Prevalence and risk factors associated with hardcore smoking among rural daily male smokers.

BACKGROUND AND OBJECTIVES: The existence of smokers who are resistant to smoking cessation interventions has attracted considerable interest in recent years. Given the paucity of data on that topic in rural China, we aimed to assess the prevalence and risk factors of hardcore smoking in rural China.

METHODS: A cross-sectional study was conducted in 14 villages in Shandong, China. A total of 1,287 male daily smokers were face-to-face interviewed. A multiple logistic regression model was used to explore the associations of demographics, environment, knowledge and attitudes about smoking, and smoking behavior characteristics with hardcore smoking among daily male smokers. A general dominance analysis model was used to access the relative contribution of the determinants that were identified in the multiple logistic regression.

RESULTS: Hardcore smokers constituted 32.9% (n = 423) of daily male smokers. Five determinants for hardcore smoking were identified in the multiple logistic regression. Dominance analysis showed higher level of smoking intensity was the most important determinant of hardcore smoking, followed by being a farmer, starting to smoke daily under the age of 20, younger age, having fewer smokers around.

DISCUSSION AND CONCLUSIONS: This study suggests that hardcore smokers account for a substantial proportion of daily male smokers and are distinct from other groups of daily smokers.

SCIENTIFIC SIGNIFICANCE: Specifically tailored tobacco-control efforts should be made to address the issues incurred by hardcore smokers. (Am J Addict 2016;XX:1-6).