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Real-world unassisted quit success and related contextual factors: a population-based study of Chinese male smokers
  1. Shuhan Jiang1,
  2. Tingzhong Yang2,
  3. Christopher Bullen3,
  4. Jinsong Chen3,
  5. Lingwei Yu4,
  6. Sihui Peng4,
  7. Ian R H Rockett5,6
  1. 1School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
  2. 2Children's Hospital/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
  3. 3National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
  4. 4Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
  5. 5Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia, USA
  6. 6Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
  1. Correspondence to Dr Tingzhong Yang, Children's Hospital/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou 310027, China; Tingzhongyang{at}


Objectives To examine the association of exposure to secondhand smoke (SHS) and tobacco advertising with unassisted smoking cessation among Chinese male smokers.

Methods A questionnaire was administered to 6500 male adult smokers from six cities in China selected in a cross-sectional multistage sampling design. The survey collected self-reported demographic characteristics, smoking and cessation status, SHS exposure and tobacco advertising exposure, with 5782 valid questionnaires included in this study. Multiple logistic regression analysis was used to assess the association of unassisted smoking cessation with exposure to SHS and tobacco advertising.

Results 42.1% of smokers who made unassisted quit attempts achieved abstinence (95% CI 32.5% to 51.7%). SHS (adjusted OR (aOR) 0.36; 95% CI 0.18 to 0.71; p=0.033) and tobacco advertising exposure (aOR 0.63; 95% CI 0.37 to 0.95; p=0.039) were negatively associated with unassisted smoking cessation.

Conclusion The vast majority of Chinese male smokers rely on unassisted methods to quit smoking. Success prevalence is high, which is very beneficial to health. This study suggests that exposure to secondhand smoking and tobacco advertising hinders the success of unassisted cessation. These findings speak to the need for environmental tobacco control measures to promote unassisted smoking cessation among Chinese adult male smokers.

  • cessation
  • environment
  • secondhand smoke
  • addiction

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  • Contributors TY designed the study. TY and SJ analysed the data. SJ drafted the manuscript. CB, JC and IRHR revised the manuscript. LY and SP collected the data.

  • Funding This study was partly funded by the National Natural Science Foundation of China (71490733/71473221) and Zhejiang Chinese Medical University (2019SR04).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Ethics Committee of Zhejiang University (2014: 1-017).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.