INTRODUCTION Psychological, physiological and social factors play an important role in the initiation, persistence, dependence and relapse of smoking behaviors, and coping style and smoking abstinence self-efficacy can all affect nicotine dependence. METHODS A cross-sectional sample of 568 quitters from 19 communities in Beijing in 2019 was surveyed. Demographic information and psychological characteristics of smokers were collected by an interview questionnaire, and psychological traits scales including the Smoking Abstinence Self-Efficacy (SASE) and the Trait Coping Style Questionnaire (TCSQ). We compared differences in psychological traits across demographic information and explored the relationship between nicotine dependence and coping styles and self-efficacy in refusing to smoke. RESULTS Significant differences were identified in self-efficacy in refusing to smoke and across dimensions among quitters by gender, job type, education level, and monthly income level (all p<0.05). Males had lower self-efficacy in the habitual/ addictive context than females; retirees had better overall self-efficacy and selfefficacy in the negative/emotional context than business service workers and professionals; and high-educated, high-income quitters had lower self-efficacy in the negative/emotional context. There are significant differences in positive coping styles among quitters of different ages, levels of education, and types of work (all p<0.05). The results further showed that the underage population, highly educated population, and practitioners other than those in retirement, are less likely to use positive coping styles. Interventional effects analysis showed that a higher sense of self-efficacy in addictive contexts can counteract some of the negative coping styles that induce smoking. CONCLUSIONS Self-efficacy played an indirect mediating role between negative coping style and nicotine dependence; individuals who used more negative coping styles were more likely to engage in smoking and therefore were more nicotine dependent. Hence, it is necessary to reduce the use of negative coping strategies and improve the self-efficacy of smoking abstinence in the face of addiction.

Objective To understand the reasons for failure of smoking cessation among community smokers in Beijing, and analyze the influencing factors of the reasons for failure to quit, in order to provide a reference for providing smoking cessation guidance services. Method Based on a cross-sectional study, a one-to-one questionnaire was used. The survey included basic demographic information, tobacco use, and past attempts to quit. And descriptive analysis was used to analyze the distribution of the reasons for the failure of smoking cessation. c2 test or Fisher's exact probability method were used to analyze the causes of smoking cessation failure, demographic indicators, tobacco use and other factors. Correspondence analysis was used to further explore the relationship between each factor and the reasons for smoking cessation failure. Result A total of 442 smokers who had tried to quit smoking were investigated. The top three reasons for failure to quit were difficulty in controlling addiction, insufficient self-willingness (54.3%), the effects of other smokers(35.3%), and lack of smoke-free support environment(26.0%). There were statistically significant differences in the distribution of the reasons for failure of smoking cessation among different ages, occupations, and discomforts during smoking cessation(All P<0.05). Correspondence analysis results show that the reasons for failure of smoking cessation among smokers aged 19-30 are mainly work or study stress. There are differences in the reasons why smokers in different occupations fail to quit smoking; The influence of other smokers and the lack of a smoke-free support environment are closely related to the desire to quit during the process of quitting. Conclusion Work or study pressure, the influence of other smokers and the lack of smoke-free support environment are the main reasons for the failure of smoking cessation attempts. Therefore, it is suggested to strengthen education in different occupational places and implement personalized smoking cessation education. It is recommended to provide tips on coping with smoking cessation and alleviating peer pressure in social situations, as well as help for stress coping and negative emotion relief in smoking cessation guidance. At the same time, it is essential to strengthen the shaping of a smoke-free support environment.

BackgroundThe prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown.MethodsWe conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model.ResultsA total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention.ConclusionCI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.

Objective: This study aimed to understand the perception of patient safety and the reporting system in public in China, and make further recommendations for the optimization of the reporting system of patient safety. Methods:The following data were collected through an online questionnaire from medical staffs and patients: recognition of patient safety, comments on patient participation, comments on spontaneous reports, attitudes toward the principles of spontaneous reports, and willingness to participate. This information was presented with frequency and percentage with 95% confidence intervals (CIs). Spearman rank correlation was used to evaluate the association of those data.Results: A total of 27,493 valid questionnaires were collected in this study. The participants who knew patient safety very well, regarded patients as an essential part to enhance patient safety, viewed spontaneous reports helpful, agreed on the 3 principles of voluntariness, anonymity, and nonpunishment of the reporter, and were willing to participate in reporting were accounted for 39.