BMC Public Health 2006, 6:65 http://www.biomedcentral.com/1471-2458/6/65 Table 4: Most influential trigger to smoke during a period of abstinence % of sample (N = 201) In social situations (e.g., in the company of other smokers, etc) After a meal When feeling negative, or down When feeling positive, or elated When feeling stressed When feeling tired During entertainment (Playing cards for money, playing Majiang, watching sport, etc.) While reading or writing When alone In the presence of alcohol social situation that involved other smokers (30.8%), fol- lowing a meal (14.4%), or feeling negative or down (13.4%) (see Table 4). From a range of items respondents were asked what kinds of situations caused them to relapse (Survey Question 16). Social situations (often involving other smokers) was highest on the list of frequent responses (34.3%), but after a meal (7.5%) was less important than being alone (8.4%), and high or low emotional states (13.4% respec- tively) (see Table 5). When asked to identify only one factor that caused them to relapse (Survey Question 17), respondents indicated that personal factors such as low perceived sense of self-con- trol (40.3%), the influence of other smokers (28.9%), and a lack of available cessation methods (16.9%) were the most frequent responses. Discussion This report describes results from a household survey of tobacco cessation and relapse related attitudes and behav- iors from a representative sample of male smokers living Table 5: Situations causing relapse among Chinese male smokers In social situations (e.g., in the company of other smokers, etc) When feeling negative, or down When feeling positive, or elated When alone After a meal During entertainment (Playing cards for money, playing Majiang, watching sport, etc.) While reading or writing When feeling tired When feeling stressed In the presence of alcohol N 62 29 27 22 18 12 10 9 7 4 N 69 27 27 17 15 12 11 10 9 4 30.8 14.4 13.4 10.9 9.0 6.0 5.0 4.5 3.5 2.0 34.3 13.4 13.4 8.4 7.4 5.9 5.4 4.9 4.4 1.9 95% C.I. 24.5 – 37.7 9.9 – 20.1 9.0 – 18.9 7.0 – 16.1 5.4 – 13.8 3.1 – 10.2 2.4 – 8.9 2.1 – 8.3 1.4 – 7.0 0.5 – 5.0 in Hangzhou, an urban city in eastern China. The regional variation in tobacco use in China has been documented [10] with prevalence rates in rural areas higher than the national average for men smokers (68.4% versus 64%) [14,15]. However, in eastern China where our study was conducted, smoking rates are lower than in other areas, and we feel much of our data is representative of this area of China. For example, a recent survey by Yang in 2002 [16] found that the smoking rate for men in Hangzhou was 42.9%. Further, we wish to point out that the WHO definition of smoking (daily smoking for 6 months) used in our survey differs from the 1996 National Survey (smoking at least one cigarette daily)[10]. However, given these differences, our data is similar to National Survey data in terms of the relatively late uptake of smoking after age 20 for most men, the high smoking rates, the propor- tion who have tried to quit (27% versus 34%) and the low rate of successful lifetime quitters (2.3% nationally versus 0%) in our study. Our survey interviews identified similar reasons for relapse among our sample of Chinese male smokers to those that have been reported for the broad category of % of sample (N = 201) 95% C.I. 27.7 – 41.3 9.0 – 18.9 9.0 – 18.9 5.0 – 13.2 4.2 – 12.0 3.1 – 10.1 2.7 – 9.5 2.4 – 8.9 2.0 – 8.3 0.5 – 5.0 Page 4 of 7 (page number not for citation purposes)