Temporal changes of smoking status and motivation in Chinese patients with hepatitis B: relationship with anxiety and depression

Abstract

Aims and objectives: The present study provided the first examination of cigarette smoking status and motivation before and after the diagnosis of hepatitis B in Chinese hepatitis B smokers.

Background: Cigarette smoking is known to contribute to the severity of chronic liver diseases. However, the rates of cigarette smoking remain high in Chinese patients with hepatitis B.

Design: We used individual interviews and brief questionnaires to collect smoking status and motivation before and after the diagnosis of hepatitis B in hepatitis B smokers. We also evaluated the relationships between anxiety and depression and cigarette smoking in Chinese hepatitis B smokers.

Method: Patients with hepatitis B (54 smokers and 127 non-smokers) were enrolled consecutively. A battery of self-report questionnaires was used to assess smoking status and motivation before and after the diagnosis of hepatitis B. All participants also were asked to complete the Hospital Anxiety and Depression Scale.

Results: We found that the number of cigarettes per day after the diagnosis of hepatitis B was higher than that before the diagnosis of hepatitis B in hepatitis B smokers. A wide range of smoking motivation was found before and after the diagnosis of hepatitis B. 'Nicotine pleasure' was the primary motivation before the diagnosis of hepatitis B, whereas 'anxiety' and 'depression' were the primary motivation for the increase in cigarette consumption after the diagnosis of hepatitis B. Anxiety and depression were more frequently observed in hepatitis B smokers than in hepatitis B non-smokers. Anxiety and depression were associated with continued smoking after hepatitis B diagnosis.

Conclusions: The present study first demonstrated that cigarette smoking status and motivation were different before and after the diagnosis of hepatitis B. Anxiety and depression play an important role in temporal changes of smoking status and motivation.

Relevance to clinical practice: These findings highlight the need for individual anxiety and depression screening and assessment in conjunction with smoking cessation efforts in hepatitis B smokers.