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Smoking is the most preventable cause of premature death in the world and its disadvantages impose heavy financial burden on the health system. Among the behavioral models of health education, the most applicable one in smoking cessation is Transtheoretical Model (TTM). This study aimed to detect the predictors of smoking cessation among hospital male personnel. The participants were 200 current and former smokers Personnel working at four hospitals. The instruments included decisional balance scale, self-efficacy scale, processes of change scale (behavioral and experiential), and stages of change which were completed by self-report. Descriptive statistics analysis showed that 66.5% of participants were located in the earlier stages of change. Bivariate spearman correlations showed that self-efficacy, processes of change and decisional balance were significantly correlated with the stage of change. Besides, ordinal regression revealed that experiential processes of change, self-efficacy and behavioral processes were the strongest predictors for the change stages of smoke cessation. The current study revealed that the readiness to quit smoking is significantly predicted by the mechanisms of self-efficacy and the process of change such as environment reevaluation, stimulus control and counter conditioning, which can lead to positive progress in the change stages of smoke cessation. The findings of this study showed that using TTM for smoking cessation would be very effective in improving readiness to quit smoking among hospitals personnel.

Background & objectives: Inappropriate nutrition places employees at risk of being overweight or obese, and not only affect their health but also indirectly may affect patients. The trans-theoretical model is one of the most common models of health promotion. It is recognized as one of the ways of identifying and changing diet, especially increasing the consumption of fruits and vegetables. In this model, behavioral changes can be seen in stages. Therefore, this study designed to determine the status of cognitive and behavioral processes and its stages of change for fruit and vegetable consumption. Methods: This cross-sectional study was conducted with the participation of 300 nursing and midwifery staffs of Ardabil hospital using systematic random sampling method. Data gathering instrument was a validated questionnaire to collect information on demographic characteristics, stages and the process of change for fruit and vegetables consumption. The data was analyzed by SPSS (ver. 23) to measure central tendency, spearman correlation test, ANOVA, and Post-hoc. Results: Average age and BMI of participants were 31±7.05 and 25.7±3.5 respectively. The majority of subjects (77.3%) were in the early stages of change (pre-contemplation, contemplation, and preparation) for fruit and vegetable consumption while, only 22.7% was in active stages (action and maintenance). The mean scores of cognitive and behavioral processes were at a higher level in the maintenance stage and the lowest in the contemplation. Finally, the mean scores of social liberation, environment re-evaluation, self re-evaluation, stimulus control and counter conditioning processes increased from the inactive stages to the active stages. Conclusion: Findings support the effect of processes of change in fruits and vegetables consumption among nursing and midwifery staffs, so that using behavioral process of change such as stimulus control and self liberation can lead to positive progress in stage of change. We suggest educational programs to increase consumption of fruits and vegetables, particularly considering individuals' current stages and processes of change.

A meta-analysis done by Guo 1 that was published in Tobacco Induced Diseases, reported a pooled odds ratio of 2.20, concluding that active smoking is significantly associated with the risk of severe COVID-19. Another current meta-analysis reported greater odds of COVID-19 progression among smokers compared to never smokers 2. Most of the studies in these meta-analyses were from China and focused only on cigarette smoking 1,2. Here, we describe characteristics of tobacco use among 193 confirmed COVID-19 patients who were interviewed during their hospitalization from 15 March to 15 April 2020, in the Imam-Khomeini Hospital of Ardabil University of Medical Sciences (ArUMS) in Iran. The protocol was approved by the Institutional Review Board of Ardabil University of Medical Sciences (Approval ID: IR.ARUMS.REC.1399.044) and verbal informed consent was obtained from the patients. All patients tested positive for SARS-CoV-2 by nasopharyngeal swabs using real-time reverse-transcription-polymerase-chain-reaction (rRT-PCR) assay; they were at least 18 years old and willing to participate in an approximately 5-min interview. Interviews were administrated in the first two days of hospitalization to collect information regarding demographics, COVID-19-associated symptoms, and use of tobacco products including waterpipe (WP, hookah), cigarettes, and e-cigarettes. As shown in Table 1, 15 (7.8%) and 14 (7.3%) of the patients reported current (past-month) WP or cigarette use, respectively. No patients were dual WP/cigarette or e-cigarette users. Of the 14 cigarette smokers, 2 had cardiovascular disease (CVD), 1 chronic respiratory illness, 1 diabetes, 2 other conditions (e.g. kidney illness or rheumatoid arthritis), and 4 reported having >1 chronic condition. Among 15 WP smokers, 3 reported having CVD, 1 other condition, and 2 having >1 chronic condition. The average time between the onset of symptoms and hospitalization was approximately 4 days for WP smokers, 3 days for cigarette smokers, and 5 days for neversmokers. More than half (n=8) of cigarette smokers and 40% (n=6) of WP smokers reported their COVID-19 symptoms as severe compared to 22% (n=36) of never-smokers. In line with a previous report 3 , the most common COVID-19 symptoms were fever and dry cough, which did not differ significantly between smokers (cigarettes or WP) and never-smokers. However, shortness of breath was reported more frequently by cigarette smokers compared to never-smokers and WP smokers. Body pain was reported more frequently among WP smokers compared to cigarette smokers and never-smokers.

BACKGROUND It is highly recommended to promptly assess motivation and readiness to change in individuals who wish to achieve significant lifestyle behaviour changes in order to improve their health. In particular, motivation should be assessed in those who face the difficulty in behavioural changes. This study is aimed to investigate the mediating effects of self-efficacy on the relationships between predicting variables and outcome variable using the Transtheoretical Model. MATERIALS AND METHODS This cross-sectional study was conducted with the participation of 300 nursing and midwifery staffs employed in hospitals of Ardabil city, which were selected by systematic random sampling method. The data gathering tool was a Transtheoretical Model scale. Validity and reliability was confirmed in previous study. The data were analysed by SPSS 19 using the descriptive statistics, Spearman correlation test and Multiple Logistic Regression Analysis. RESULTS In total, 41.34% of the samples had normal BMI. The majority of subjects (77.3%) were in the early stages of change for fruit and vegetable consumption and only 22.7 percent were located in active stages. Regression revealed that self-efficacy was the strongest predictor of stage of change (β= 0.357, P= 0.001) and mediated the relationships of behavioural processes with stages of change (β= 0.369, P= 0.001). CONCLUSION This study showed a strong correlation between self-efficacy, decisional balance and processes of change with stages of change. So, we suggest that in order to promoting the fruit and vegetable consumption, these variables be considered as the basis of the interventional program. Also considering the mediating effect of self-efficacy as the strongest predictor, we suggest a targeted and appropriate application of this variable in the interventions.