ABSTRACT
INTRODUCTION: Predictors for smoking cessation have been identified in different studies but some of the predictors have been variable and inconsistent. In this study, we reviewed all the potential variables including medication, counselling, and others not commonly studied to identify the robust predictors of smoking cessation. METHODS: This historical cohort study was conducted in smoking cessation clinics in Hong Kong. Subjects who volunteered to come for free treatment between January 2010 and December 2011 were reviewed. Those under the age of 18 years, or who were mentally unstable or cognitively impaired were excluded. Counselling and quit-smoking medications were provided to the participants. The outcome measure was self-reported 7-day point prevalence abstinence rate at week 26. RESULTS: Univariate analysis showed that the following were significant predictors of quitting: (1) psychosocial variables such as feeling stressed, feeling depressed, confidence in quitting, difficulty in quitting, importance of quitting, Smoking Self-Efficacy Questionnaire score; (2) smoking-related variables such as number of cigarettes smoked per day, Fagerström Test for Nicotine Dependence score, number of high-risk situations encountered; (3) health-related variable of having mental illness; (4) basic demographics such as age, marital status, and household income; and (5) interventional variables such as counselling and pharmacotherapy. Multiple logistic regression showed that the independent predictors were age, having mental illness, daily cigarette consumption, Fagerström Test for Nicotine Dependence score, reasons for quitting, confidence in quitting, depressed mood, external self-efficacy, intervention with counselling and medications. CONCLUSIONS: This clinic-based local study offers a different perspective on the predictors of quitting. It reminds us to adopt a holistic approach to deal with nicotine withdrawal, to enhance external self-efficacy to resist temptation and social influences, to provide adequate counselling, and to help smokers to cope with mood problems.
Subject(s)
Smoking Cessation/methods , Smoking Prevention , Tobacco Use Disorder/rehabilitation , Adult , Cohort Studies , Counseling/methods , Female , Follow-Up Studies , Hong Kong , Humans , Logistic Models , Male , Middle Aged , Outcome Assessment, Health Care , Retrospective Studies , Self Efficacy , Smoking/psychology , Smoking Cessation/psychology , Surveys and Questionnaires , Tobacco Use Disorder/psychologyABSTRACT
BACKGROUND: Eczema lesions are characterized by impaired expression of antimicrobial peptides such as cathelicidin, which play crucial roles in the innate immune defence against cutaneous infections. LL-37 corresponds to amino acids 134-170 of human cathelicidin and is a multifunctional host defence molecule essential for normal immune responses to infection and tissue injury. OBJECTIVES: The aim of this study was to investigate the relationship between childhood eczema and circulating LL-37 levels. METHODS: One hundred and forty-four eczema children and 36 controls were recruited. Eczema severity was assessed by SCORing Atopic Dermatitis (SCORAD) and serum LL-37 concentration measured using enzyme immunoassay. Patients' skin hydration and transepidermal water loss at forearms were measured using Corneometer and Tewameter. RESULTS: Patients' mean SCORAD was 49.2 and their disease was classified as mild (n=28; 12.8%), moderate (n=95; 43.6%) and severe (n=95; 43.6%). Serum LL-37 concentrations did not differ between eczema patients and controls (mean: 832 pg/mL vs. 952 pg/mL, P=0.471). However, serum LL-37 concentrations increased with increasing eczema severity among the patients (P=0.005 for trend). This biomarker shows weakly positive correlation with patients' objective SCORAD (r=0.207, P=0.013) and age (r=0.170, P=0.041), but not skin hydration or transepidermal water loss (P>0.09). Linear regression confirmed significant association between objective SCORAD and serum LL-37 when adjusted for age and gender as covariates (ß=0.171, P=0.038). On the other hand, serum LL-37 did not differ between patients with and without heavy growth of staphylococci (P=0.151). CONCLUSIONS: Circulating LL-37 may be a biomarker for severity of childhood eczema, which supports the importance of innate immunity in eczema pathogenesis.
