Abstract

Background: Chilean women have one of the highest smoking prevalence in the world. Aim To estimate the main factors associated with smoking initiation and quitting among a cohort of adult women living in a low socioeconomic status area of Santiago, Chile. Material and methods: A random population-based sample of 1,100 women, 18 years and older, were selected from a community located in the South East area of Santiago. Sociodemographic, as well as smoking, beliefs, behaviors, stages of change and nicotine addiction level were recorded during a personal interview. After an average follow-up period of 5.5years, women were re-evaluated. Results: Seventy-three percent of women completed the study. At baseline, 39% of women were smokers. At the end of the study, there was an absolute smoking rate reduction of 7.1% (p <0.001). The main variables associated with smoking initiation were younger age (Odds ratio (OR): 1.08, 95% confidence intervals (CI): 1.05-1.12), higher education level (OR: 1.2, 95% CI: 1.07-1.35), and having fewer children (OR: 1.3 95% CI: 1.01-1.66). Factors related with quitting were younger age of onset (OR: 1.06 95% CI: 1.02-1.1), higher level of nicotine dependence (OR: 4.22, 95% CI: 1.74-10.27), and higher perception of smoking addiction (OR: 4.34, 95% CI: 2-9.09). Stage of change was associated with smoking cessation but its effect was diluted after adjusting for the level of nicotine addiction. Conclusions: Sociodemographic and family factors were the main variables related with initiation, whereas age of onset, belief of addiction, and nicotine dependence were the main factors related with cessation. Women with a high motivation for quitting should be evaluated for nicotine addiction level to define the best strategy for intervention.