Readiness for Smoking Quitting of Primary Health Care Clinic Patients

Dr. Riyadh Al Ahmadi

National Guard Program  – Riyadh  2013/2014

Background: Smoking is one of the most significant risk factors for early mortality with nearly five million deaths occurring worldwide (12% of deaths in adults over 30 years of age).The percentage of smokers in Saudi Arabia ranges 35 to 45% among adult males. Smoking is a reversible cause of morbidity, that is why, providing smokers with assistance in quitting may contribute in reducing prevalence of smoking-related disorders.

Objectives: To assess the smoking habits, degree of nicotine addiction and readiness to quit among male smokers visiting primary health care clinics.

Methods: This cross sectional study was conducted at primary healthcare clinics of Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia. Adult male patients were screened by using an Arabic questionnaire and smokers were included in the study. Data were collected on demographics, smoking habits, nicotine addiction, and readiness to quit. Descriptive statistics were carried out on all variables. Relationships were explored using T-test, Chi-square, linear regression and Kruskal Wallis tests.

Results: Smokers included were 352 with mean age 33.4 yrs. Among the trigger factors, anger and stress was found in 50%, caffeine in 32% and smoking friends in 35% of the participants. Among reasons for relapse 45% stated it was habit, while 34% blamed friends. Over 31% needed a cigarette within 5 minutes of waking up and nearly 60% smoked during illness. Nearly 90% believed that smoking was harmful but only 61.3% thought it caused cancer. Over 48% were ready to quit within a month (preparation stage) while 26% were not ready to quit for another 6 months (precontemplation).Looking at number of pack smoking per day and associated variables, the study found duration of smoking more than 10 years were significantly associated with being heavy smokers(p value<.001). The desire to smoke during fasting rather than eat and after meal were significantly higher in heavy smokers(p values><.001& .003, respectively). Hypertension was more common among heavy smokers. In relationship of variable with stage of readiness to quit, being married (p value 0.028), and being hyperlipiedemic were significantly associated (p value 0.01).Religious reasons, family or fear of withdrawal symptoms were significantly associated with improved readiness to quit.

Conclusion: Smokers were well aware of the harmful nature of smoking. Nearly half of them were in preparation stage of ready to quit within a month. Personal health and family reasons is strongest factor to quit, improvement of readiness period to quit was associated with family reason. Heavier smokers were more likely to find it difficult to quit, but had a stronger desire to quit.

Keywords: Smoking habits, readiness to quit, primary health care, precontemplation, contemplation, packs per day.

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