Smoking Cessation In Kuwait Health And Social Care Essay

Methods: Study design: a cross sectional survey was conducted done during 1st January 2007 to 30th September 2008. A sample of 609 tobacco users, who go toing smoking surcease clinic at Hawally governorate to discontinue smoke during this period, demographic, behavioural and environmental informations towards smoke and quitting were collected.

Consequences: Male represent 89.7 % of the studied sample and two tierce of them were married. The Kuwaiti tobacco users represent one tierce ( 34.6 % ) and the overall average induction age of the smoke was ( 19 ± 5.4 ) old ages, while the average continuance of the smoke was 15.8 ± 4.6 old ages. The bulk of the studied samples ( 84.9 % ) were smoke more than 20 coffin nails / twenty-four hours.

The survey revealed that smoking discontinuing were more likely with age group 40-50 old ages, male, older induction of smoke and besides single who had a smoke policy at work topographic point, no other spouse fume at place and were physically active were more likely to quite smoke.

Decision: Results suggest the demand to effectual steps to forestall induction, advancing smoking surcease plan, affecting family members and support policy of smoking surcease at workplace.

Keywords: Smoke, smoking surcease and factor associated.

Introduction

Tobacco usage is considered to be one of the

chief preventable causes of decease all over the

universe. The universe wellness organisation ( WHO ) is considered about the figure of tobacco users as it increases quickly. WHO attributes about 5 1000000s decease a twelvemonth to tobacco usage. This figure expected to be doubled by the twelvemonth 2020. ( 1 ) It is estimated that 70 % of these deceases will happen in developing states. ( 2-3 ) Smokers who quit smoking before age 50 cut in half their hazard of deceasing in the following 15years ( 4 ) In add-on, the cost economy from reduced baccy usage ensuing from the execution of effectual smoke surcease intercession would more than wage for these intercessions within three to four old ages. ( 5 )

Tobacco usage is habit-forming, about 70 % of tobacco users want to discontinue smoke, but merely 25 % are able to discontinue for good each twelvemonth.

About all states have adopted the national anti baccy statute law. Equally important as the spread of statute law is the increased strength and effectivity of late enacted legislative acts. Governorates have banned all advertisement and publicity of baccy, have well raised revenue enhancements on the monetary value of baccy merchandises, and have expanded limitation on smoking in public, work topographic points and public transit. ( 6 )

Cigarette smoke in Kuwait is increasing, particularly among immature males, and the age of get downing smoke is worsening. Memon et Al ( 7 ) and Moody et Al ( 8 ) reported that, 34.3 % of males and 1.9 % of females smoked coffin nails and 13.8 % of males and 7.7 % of female began smoking coffin nails between the age of 10 and 14 old ages.

The universe Health Organization ( WHO ) reports that smoking prevalence among immature people in Arab states differ greatly: 7 % in Oman, 18 % in Kuwait, 23 % in Iraq, 25 % in Saudi Arabia and Jordan, 31 % in Syria, 43 % in Yemen and 53 % in Lebanon. ( 9 )

There have been different surveies address factors associated with successful smoking surcease. Demographic factors as age, sex, matrimonial position and instruction have examined whether they differed between successful quitters and unsuccessful

quitters ( 10-15 ) for illustration, Hymowitz et Al ( 13 ) found that being older, male and holding higher income predicated surcease, as behavioural factors included smoking fewer coffin nails and holding old quit efforts.

In add-on, Borland et Al ( 16 ) found that holding higher instruction was a factor associated with successfully discontinuing.

Behaviors factors related to discontinuing smoke is finding for keeping the pattern of

discontinuing. Past surveies in Kuwait were limited to specific population like as doctor, pupil

and non informed the general population. ( 7,8,17 ) Acknowledging the dynamic procedure of smoking behaviour, the figure of quit efforts and the figure of coffin nails smoked daily were forecasters for smoking surcease. ( 18,19 )

ISSN 1110-0834Environmental factors are important forecasters for smoking surcease. Several surveies found that being in day-to-day contact with other tobacco users reduced the likeliness of smoking discontinuing. ( 20,21 ) Farkas et Al ( 22 ) found that smoking control in both the workplace and in the place were important factors of successful quitting.

