性女性
个体戒烟认知吸烟相关疾病风险感知1.29(1.05~1.59)a0.98(0.70~1.38)1.81(1.47~2.23)c2.55(1.64~3.97)c
戒烟积极结果预期1.27(1.06~1.51)b0.97(0.76~1.23)1.31(1.10~1.56)b1.38(0.98~1.95)
戒烟消极结果预期1.01(0.87~1.19)0.92(0.73~1.18)0.78(0.65~0.93)b0.89(0.61~1.31)
启动戒烟自我效能1.02(0.86~1.21)1.08(0.79~1.47)1.85(1.50~2.28)c1.95(1.26~3.00)b
维持戒烟自我效能1.01(0.84~1.20)1.05(0.77~1.45)1.94(1.56~2.42)c2.01(1.27~3.17)b
恢复戒烟自我效能1.06(0.89~1.27)1.07(0.78~1.46)2.12(1.70~2.65)c1.94(1.24~3.03)b
启动戒烟行动计划1.04(0.88~1.23)0.99(0.72~1.36)2.07(1.67~2.55)c1.99(1.28~3.10)b
维持戒烟行动计划1.00(0.84~1.19)0.94(0.67~1.31)2.09(1.68~2.60)c2.16(1.34~3.48)b
配偶支持现状共同居住配偶吸烟
1.001.001.001.00
0.68(0.31~1.49)1.95(0.97~3.93)0.54(0.26~1.14)1.72(0.54~5.44)
配偶支持
情感支持1.05(0.98~1.12)1.02(0.91~1.14)1.08(1.01~1.16)a1.26(1.07~1.49)b
物质支持1.04(0.98~1.11)1.00(0.89~1.13)1.05(0.98~1.13)1.07(0.90~1.28)
), ArticleFig(id=1241070725558227913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056956375936, language=CN, label=表4, caption=

已婚吸烟者戒烟认知和配偶支持与戒烟尝试及戒烟意愿的关联性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变型变量戒烟尝试家人支持下的戒烟意愿
男性女性男性女性
个体戒烟认知吸烟相关疾病风险感知1.29(1.05~1.59)a0.98(0.70~1.38)1.81(1.47~2.23)c2.55(1.64~3.97)c
戒烟积极结果预期1.27(1.06~1.51)b0.97(0.76~1.23)1.31(1.10~1.56)b1.38(0.98~1.95)
戒烟消极结果预期1.01(0.87~1.19)0.92(0.73~1.18)0.78(0.65~0.93)b0.89(0.61~1.31)
启动戒烟自我效能1.02(0.86~1.21)1.08(0.79~1.47)1.85(1.50~2.28)c1.95(1.26~3.00)b
维持戒烟自我效能1.01(0.84~1.20)1.05(0.77~1.45)1.94(1.56~2.42)c2.01(1.27~3.17)b
恢复戒烟自我效能1.06(0.89~1.27)1.07(0.78~1.46)2.12(1.70~2.65)c1.94(1.24~3.03)b
启动戒烟行动计划1.04(0.88~1.23)0.99(0.72~1.36)2.07(1.67~2.55)c1.99(1.28~3.10)b
维持戒烟行动计划1.00(0.84~1.19)0.94(0.67~1.31)2.09(1.68~2.60)c2.16(1.34~3.48)b
配偶支持现状共同居住配偶吸烟
1.001.001.001.00
0.68(0.31~1.49)1.95(0.97~3.93)0.54(0.26~1.14)1.72(0.54~5.44)
配偶支持
情感支持1.05(0.98~1.12)1.02(0.91~1.14)1.08(1.01~1.16)a1.26(1.07~1.49)b
物质支持1.04(0.98~1.11)1.00(0.89~1.13)1.05(0.98~1.13)1.07(0.90~1.28)
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个体认知和配偶支持对已婚吸烟者戒烟行为的性别差异研究
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张城倩 1, 2 , 张蓝超 1 , 林浩 1 , 林昊翔 3 , 曹望楠 1 , 常春 1
现代预防医学 | 健康与社会行为 2025,52(8): 1455-1460
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现代预防医学 | 健康与社会行为 2025, 52(8): 1455-1460
个体认知和配偶支持对已婚吸烟者戒烟行为的性别差异研究
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张城倩1, 2, 张蓝超1, 林浩1, 林昊翔3, 曹望楠1 , 常春1
作者信息
  • 1.北京大学医学部公共卫生学院,北京 100191
  • 2.淄博市临淄区疾病预防控制中心慢性病预防控制科
  • 3.北京大学全球健康发展研究院
  • 张城倩(1990—),女,硕士在读,主管医师,研究方向:健康教育与健康促进、慢性非传染性疾病预防控制

