Gender and Socio-economic Differences in Daily Smoking and Smoking Cessation Among Adult Residents in a Greek Rural Area

Abstract

Despite the well-known health risks, smoking is still highly prevalent worldwide. Greece has the highest level of adult smoking rate (40%) across the European Union. We investigated gender and socio-economic differences in daily smoking and smoking cessation among Greek adults. We conducted a cross-sectional survey between October and November 2009 in 434 adults residing in a Greek rural area. Data were collected with the use of the World Health Organization Global Adult Tobacco Survey (WHO GATS) Core Questionnaire. Respondents were classified into smokers (if they had smoked at least 100 cigarettes in their lifetime and continued to smoke) or non-smokers. Overall, 58.1% (n=252) were smokers (58.5% male, n=127 and 57.8% female, n=125); 51.2% (n=222) were younger than 18 years-old when they started smoking. Men tended to start smoking at a younger age, to smoke more cigarettes/day and to have smoked a greater average of cigarettes during the last 5 days. Overall, 82.5% of smokers attempted to stop smoking a year prior to the study, with women having a greater difficulty in quitting smoking. The main source of information on smoking was the mass media (73.5%) and books (53.7%), whereas doctors and other health professionals were the least listed source of relative information (27.7 and 8.1%, respectively). Smoking rates among Greek adults were high, but a considerable number of individuals who smoked, wished to quit and had attempted to do so. Smoking cessation clinics are not perceived as a valuable support in quitting effort.

Is There any Gender Difference for Smoking Persistence or Relapse Following Diagnosis or Hospitalization for Coronary Heart Disease? Evidence From a Systematic Review and Meta-Analysis

“…This is a concern because, as foreshadowed, the risks from smoking are even greater for females than males and the dangers of relapse post-diagnosis or hospitalization for CHD are significant in terms of subsequent mortality and morbidity in both genders. 8,19,25,36,42 In this meta-analysis, the rate of persistent smoking or relapse post-diagnosis or hospitalization was similar amongst females and males. This is contrary to our hypothesis which suggested that females might find it more difficult to quit smoking than males and, therefore, be more vulnerable to relapse.…”

“…20,52 Whilst gender does not, therefore, appear to be a predictor for relapse, factors which have been found to be associated with failed quit attempts or resumption postdischarge include: low-confidence in quitting; fewer prior attempts to quit; low household income; having other smokers in the household; high nicotine dependence; low self-efficacy; severity of withdrawal symptoms; lower education level; ethnicity; behavioral and psychosocial factors. 14,16,19,[53][54][55] People who are depressed or suffer from anxiety or psychiatric disorders are known to be particularly vulnerable to relapse. 14,50 Women have been shown to find smoking cessation more difficult at certain stages of the menstrual cycle; but in light of the older age of onset of CHD in women, 6 it is unlikely to be a factor in smoking relapse amongst this generally post-menopausal cohort.…”

“…15,17 Consequently, there has been some speculation and debate regarding whether females have more difficulty in quitting smoking than males or are more vulnerable to relapse. [16][17][18][19][20] Gender differences in the experience of smoking cessation and relapse in patients with CHD have implications for the design and implementation of smoking cessation interventions. 8,15,17 To date there has been no published systematic review focusing on gender differences in relapse in the CHD population.…”

Gender Differences in Outcome of an Attempt to Stop Smoking Among Smokers Attending a Smoking Cessation Clinic in Taiwan

“…In many Western countries, the prevalence of smoking among men and women is roughly similar (Birmpili et al, 2012; Croghan et al, 2009). In Taiwan, men have a much higher prevalence of smoking (39.0%) as compared to women (5.1%; Chang, Sung, Zhu, & Chiou, 2014).…”

APOE e4 genotype and cigarette smoking in adults with normal cognition and mild cognitive impairment: a retrospective baseline analysis of a national dataset

“…Previous research has shown that race can influence the APOE genotype's effect on cognition (28–30). Finally, we had sex differences in the normal cognition group versus the mild cognitive impairment group, and sex differences are known to influence smoking outcomes (31–33). …”