Stages of change of the readiness to quit smoking among a random sample of minority Arab -male smokers in Israel

Abstract

BackgroundDespite advanced smoking prevention and cessation policies in many countries, the prevalence of cigarette smoking among indigenous and some ethnic minorities continues to be high. This study examined the stages of change (SOC) of the readiness to quit smoking among Arab men in Israel shortly after new regulations of free-of-charge smoking cessation workshops and subsidized medications were introduced through primary health care clinics.MethodsWe conducted a countrywide study in Israel between 2012–2013. Participants, 735 current smokers; 18–64 years old; were recruited from a stratified random sample and interviewed face-to-face using a structured questionnaire in Arabic. We used ordered regression to examine the contribution of socio-economic position (SEP), health status, psychosocial attributes, smoking-related factors, and physician advice to the SOC of the readiness to quit smoking (pre-contemplation, contemplation and preparation).ResultsOf the current smokers, 61.8 % were at the pre-contemplation stage, 23.8 % were at the contemplation stage, and only 14.4 % were at the preparation stage. In the multinomial analysis, factors significantly (P < 0.05) contributing to contemplation stage compared to pre-contemplation stage included [odds ratio (OR), 95 % confidence interval (CI)]: chronic morbidity [0.52, (0.31-0.88)], social support [1.35, (1.07-1.70)], duration of smoking for 11–21 years [1.94, (1.07-3.50)], three or more previous attempts to quit [2.27, (1.26-4.01)], knowledge about smoking hazards [1.75, (1.29-2.35)], positive attitudes toward smoking prevention [1.44, (1.14-1.82)], and physician advice to quit smoking [1.88, (1.19-2.97)]. The factors significantly (P < 0.05) contributing to preparation stage compared to pre-contemplation stage were [OR, (95 % CI)]: chronic morbidity [0.36, (0.20-0.67)], anxiety [1.07, (1.01-1.13)], social support [1.34, (1.01-1.78)], duration of smoking 5 years or less [2.93, (1.14-7.52)], three or more previous attempts to quit [3.16, (1.60-6.26)], knowledge about smoking hazards [1.57, (1.10-2.21)], and positive attitudes toward smoking prevention [1.34, (1.00-1.82)].ConclusionsMost Arab men who currently smoke are in the pre-contemplation stage, indicating low readiness to quit smoking. New policies of free-of-charge smoking-cessation group sessions and subsidized medications introduced through primary health care clinics in Israel may be less effective among Arab men. For these policies to promote cessation more successfully, tailored interventions and campaigns may be needed to increase the readiness to quit smoking in this population, especially for those at the pre-contemplation stage.

Factors associated with stage of change in smoker in relation to smoking cessation based on the Korean National Health and Nutrition Examination Survey II-V

“…In thet study by Cambell et al between 2003–2004, 39.6%, 43.4%, and 13.9% of 594 Australians were assigned to the pre-contemplation, contemplation, and preparation groups, respectively; these values are similar to those in our study of the Korean population [16]. Daoud et al reported that 61.8%, 23.8%, 14.4% were in the pre-contemplation, contemplation stage, and preparation stage, respectively, among Arab men between 2012–2013 [10]. The preparation group showed the least proportion of less than 15% in all studies.…”

“…: Stanton et al reported that conditions such as anxiety, depression, and substance abuse were related to higher tobacco use, although proportion of cigarette smoking declined significantly over time among adults with no chronic condition [29]. Anxiety, stressful life events, and social support were psychological factors relevant to the stages of changes, as reported by Daoud et al [10]. In our study, although the proportion of people diagnosed with depression was lower in the pre-contemplation group, levels of suicidal ideation and attempted suicide were higher.…”

Evaluation of Patients in a Smoking Cessation Support Group Using the Nursing Outcomes Classification

“…A study conducted in Israel found, at the start of treatment 95% of patients were willing to quit smoking. However, when asked about their expectations for abstinence achievement, some patients had very low expectations (Daoud et al., ). These data emphasize the need to assess how determined and motivated a smoker is to quit smoking, aiming to understand the stage at which patients are starting in order to assist them at each stage of the process.…”

Social characteristics associated with disparities in smoking rates in Israel

“…Previous data from periodic telephone surveys in Israel showed that between 2000 and 2008 smoking rates decreased by 3.5 % among adult Jewish men, while an increase of 6.5 % was reported among Arab men [13]. A recent study also showed that Arab male smokers have low intention to stop smoking, with 60 % of current smokers being in the pre-contemplation phase [30]. …”