通讯作者:

曹望楠,E-mail:
A study on the influence of individual cognition and spousal support on smoking cessation behavior among married smokers: focusing on gender differences
Cheng-qian ZHANG1, 2, Lan-chao ZHANG1, Hao LIN1, Hao-xiang LIN3, Wang-nan CAO1 , Chun CHANG1
Affiliations
  • Peking University School of Public Health, Beijing 100191, China
出版时间: 2025-04-25 doi: 10.20043/j.cnki.MPM.202410102
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目的

探讨个体戒烟认知和配偶支持对已婚吸烟者戒烟行为的影响,分析性别差异对戒烟行为的作用。

方法

采用方便抽样法,从江苏和山东招募已婚吸烟者进行线上问卷调查,收集人口学特征、吸烟与戒烟情况、个体戒烟认知及配偶支持等信息。采用二元logistic回归分析戒烟认知、配偶支持与戒烟尝试及家人支持下的戒烟意愿的关系。

结果

715名已婚吸烟者完成问卷调查。控制潜在混杂因素后,结果显示男性已婚吸烟者的吸烟相关疾病风险感知(aOR=1.29,95% CI:1.05~1.59)和戒烟积极结果预期(aOR=1.27,95% CI:1.06~1.51)与戒烟尝试呈正相关,而女性的戒烟认知与戒烟尝试未见统计学关联。无论性别,吸烟相关疾病风险感知、自我效能感、戒烟计划及配偶情感支持与戒烟意愿均呈正相关;戒烟消极结果预期(aOR=0.78,95% CI:0.65~0.93)与男性吸烟者的戒烟意愿呈负相关,但与女性的戒烟意愿未见统计学关联。

结论

吸烟相关疾病风险感知和戒烟积极结果预期是男性已婚吸烟者戒烟尝试的保护因素,而女性吸烟者的戒烟认知未转化为实际戒烟行为。此外,戒烟消极结果预期是男性已婚吸烟者戒烟意愿的危险因素。因此,应结合性别差异制定个性化戒烟干预策略。

吸烟  /  戒烟尝试  /  戒烟意愿  /  配偶支持
Objective

To explore the effects of individual smoking cessation cognition and spousal support on married smokers’ smoking cessation behavior, and to analyse the role of gender differences on smoking cessation behavior.

Methods

A convenience sampling method was used to recruit married smokers from Jiangsu and Shandong to conduct an online questionnaire survey to collect information on demographic characteristics, smoking and cessation, individual smoking cessation cognition and spousal support. Binary logistic regression was used to analyse the relationships between smoking cessation cognition, spousal support, smoking cessation attempts, and the willingness to quit smoking with family support.

Results

715 married smokers completed the questionnaire. After controlling for potential confounders, the results showed that perceived risk of smoking-related diseases (aOR=1.29, 95% CI: 1.05–1.59) and positive outcome expectations for quitting (aOR=1.27, 95% CI: 1.06–1.51) were positively associated with smoking cessation attempts among married male smokers, whereas no statistical associationwas found between smoking cessation cognition and smoking cessation attempts among women. Regardless of gender, perceived risk of smoking-related diseases, self-efficacy, smoking cessation plan, and spousal emotional support were positively associated with the willingness to quit smoking; negative outcome expectations for quitting (aOR=0.78, 95% CI: 0.65–0.93) were negatively associated with the willingness to quit smoking among male smokers, while no statistically significant associationwas found among female smokers.