Method

The present survey is transverse sectional survey was done to depict smoke forms and factors associated with smoking surcease among the tobacco users sing the smoke surcease clinic from 1st of January 2007 to 30th of June 2008.

All tobacco users attended were completed questionnaires include:

Socio-demographic features as age, sex, instruction, and matrimonial position, smoking forms were assessed by inquiring approximately age at which they started smoking on a regular basis, the figure of coffin nails smoked per twenty-four hours, the figure of life clip quit effort was made that lasted at least 24 hours. The figure of old ages of smoke was derived by deducting age at which a represented started to smoke on a regular basis from his or her current age.

Behavioral features were include some

of these forms and physical activity ( physical activity mean regular physical activity at least 3 times per hebdomad for at least 10 proceedingss each clip ) versus less physically active. Environmental

factors were assessed by inquiring about some environmental factors in place and work topographic point associating to smoke.

All the tobacco users were used Nicotine replacing therapy ( NRT ) ( nicotine spots ) during their hebdomadal visits. Which help the tobacco users to discontinue, avoid backdowns symptoms peculiarly when combined with guidance by doctor through smoking stop clinic. This guidance has a function in behavior alteration and alteration towards surcease for all the tobacco users in add-on to ( NRT ) .

Follow up was done by hebdomadal visit, discontinuing

of smoke considered if quit smoke wholly for 3 months at least during follow up of everyday visits.

Statistical analysis:

Datas were collected and analysis utilizing SPSS version 11.0 ( SPSS, Inc, 1999, Chicago, III ) ( 23 )

Datas were express as figure, average and per centums.

Standard descriptive statistics were used to sum up the informations collected from socio-demographic, behaviour and environmental

factors.

Chi square trial was used to compare the frequences between the groups. The significance degree was considered at P-value & A ; lt ; 0.05.

Multiple logistic arrested developments were used for the concluding analysis to foretell factors associated with smoking surcease. The association between demographic, behavioural and environmental

factors and the out semen were expressed in

odds ratios ( OR ) with 95 % assurance interval

( 95 % CI ) .

All variable in the logistic theoretical account were categorized into 2 or more classs ( R = mention class ) : demographic factors: Age ( old ages ) & A ; lt ; 30® , 30-39, 40-49, ? 50 ; sex female ® male ; Marital position married ® non married. Behavioral factor: life clip discontinue 1-3 clip ® & A ; gt ; 3 ; induction age of smoking ? 14years ® , 15-19, ? 20 old ages, continuance of smoking ? 30 ® and 20-29, 10-19 and & A ; lt ; 10 twelvemonth. Physical activity: inactive ® active. Environmental factor: smoke policy at work, No ® Yes, other spouse smoked at place: Yes ® , No.

Consequence

A sample size of 609 tobacco users attended a smoke surcease clinic and follow up for at least 3 months. The overall average age of the studied sample was ( 37.2 ±12.1 ) old ages. Where the highest per centum was among the age group ( 30-39 ) old ages while

the lowest per centum ( 16.8 % ) were among the

aged 50 old ages or more. The bulk of the sample were male ( 89.7 % ) and 64 % of the sample were married.

Sing to education about one 3rd ( 35 % ) of the studied sample were had university instruction or more. And non-Kuwaiti persons represent two 3rd ( 65.4 % ) of the studied sample.

Table II shows the distribution of smoke

forms harmonizing the nationality. The average induction age of smoke was earlier in Kuwaiti tobacco users ( 17.2 ±6.4 ) old ages, while the average continuance of smoke was higher among non-Kuwaiti people ( 16.1 ±5.7 ) old ages.

The mean day-to-day ingestion of coffin nails was higher among non-Kuwaiti tobacco users ( about 31 coffin nails per twenty-four hours ) .

