基于保护动机理论的我国 18∼44 岁成年人电子烟戒断意愿和戒断行为的影响因素

Cessation intention and behavior of e-cigarettes and associated factors among 18-44 Chinese adults：Based on protection motivation theory

摘要

目的：基于保护动机理论（protection motivation theory，PMT），探讨中国成年人电子烟使用者的戒断意愿和戒断行为的现状及其影响因素。方法：本研究为横断面研究，数据来源于 2023 年开展的一项针对我国 18∼44 岁成年人的＂电子烟使用调查＂，覆盖全国31个省（自治区、直辖市），选取其中550名当前电子烟使用者作为研究对象。在控制社会人口学因素后，采用多重线性回归模型，分析电子烟戒断意愿的影响因素；采用二元 Logistic 回归分析电子烟戒断行为的影响因素。此外，根据研究对象的吸烟状态进行亚组分析。结果：研究对象的电子烟戒断意愿得分为 3.52±0.96,31.64\% 的研究对象曾尝试戒断电子烟。调整协变量后发现，戒断意愿与 PMT 结构中的威胁评估路径和应对评估路径均存在关联，在威胁评估路径中，严重性（β=0.14）和易感性（β=0.12）与戒断意愿呈正相关，而外在回报（β=-0.12）呈负相关；在应对评估路径中，反应效能（β=0.26）和自我效能（β=0.28）均与戒断意愿呈正相关。戒断行为仅与威胁评估路径中的严重性（OR=1.58）呈正相关，同时与戒断意愿呈正相关。亚组分析结果显示，无论何种吸烟状态，其电子烟戒断意愿均与威胁评估路径（β=0.20,β=0.31）和应对评估路径（β=0.23,β=0.21）呈正相关。结论：PMT 为解释成年人电子烟戒断行为的影响因素提供了有价值的理论框架。威胁评估路径相关因素不仅影响戒断意愿，也影响实际戒断行为。PMT 相关因素的作用在不同吸烟状态人群中存在差异，提示未来的政策制定和干预措施应关注认知提升，并针对不同亚组电子烟使用者制定更具针对性的电子烟戒断策略。

Abstract

Objective：Based on protection motivation theory（PMT），this study aimed to examine the current status of e-cigarette cessation intention and cessation behavior，as well as their associated factors， among adult e-cigarette users in China. Methods：This was a cross-sectional study.The data were de- rived from a nationwide＂E-cigarette Use Survey＂conducted in 2023，covering 31 provinces（municipali- ty，autonomous region）in China.A total of 550 current e-cigarette users aged 18-44 years were selec- ted as the study population.After adjusting for sociodemographic variables，multiple linear regression models were used to identify factors associated with e-cigarette cessation intention，while binary Logistic regression models were applied to examine factors associated with e-cigarette cessation behavior.In addi- tion，subgroup analyses were conducted according to smoking status to explore potential differences among exclusive e-cigarette users and dual users of e-cigarettes and combustible cigarettes. Results：The mean score of e-cigarette cessation intention was 3.52±0.96 ，and 31.64％of participants reported having at- tempted to quit e-cigarettes.After adjustment for covariates，cessation intention was associated with both the threat appraisal and coping appraisal pathways within the PMT framework.Specifically，in the threat appraisal pathway，severity（β=0.14）and vulnerability（β=0.12）were positively associated with ces- sation intention，whereas perceived extrinsic rewards (β=-0.12) were negatively associated.In the coping appraisal pathway，both response efficacy (β=0.26) and self-efficacy (β=0.28) were positive- ly associated with cessation intention.Regarding cessation behavior，only severity (OR=1.58) in the threat appraisal pathway was positively associated，and cessation intention was also positively associated with cessation behavior.Subgroup analyses further showed that，regardless of smoking status，cessation intention was positively associated with both the threat appraisal pathway (β=0.20,β=0.31) and the coping appraisal pathway (β=0.23,β=0.21). Conclusion：PMT provides a valuable theoretical framework for understanding e-cigarette cessation among adults.Factors related to the threat appraisal pathway are associated not only with cessation intention but also with actual cessation behavior.More- over，the associations of PMT-related factors vary across different smoking status subgroups.These findings suggest that future e-cigarette control policies and interventions could focus on enhancing risk perception and cognitive awareness，and develop more targeted cessation strategies for specific subgroups.

关键词

电子烟 / 吸烟戒断 / 意愿 / 行为和行为机制 / 保护动机理论 / 成年人

Key words

E-cigarettes / Tobacco use cessation / Intention / Behavior and behavior mechanisms / Pro- tection motivation theory / Adult

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基金资助

国家自然科学基金(82173637)