Conclusion

Perceived risk of smoking-related diseases and positive outcome expectations for quitting are protective factors for smoking cessation attempts among married male smokers, while female smokers’ smoking cessation cognition failed to translate into actual quitting behavior. Additionally, negative outcome expectations for quitting are risk factors for willingness to quit smoking among married male smokers. Therefore, individualized smoking cessation intervention strategies should be developed taking into account gender differences.

Smoking  /  Smoking cessation attempts  /  Willingness to quit smoking  /  Spousal support
张城倩, 张蓝超, 林浩, 林昊翔, 曹望楠, 常春. 个体认知和配偶支持对已婚吸烟者戒烟行为的性别差异研究. 现代预防医学, 2025 , 52 (8) : 1455 -1460 . DOI: 10.20043/j.cnki.MPM.202410102
Cheng-qian ZHANG, Lan-chao ZHANG, Hao LIN, Hao-xiang LIN, Wang-nan CAO, Chun CHANG. A study on the influence of individual cognition and spousal support on smoking cessation behavior among married smokers: focusing on gender differences[J]. Modern Preventive Medicine, 2025 , 52 (8) : 1455 -1460 . DOI: 10.20043/j.cnki.MPM.202410102
烟草使用是全球重大公共卫生问题,每年导致800多万人死亡。我国是世界最大的烟草生产国和消费国,吸烟人数超过3亿,每年因烟草相关疾病死亡超过100万[1]。烟草使用导致的疾病病程复杂,治疗周期长且费用高昂,给国家造成了严重的疾病负担,因此,鼓励和帮助吸烟者戒烟是减少烟草相关疾病发病率、死亡率和医疗支出最快捷的方法[2]。研究表明,较强的戒烟意愿和有过戒烟尝试都是成功戒烟的前提[3]。然而,相比其他中、高等收入国家,我国吸烟者的戒烟意愿和戒烟尝试比例普遍偏低[3-4]
既往研究发现,配偶吸烟状况显著影响个体的戒烟行为[5-6]。具体而言,配偶吸烟的个体尝试戒烟和成功戒烟的可能性较低,而当一方成功戒烟时,另一方尝试戒烟的可能性会显著增加;相反,配偶不吸烟的个体在戒烟过程中更容易获得成功。影响配偶间出现这种相似健康行为的一个重要因素是配偶支持[7]。在中国文化背景下,男性倾向于将配偶视为主要的社会支持来源,而女性则更可能依赖朋友和其他家人的支持[8]。此外,男性戒烟行为较易受配偶积极支持的影响,而女性获得的配偶支持通常较少,这可能与社会对女性吸烟的负面认知、男性对女性戒烟关注度较低等因素有关[9-10]。因此,在研究配偶关系中社会支持对戒烟行为的影响时,需要考虑性别差异。
