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Individual and interpersonal triggers to quit smoking in China: a cross-sectional analysis
  1. Pek Kei Im1,2,
  2. Ann McNeill3,
  3. Mary E Thompson4,
  4. Geoffrey T Fong5,6,9,
  5. Steve Xu5,
  6. Anne C K Quah5,
  7. Yuan Jiang7,
  8. Lion Shahab8
  1. 1Department of Anthropology, University College London, London, UK
  2. 2Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  3. 3Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
  4. 4Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
  5. 5Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
  6. 6Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  7. 7National Tobacco Control Office, Chinese Center for Disease Control and Prevention, China
  8. 8Department of Epidemiology and Public Health, University College London, London, UK
  9. 9School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  1. Correspondence to Dr Lion Shahab, Department of Epidemiology & Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK; lion.shahab{at}


Aims To determine the most prominent individual and interpersonal triggers to quit smoking in China and their associations with sociodemographic characteristics.

Methods Data come from Waves 1–3 (2006–2009) of the International Tobacco Control (ITC) China Survey, analysed cross-sectionally as person-waves (N=14 358). Measures included sociodemographic and smoking characteristics. Those who quit between waves (4.3%) were asked about triggers that ‘very much’ led them to stop smoking, and continuing smokers about triggers that ‘very much’ made them think about quitting. Triggers covered individual (personal health concerns, cigarette price, smoking restrictions, advertisements, warning labels) and interpersonal factors (family/societal disapproval of smoking, setting an example to children, concerns about secondhand smoke).

Results Over a third of respondents (34.9%) endorsed at least one trigger strongly; quitters were more likely than smokers to mention any trigger. While similar proportions of smokers endorsed individual (24.4%) and interpersonal triggers (24.0%), quitters endorsed more individual (61.1%) than interpersonal (48.3%) triggers. However, the most common triggers (personal health concerns; setting an example to children) were the same, endorsed by two-thirds of quitters and a quarter of smokers, as were the least common triggers (warning labels; cigarette price), endorsed by 1 in 10 quitters and 1 in 20 smokers. Lower dependence among smokers and greater education among all respondents were associated with endorsing any trigger.

Conclusions Individual rather than interpersonal triggers appear more important for quitters. Major opportunities to motivate quit attempts are missed in China, particularly with regard to taxation and risk communication. Interventions need to focus on more dependent and less-educated smokers.

  • Public policy
  • Low/Middle income country
  • Taxation
  • Price
  • Packaging and Labelling
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