Evaluation of the prevalence of tobacco use and the factors affecting it in people aged 15 years and over who applied to family health centres in Konya province centre

Objective: In this study, to determine the smoking and tobacco use frequency at the age of 15 and older in the Konya provincial center, to create an effective awareness of smokers to quit smoking, especially teenagers and beginners to smoke, to identify this reason for those who are trying to quit smoking but have low motivation for different reasons, to determine whether smokers are ready to quit smoking, types of physical and psychological dependence on smoking, as a result of studying the influencing factors and the relationships between them, it is aimed to better understand the causes of smoking and identify appropriate steps to Decongest smoking. Materials and methods: Our study was carried out on a voluntary basis outside the ASMs after completing their work in the ASMs, with prior information given to patients over the age of 15 and their relatives who applied to the ASMs in Konya city centre. In the study, a questionnaire consisting of 86 open-ended and closed-ended questions was applied to 900 participants. Turkish adaptation of globally accepted questions was used to categorise smoking status. Turkish adaptation of the questionnaire proposed by Prochaska et al. was used to classify smokers and quitters in terms of the gradual change process in quitting. The Fagerstrom Nicotine Dependence Test (FNBT) was used to assess the addiction levels of the smokers. The collected data were analysed using the statistical software R 4.3.1 (R Core team, 2023). Findings: The mean age of the participants who smoked was 36.6 ± 4.61 years, the mean age of the participants who quit smoking was 37.9 ± 4.97 years, and the mean age of the participants who had never smoked was 34.5 ± 4.84 years. Of the participants, 55% were female (n=497) and 45% (n=403) were male. A total of 900 voluntary participants aged 15 years and over, 300 from each of Karatay, Selçuklu and Meram regions, were surveyed. The mean age of the participants was 35.60 ± 18.51 years, mean height was 167.06 ± 9.27 cm, and mean weight was 71.64 ± 15.64 kg. The mean age at initiation of smoking was 17.63 ± 5.63 years among the current smokers (n=269) who participated in the study. The mean duration of smoking was 17.35 ± 14.76 years. The mean duration of smoking abstinence of 119 smokers who quit smoking in the study was 9.36 ± 9.22 years. The mean age of starting smoking was 17.57 ± 3.94 years and the mean duration of smoking was 14.76 ± 15.09 years. A statistically significant relationship was found between the age groups of the individuals and their smoking status (p<0.05). A statistically significant relationship was found between the gender of the individuals and their smoking status (p<0.05). While 34% (n=91) of smokers were female, 66% (n=178) were male. Among those who quit smoking, 37% (n=44) were female and 63% (n=75) were male. Among never smokers, 71% (n=362) were female and 29% (n=150) were male. There is a statistically significant difference between the average age at the beginning of smoking in male and female smokers in the study (p<0.05). The mean age of smoking initiation of female smokers in the study was higher than that of male smokers. There is a statistically significant difference between the duration of smoking of men and women who quit smoking in the study (p<0,05). The average smoking duration of men who quit smoking in the study is higher than that of women who quit smoking and more than twice as much. There was a statistically significant relationship between marital status and smoking status (p<0.05). While 64% (n=171) of smokers were married, 36% (n=98) were single or divorced. Among those who quit smoking, 71% (n=85) were married and 29% (n=34) were single or divorced. Among never smokers, 55% (n=280) were married and 45% (n=232) were single or divorced. A statistically significant correlation was found between smoking status and whether the individuals had children or not (p<0.05). While 60% (n=161) of smokers had children, 40% (n=108) did not. A statistically significant relationship was found between the educational status of the individuals and their smoking status (p<0.05). A statistically significant relationship was found between the employment status of the individuals and their smoking status (p<0.05). While 79% (n=212) of smokers were employed, 10% (n=26) were not working anywhere and 11% (n=31) were housewives. A statistically significant relationship was found between the income levels of the individuals and their smoking status (p<0.05). A statistically significant relationship was found between the chronic disease status of the individuals and their smoking status (p<0.05). While 18% (n=49) of smokers had a chronic disease, 82% (n=220) did not have a chronic disease. A statistically significant relationship was found between alcohol use and smoking status (p<0.05). While 27% (n=73) of the smokers used alcohol, 73% (n=196) did not use alcohol. The relationship between regular drug use and smoking status was found to be statistically significant (p<0.05). When the distribution of smokers (n=269) in the study was analysed according to Fagerström addiction level, it was seen that 2% (n=6) were very slightly addicted, 39% (n=104) were slightly addicted, 23% (n=61) were moderately addicted, 33% (n=90) were very addicted and 3% (n=8) were extremely addicted. A statistically significant difference was found in the mean age of starting smoking according to the Fagerström dependence levels of the smokers in the study (p<0.05). It is seen that the age of starting smoking is higher in less dependent people than in medium and highly dependent people. When the participants in our study, who were 120 current smokers and did not try to quit smoking, were categorised according to the transtheoretical model, 85% (n=102) were in the pre-thinking stage, 5% (n=6) in the thinking stage and 10% (n=12) in the preparation stage. The factors that were effective in quitting smoking were asked to the people who quit smoking in the study, and 48% (n=57) of these people stated that health problems, 27% (n=32) stated that there was no special reason, 24% (n=28) stated that their family had an effect, 24% (n=28) stated that the effect of cigarette prices, 8% (n=9) stated that economic reasons, 5% (n=6) stated that the effect of friends, and 5% (n=6) stated that the discomfort felt by their close environment was effective. It was observed that 79% (n=94) of the people who quit smoking in the study quit smoking suddenly, 17% (n=20) quit smoking gradually, 3% (n=4) quit smoking with NRT, and 1% (n=1) quit smoking with varenicline. Conclusions: Health professionals have an important role in the fight against smoking. However, the most important task falls to the first-line workers and family physicians. Family physicians, to whom individuals from all age groups primarily apply, are in a very important position in preventing the people who apply to them from starting smoking and making the current smokers quit smoking with their importance in fulfilling preventive health services, their special discipline and their holistic approach to their patients. The lack of knowledge about the harms of smoking, which we found in our study and which is parallel to many studies in the literature, has a great effect on both the reason for starting and the success in quitting. In this direction, along with national and local policies, adequate information about smoking and its harms to be given by family physicians is the most important factor in the fight against smoking.