个体戒烟认知水平同样对戒烟意愿及戒烟行为有显著影响[11]。本研究基于健康行动过程取向理论(health action process approach,HAPA),测量吸烟者在戒烟各阶段的行为变化,评估其戒烟认知水平。目前国内关于社会支持对戒烟的研究较多,但针对个体戒烟认知及配偶支持在戒烟过程中的作用,尤其是性别差异方面的研究仍较为匮乏。因此,本研究旨在为制定针对性的戒烟干预措施及政策提供参考依据,以满足不同性别吸烟者的个性化需求。
采用方便抽样法,于2022年7月在江苏和山东通过广告和推荐招募已婚现在吸烟者作为调查对象。纳入标准:①年龄≥18岁;②在过去一周内至少吸过一支烟;③自愿参加本研究。排除标准:①存在严重脏器功能衰竭者;②被诊断为精神疾病患者或吸毒者;③孕期或哺乳期女性吸烟者。根据横断面调查样本量估算公式,设定戒烟尝试率p为23.7%[12],双侧检验显著性水平α取0.05,容许误差d取0.15p,并考虑20%无应答率,所需样本量应为660例。本研究由北京大学医学部伦理委员会批准(编号:IRB00001052-18055),并已取得所有调查对象的知情同意。
采用自行设计的调查问卷,通过问卷星平台以自填问卷形式完成调查。问卷设计包含逻辑跳转、必答项设置、前后填答矛盾提醒及注意力测试题目,并通过一致性检测和数据清理剔除无效问卷,确保数据质量。问卷平均填写时间为9.1分钟(标准差6.6分钟)。
①人口学特征(性别、年龄、文化程度、月平均收入等);②吸烟与戒烟现状(烟草依赖程度、有无戒烟尝试、戒烟尝试次数及方法、家人支持下的戒烟意愿等);③个体戒烟认知;④配偶支持现状(配偶吸烟状况、情感支持与物质支持)。
烟草依赖程度参照《中国临床戒烟指南》(2015年版)中的《烟草依赖评估量表》评估,0~3分为轻度,4~6分为中度,≥7分为重度[13]。戒烟尝试通过“您曾尝试过戒烟吗?①否②是”评估,选择“是”代表尝试过戒烟,并进一步填写戒烟尝试次数等。家人支持下的戒烟意愿通过“如果我的家人包括孩子想让我戒烟,您是否会考虑戒烟?①考虑戒烟②不考虑戒烟”评估,选择“考虑戒烟”者视为具备戒烟意愿。
个体戒烟认知是基于HAPA理论的戒烟评估量表[11],包括8个维度共26个条目,即吸烟相关疾病风险感知,戒烟积极结果预期、戒烟消极结果预期,启动、维持及恢复戒烟自我效能,启动及维持戒烟行动计划。量表采用Likert5级评分(1=非常不同意,5=非常同意),得分越高表示认同程度越高。信度分析显示Cronbach α为0.924~0.987;效度分析显示数据适合因子分析(KMO=0.951,Bartlett球形检验P<0.001),共提取四个因子,累计方差解释率为86.75%。
配偶支持包括情感支持和物质支持,评分范围为0~10分(0=完全没有,10=非常多),得分越高表示配偶支持水平越高。
从问卷星系统导出数据并清洗后,使用SPSS 26.0进行统计分析。连续变量不符合正态分布采用MQ1,Q3)描述,组间差异采用Mann-Whitney U检验;计数资料以例数和构成比表示,组间差异采用χ2检验。分别以是否有过戒烟尝试、有无家人支持下的戒烟意愿为因变量,对人口学特征、烟草依赖程度、戒烟相关认知及配偶支持等进行单因素logistic回归分析,计算ORu单因素比值比(univariate odds ratio,ORu)和95%置信区间(confidence interval, CI)。控制具有统计学关联的人口学特征等潜在混杂因素后,计算aOR调整后的比值比(adjusted odds ratio,aOR)和95% CI。双侧检验,检验水准α=0.05。
本次调查共招募已婚吸烟者718人,剔除3份无效问卷,纳入研究对象715人(男性555人,77.6%;女性160人,22.4%)。吸烟者以30~44岁占比最多,本科学历为主,31.7%为中度及以上烟草依赖。戒烟尝试率为33.4%,家人支持下的戒烟意愿为79.4%。性别在年龄、戒烟尝试次数及家人支持下的戒烟意愿方面,差异有统计学意义。见表1