The mean figure of effort to discontinue smoke was about similar in both Kuwaiti and non-Kuwaiti tobacco users, ( 2.1 ± 2.2 and 2.3 ± 2.0 ) severally. The bulk of Kuwaiti tobacco users and non-Kuwaiti were heavy tobacco users ( smoke more than 20 coffin nails per twenty-four hours ) .

Table III represents demographic, behavioural and environmental factors related to smoking cassation. The age group ( 40-49 old ages ) represent the highest per centum ( 49.3 % ) among who successfully quit smoking on the other manus the age group ( 30-39 old ages ) shows the highest per centum among who tried to discontinue but failed. There was important difference for the age group sing smoking discontinuing P & A ; lt ; 0.05. Male gender show important differences sing smoking quitting.

Sing behavioural factors there was no important differences harmonizing to smoking discontinuing and figure of quit effort of smoke. On the other manus, continuance of smoke and initiating of smoke, shows important differences among who non discontinue smoke and who successfully quit smoking P & A ; lt ; 0.05.

Physical activity represents important differences among the studied sample who try to discontinue smoking but failed and who successfully quit smoke.

Sing to environmental factors, there was a important difference among who those non quit smoke and who successfully quit smoke.

Among who successfully quit smoke, ( 52 % ) were reveled that, their was a smoke policy at work site, compared to 42.5 % who non discontinue smoke, besides 53.4 % of them represent that no other people smoke at place compared to merely ( 28.3 % ) among who try to discontinue but failed. There was a important difference between the two groups sing the environmental factors.

Table IV demonstrates multiple arrested development analysis for factors associated with smoking discontinuing. The odds of smoking discontinuing addition by twice among the age group ( 40 – 49 old ages ) . Male were important associated with smoking surcease.

Sing to smoking forms people with less continuance of smoke ( & A ; lt ; 10 old ages ) were more likely to discontinue smoke ( OR = 1.8 ) and people with older induction of smoke ( 20 old ages or more ) were 1.2 times every bit likely to be quit smoking as those with less than 20 old ages of age induction smoke.

Besides physical active as a behavioural factor people were 2.3 times every bit likely to discontinue smoke as people physically inactive. The two environmental factor were associated with smoking discontinuing were people with presence of smoke policy at work and no other spouse fume at place were more likely to win in smoking discontinuing OR=3.6 and =2.8 severally.

Table I: Demographic feature of the tobacco users go toing

the smoke surcease clinic

Features

Number =609

%

Age group ( in old ages ) :

18-29

30-39

40-49

? 50 old ages

{ average age ( 37.2± 12.1 ) old ages }

168

195

144

102

27.6

32.0

23.6

16.8

Sexual activity:

Male

Female

546

63

89.7

10.3

Marital position:

Married

Unmarried

390

219

64.0

36.0

Educational degree:

Intermediate school or less

High school

Diploma

University grade or more

123

162

111

213

20.2

26.6

18.2

35.0

Nationality:

Kuwaiti

Non-Kuwaiti

211

398

34.6

65.4

Table II: Smoke forms of the studied sample harmonizing to nationality

Smoking form

Kuwaiti

N=211

Non-Kuwaiti

N=398

Entire

N=609

Average induction age of smoke ( old ages )

17.2±6.4

20.1±5.3

19.0±5.4

Average continuance of smoke ( old ages )

14.9±4.3

16.1±5.7

15.8±4.6

Mean no of smoked coffin nail /day

27.3±19.1

31.6±8.09

29.6±18.6

Mean no of effort to discontinue

2.1±2.2

2.3±2.0

2.2±2.1

Table Three: Selected demographic, behavioural and environmental factors harmonizing

to smoking surcease of the studied sample

Non quit

smoke N=463

Successfully discontinue

smoking N=146 *

P value

x2

NO %

NO %

Age ( old ages )

18-29

30-39

40-49

?50 old ages

146

164

75

78

31.5

35.4

16.2

16.9

22

31

69

24

15.1

21.2

49.3

16.4

P & A ; lt ; 0.05

Sexual activity:

Female ® ( n=63 )

Male ( n=546 )

54

409

85.7

74.9

9

137

14.3

25.1

P & A ; lt ; 0.05

Marital position:

