Perceived Stress and Smoking Cessation: The Role of Smoking Urges

Self-management behavior and its influencing factors among adults with chronic obstructive pulmonary disease in Colombo, Sri Lanka: A cross-sectional study

Background

Self-management behaviors are essential to take care of chronic obstructive pulmonary disease (COPD). However, data on COPD self-management practices in Sri Lankan adults is limited. Therefore, identifying the level of COPD self-management and examining its influencing factors are essential for healthcare providers to manage COPD effectively.

Objectives

This research aimed to describe the level of self-management behaviors and determine whether dyspnea, perceived stress, COPD knowledge, and social support can predict self-management in adults with COPD in Colombo, Sri Lanka.

Methods

A predictive correlational study was conducted, and 108 adults with mild to moderate COPD were recruited from the central chest clinic in Colombo, Sri Lanka, from March to April 2024 using a simple random sampling technique. A self-administered questionnaire was used to gather data included demographic characteristics. The other instruments used were the COPD Self-Management Scale, the Perceived Stress Scale, the COPD Knowledge Questionnaire, and the Perceived Social Support Scale. Descriptive statistics and multiple regression were used for data analysis.

Results

The study showed a moderate self-management level with a mean of 3.04 ± 0.35. All variables could explain 41.7% of the variance in self-management among adults with mild to moderate COPD and COPD self-management behaviors significantly predicted by dyspnea (β = 0.212, p = 0.006), perceived stress (β = -0.195, p = 0.018), COPD knowledge (β = 0.263, p = 0.001), and perceived social support (β = 0.366, p <0.001).

Conclusion

The study shows evidence that a program to intervene targeting COPD knowledge and perceived social support, in addition to reducing dyspnea and perceived stress, can be beneficial in promoting better self-management behaviors among adults with mild to moderate COPD.

National prevalence of smoking among adolescents at tobacco tax increase and COVID-19 pandemic in South Korea, 2005-2022

Prior research has predominantly focused on the overall effects of the tobacco tax increase and the COVID-19 pandemic on adolescent smoking behavior. However, there is a need to examine both the immediate and sustained associations of these two factors on subgroups of adolescents, employing an interrupted time-series model. We aimed to investigate the immediate and sustained association of tobacco tax increase and the COVID-19 pandemic on adolescent smoking prevalence. This study utilized data from the Korea Youth Risk Behavior Web-Based Survey to analyze the prevalence of current smoking among all participants (CSP) and the prevalence of daily smoking among current smokers (DSP) of Korean adolescents (n = 1,159,995; mean, age 14.99; male 51.5%) over 18 years from 2005 to 2022. The study examined 18-year trends in CSP and DSP among Korean adolescents, emphasizing the influences of the 2015 tobacco tax increase and the COVID-19 pandemic, using β coefficients and their differences (βdiff) from an interrupted time-series ARIMA model. While CSP exhibited a decreasing trend, DSP exhibited an increasing trend. Tobacco tax increase was associated with both the short and long terms in smoking prevalence, however, the short-term association on prevalence (CSP, - 3.076 [95% CI, - 3.707 to - 2.445]; DSP, - 4.112 [95% CI, - 6.488 to - 1.735]) was stronger. The pandemic was associated with an immediate increase in DSP (9.345 [95% CI, 5.285-13.406]). These effects were strongest among adolescents from low economic status and those exposed to familial secondhand smoking. Supportive programs for adolescents in low-income families will help overcome the effects associated with the pandemic. As a tobacco tax increase was associated with a reduction in smoking prevalence, this could be one method to overcome the effects of the pandemic.