男性与女性已婚吸烟者在吸烟相关疾病风险感知等8个测量维度得分差异均有统计学意义。男性在戒烟消极结果预期得分较高(P<0.001),而女性在吸烟相关疾病风险感知(P=0.001)、戒烟积极结果预期(P=0.011)、戒烟自我效能(P<0.001)及戒烟行动计划(P<0.001)得分较高。
男性中6.3%的配偶吸烟,女性则达47.5%,性别差异有统计学意义(P<0.001)。配偶在情感支持和物质支持方面的性别差异无统计学意义(P>0.05)。见表2
戒烟尝试方面,单因素logistic回归分析显示,男性已婚吸烟者的研究生及以上学历与戒烟尝试呈负相关(ORu=0.37,95% CI:0.16~0.83)。女性已婚吸烟者在不同年龄、文化程度及月平均收入组的戒烟尝试差异无统计学意义(P>0.05)。
家人支持下的戒烟意愿方面,男性已婚吸烟者的本科学历与戒烟意愿呈正相关(ORu=2.10,95% CI:1.17~3.77)。女性已婚吸烟者在不同年龄、文化程度及月平均收入组之间的戒烟意愿差异均无统计学意义(P>0.05)。见表3
此外,与轻度烟草依赖相比,中度及以上烟草依赖与女性戒烟尝试呈正相关(ORu=2.88,95% CI:1.43~5.80),与男性戒烟意愿呈负相关(ORu=0.51,95% CI:0.34~0.77)。
戒烟尝试方面,吸烟相关疾病风险感知(aOR=1.29,95% CI:1.05~1.59)和戒烟积极结果预期(aOR=1.27,95% CI:1.06~1.51)是男性已婚吸烟者戒烟尝试的保护因素;而女性戒烟认知与戒烟尝试无统计学关联(P>0.05)。
家人支持下的戒烟意愿方面,戒烟积极结果预期(aOR=1.31,95% CI:1.10~1.56)是男性已婚吸烟者戒烟意愿的保护因素,而消极结果预期(aOR=0.78,95% CI:0.65~0.93)是男性戒烟意愿的危险因素;女性已婚吸烟者的戒烟积极结果预期和消极结果预期与戒烟意愿均无统计学关联(P>0.05)。见表4
配偶的情感支持和物质支持与戒烟尝试均无统计学关联(P>0.05)。配偶的情感支持是男性(aOR=1.08,95% CI:1.01~1.16)和女性(aOR=1.26,95% CI:1.07~1.49)已婚吸烟者戒烟意愿的保护因素,而配偶的物质支持与戒烟意愿无统计学关联(P>0.05)。见表4
本研究从性别差异的角度探讨了已婚吸烟者的戒烟认知和配偶支持对戒烟尝试及戒烟意愿的影响。结果显示,女性已婚吸烟者的戒烟认知水平高于男性,但这一认知优势未有效转化为实际戒烟行为;而增强吸烟相关疾病风险感知和戒烟积极结果预期均有助于提高男性吸烟者的戒烟尝试。此外,无论性别,增强吸烟相关疾病风险感知、自我效能感、戒烟计划及配偶情感支持均有助于提高吸烟者的戒烟意愿,而较高的戒烟消极结果预期可能降低男性吸烟者的戒烟意愿,但对女性吸烟者无显著影响。
本次调查显示,已婚吸烟者的整体戒烟尝试率为33.4%,与既往文献报告的低戒烟尝试率基本一致[3,12],反映我国吸烟者主动戒烟行为仍显不足。约80%的吸烟者表示在家人支持下更愿意尝试戒烟,女性比例更高(91.3%vs.76.0%),表明家庭支持对女性影响较大,有助于其健康行为的改善[14-15]。此外,已婚吸烟者的配偶支持总体水平较高,提示戒烟干预应充分发挥配偶及家庭支持的积极作用,以增强吸烟者的戒烟意愿并促进其戒烟行为。
尽管女性已婚吸烟者的戒烟认知水平高于男性,但未有效转化为后续戒烟行为,这种认知-行为偏差提示在戒烟路径上可能存在诸多的障碍因素。具体而言,女性可能因社会角色期望、家庭责任及社交压力等多重因素,缺乏足够时间和精力参与戒烟干预[8,16]。此外,女性更易将吸烟作为缓解负面情绪的短期应对策略[16],且对戒烟后体重增加的担忧可能降低其戒烟动力[17]。值得注意的是,当前社会针对女性的戒烟服务(如心理支持、同伴互助等)仍较匮乏,难以形成持续且有效的支持体系,进一步加剧了女性吸烟者戒烟认知与实际行为之间的脱节。