Married ® ( n=391 )

Not married ( n=219 )

293

170

75.2

77.6

97

49

24.8

22.4

P & A ; gt ; 0.05

Behavioral factor

Life clip quit effort

1-3 ®

& A ; gt ; 3

144

319

31.1

68.9

47

99

32.2

67.8

P & A ; gt ; 0.05

Age foremost smoked on a regular basis

?14 old ages ®

15-19

?20 old ages

118

211

144

25.5

43.4

31.1

35

47

64

24.0

32.2

43.8

P & A ; lt ; 0.05

Duration of smoke

& A ; lt ; 10 old ages

10-19

? 20 ®

49

165

249

10.6

35.6

53.8

38

56

42

26.0

38.3

35.7

P & A ; lt ; 0.05

Physically activity

Inactive ®

Active

259

204

55.9

44.1

55

91

37.7

62.3

P & A ; lt ; 0.01

Environmental factors:

Smoke policy at work

No ®

Yes

266

197

57.5

42.5

70

76

47.9

52.1

P & A ; lt ; 0.05

Other spouse smoked at place

Yes ®

No

332

131

71.7

28.3

68

78

46.6

53.4

P & A ; lt ; 0.01

* Quit Rate = 24 %

Table Four: Factor foretelling smoking surcease: Consequences of multivariate

logistic arrested development analysis.

Factors

Oddss ratio

( OR )

95 % CI

Upper lower

P value

Age group

18-29 ®

30-39

40-49

? 50 old ages

1

0.6

2.16

0.9

0.9

3.51

0.4 1.4

& A ; gt ; 0.05

& A ; lt ; 0.05

& A ; gt ; 0.05

Sexual activity

Female®

Male

1

1.72

1.03 2.73

& A ; lt ; 0.04

Marital position

Married ®

Not married

1

0.8

0.4 1.2

& A ; gt ; 0.05

Behavioral factor:

Life clip quit effort

1-3 ®

& A ; gt ; 3

1

0.5

0.3 1.1

& A ; gt ; 0.05

Age foremost smoked on a regular basis

?14 old ages ®

15-19

?20 old ages

1

0.3

1.2

0.2 0.5

1.07 2.49

& A ; gt ; 0.05

& A ; lt ; 0.05

Duration of smoke

? 20 ®

10-19

& A ; lt ; 10 old ages

1

0.9

1.85

1.7

2.23 9.31

& A ; gt ; 0.05

& A ; lt ; 0.05

Physical activity

Inactive ®

Active

1

2.31

1.84 8.45

& A ; lt ; 0.05

Environmental factors:

Smoke policy at work

No ®

Yes

1

3.64

1.71 5.67

& A ; lt ; 0.01

Other spouse smoked at place

Yes ®

No

1

2.81

1.92 4.61

& A ; lt ; 0.05

Discussion

Published surveies on epidemiology of smoke in Kuwait have been restricted to specific groups such as doctor, university pupils, married twosomes and wellness attention workers. These surveies have reported prevalence rate ( 38.1 % ) in doctor. ( 24 ) ( 30 % ) in male pupil, ( 25 ) ( 37 % ) in married work forces and ( 0.5 % ) in married adult females ( 26 ) and ( 16.8 % ) among wellness attention workers. ( 17 )

This survey focused on forms of coffin nail smoke among tobacco users go toing smoking surcease clinic with respect to assorted socio-demographic, behavioural and environmental factors related their life and working environment that associated with smoke surcease.

The kineticss of smoking induction and surcease should be assessed for implementing any effectual control policies. Smoking form and quitting and the factor impacting smoking discontinuing have examined in past surveies merely sing demographic factors as sex, age, matrimonial position, degree of instruction. We know all the tobacco users want to discontinue smoke but non all of them win in discontinuing. Te better guide the procedure of successful surcease, we must understand the implicit in moral force of the of the discontinuing procedure non merely to the demographic features, but besides with the behavioral and environmental life and working characteristic related to smoke.