本研究发现,吸烟相关疾病风险感知、自我效能感及戒烟计划与戒烟意愿呈正相关,与既往研究保持一致且性别差异不明显[18-19]。然而,高戒烟积极结果预期(如减少吸烟相关开支)和低戒烟消极结果预期(如戒烟对社交的负面影响)与男性吸烟者的戒烟意愿呈正相关,但在女性吸烟者中未观察到类似结果。这可能提示,男性在戒烟过程中更关注健康收益与风险规避,其戒烟积极结果预期能够更直接提升其戒烟意愿。而女性更倾向于综合考虑健康改善与社会及心理因素的平衡,削弱了健康收益对其戒烟意愿的激励作用,这可能与女性对社交关系、体重管理和情绪调节更高敏感性有关。因此,性别差异在戒烟决策中的具体机制仍需进一步探讨。
本研究结果显示,配偶情感支持与吸烟者的戒烟意愿呈正相关,而物质支持未呈现显著关联,既往研究亦有类似结论[20-21],表明情感支持在激发戒烟动机方面更为关键。从作用机制来看,配偶给予的理解、鼓励和关怀等情感支持能够增强吸烟者的自我效能感和内在戒烟动机,从而促进戒烟行为[22]。然而,既往研究提示在特定情境下,物质支持(如补贴戒烟药物、发放现金奖励等)能够有效降低戒烟成本,提高吸烟者戒烟干预的参与度和依从性[23]。因此,戒烟干预应综合考虑情感与物质支持,以优化干预效果。此外,本研究未发现配偶支持对戒烟意愿的性别差异,表明不同性别的已婚吸烟者对情感支持的需求及其对戒烟行为的促进作用较为一致[24],建议戒烟干预采用性别中立策略,确保不同性别吸烟者均能获得平等的社会支持与干预服务,以提升干预覆盖面和有效性。
本研究未发现配偶吸烟状况对男女吸烟者戒烟行为显著影响,这与部分既往研究不一致[25],可能原因包括:首先,夫妻间的健康行为随着共同生活时间延长趋于一致,降低了配偶吸烟对戒烟行为的影响[7];其次,个体的健康认知、风险感知及心理状态的差异使戒烟动机难以一致。未来研究可进一步探讨夫妻间健康行为互动机制。
本研究存在一定局限性。第一,横断面设计无法推断因果关系;第二,方便抽样可能导致选择偏倚,且样本主要来自江苏、山东城市地区,受教育程度较高,限制了结果的外推性;第三,自我报告数据可能存在回忆偏倚和社会期望偏倚;最后,未纳入其他可能影响戒烟的因素,如夫妻关系满意度、个人心理状态等。
尽管如此,本研究基于HAPA理论,聚焦已婚吸烟者的性别差异,深入分析个体戒烟认知和配偶支持与戒烟行为的复杂关系。研究结果明确了情感支持对戒烟意愿的关键作用,揭示了个体戒烟认知向行为转化的障碍,为戒烟干预提供了实证依据。总体而言,本研究拓展了对戒烟行为多重影响因素的理解,并为优化戒烟干预策略提供了理论与实践支持。
  • 国家自然科学基金面上项目(82173637)
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2025年第52卷第8期
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doi: 10.20043/j.cnki.MPM.202410102
  • 接收时间:2024-10-10
  • 首发时间:2026-03-17
  • 出版时间:2025-04-25
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  • 收稿日期:2024-10-10
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国家自然科学基金面上项目(82173637)
作者信息
    1.北京大学医学部公共卫生学院,北京 100191
    2.淄博市临淄区疾病预防控制中心慢性病预防控制科
    3.北京大学全球健康发展研究院

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
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红菇属 Russula 17 8.13
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