Forms of smoking in work forces and adult females differ between developing and industrialisation states. Significantly more work forces ( 40 % -50 % ) but fewer adult females ( 2 % -10 % ) fume in developing states compared with about ( 25 % -30 % ) of both work forces and adult females who smoke in industrialised states. ( 27 ) In our survey female represent merely ( 10.3 % ) from the studied sample go toing smoking surcease clinic. This is chiefly due to socio-cultural factors as in our societies it may be considered improper indicate for female to be seen or known for smoking wont.

The bulk of regular tobacco users begin smoking in early adolescence. In our survey, the average age of smoking induction was less than 20 old ages. It was lower among Kuwaiti tobacco users. ( 17.2±6.4 ) old ages. This determination was consistent with consequences of other surveies in Kuwait. ( 7,17 )

Further more, other surveies suggest that persons who initiate coffin nail smoke during childhood are at higher hazard of going long term tobacco users than those who initiate smoke subsequently. ( 28 ) ( 29 ) The consequence of this survey showed that older age of smoking induction was a important factor of smoking discontinuing ( OR=1.2times ) .

A major attempt should be directed towards implementing wellness instruction plans for kids and adolescent anti baccy instruction

and consciousness should be an built-in portion of the course of study in schools and colleges.

Sing to behavioural factors:

The present survey reported that no association between figure of effort to discontinue and smoking surcease and this agree with the determination of other studied. ( 10 ) ( 30 )

On other manus Hymowitz EL Al ( 13 ) found that holding more than one quit effort was associated with successful surcease.

The survey represent that the older induction age of smoke, less continuance of smoke and presence physical activity were a important factor sing smoking surcease. The account for this determination reflected that persons who showed less smoke and physically active were greater motive to cut down the wellness hazard of smoking than who with sedentary life. This finding consistent with the determination of other writers, who showed that, older age of induction, less continuance of smoke and physical activity were important factor for successful surcease. ( 10, 31, 32 )

Sing to environmental factors the present survey found that a high per centum for presence of other spouse smoked at place. This environmental factor may impact immature people attitude sing smoke besides the influence of household member and friends ( pear force per unit area ) ( 33 ) This an of import issue refering the wellness consequent of inactive smoke on kids and other household members and a worners of jeopardies of inactive smoke should be increased and involved in community plan directed to smoking control. Evidence of the serious wellness effect of environmental baccy fume for both grownup and kids has accumulated. ( 34 ) In add-on the influence of smoke among pears was considered the most common ground for non trying to discontinue. ( 7 )

Our survey showed the important influence of the two environmental factors ( absence of other spouse fume at place and presence of smoke policy at work ) . This determination supported by other surveies, where Ochung WL and Jennifer K ( 10 ) found that, a fume free place and presence of smoke policy at work were positively associated with smoking surcease.

In other survey, Hymowitz el Al ( 13 ) identified the absence of other family tobacco user as a important factor for surcease. Finally, Borland et Al ( 16 ) and Derby et Al ( 35 ) reported the positive influence of the societal support of smoking surcease after the execution of smoke policy for workers. So protecting non smoke from exposure to environmental baccy usage is a major end for most tobacco control plan. ( 36 ) Besides protecting workers in the work topographic point through policy based smoking limitation is an of import issue. ( 37 )

Despite the presence of statute law in Kuwait censoring smoking in public topographic points and governmental work sites, the jurisprudence has non been successfully implemented.

Decision

The present survey suggest the demand of take downing induction of smoke usage among immature people through school wellness plan against baccy usage

The survey besides suggest that surcease plans should take a multi – sectoral attack as demographic features, smoking related behaviour ‘s and life and on the job environmental factors related to smoke, that significantly affect the ability of the tobacco users for discontinuing procedure.These effectual plans should affect household members and co-workers at work site.

The function of smoking stop clinics should be promoted for effectual guidance for tobacco users, their relations and friends to increase surcease rate

Cross sectional surveies should be conducted on a regular basis to gauge the other determiners that support smoking quitting that help tobacco users for non get worsing.These surveies would supply base line informations for implementing smoke-free policies that support surcease