北京大学学报(医学版) ›› 2026, Vol. 58 ›› Issue (3): 575-583. doi: 10.19723/j.issn.1671-167X.2026.03.018

• 论著 • 上一篇    下一篇

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

张晓悦1, 杨晓晨1, 林昊翔2, 纪颖1, 曹望楠1, 常春1,*()   

  1. 1. 北京大学公共卫生学院社会医学与健康教育系,北京 100191
    2. 北京大学全球健康发展研究院,北京 100871
  • 收稿日期:2026-02-25 出版日期:2026-06-18 发布日期:2026-04-15
  • 通讯作者: 常春
  • 基金资助:
    国家自然科学基金(82173637)

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

Xiaoyue ZHANG1, Xiaochen YANG1, Haoxiang LIN2, Ying JI1, Wangnan CAO1, Chun CHANG1,*()   

  1. 1. Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
    2. Institute for Global Health and Development, Peking University, Beijing 100871, China
  • Received:2026-02-25 Online:2026-06-18 Published:2026-04-15
  • Contact: Chun CHANG
  • Supported by:
    the National Natural Science Foundation of China(82173637)

RICH HTML

  

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。

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

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 derived from a nationwide "E-cigarette Use Survey" conducted in 2023, covering 31 provinces (municipality, autonomous region) in China. A total of 550 current e-cigarette users aged 18-44 years were selected 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 addition, 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 attempted 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 cessation 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 positively 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.

Key words: E-cigarettes, Tobacco use cessation, Intention, Behavior and behavior mechanisms, Protection motivation theory, Adult

中图分类号: 

  • R163.2

图1

本研究中保护动机理论的要素框架图"

表1

研究对象电子烟戒断意愿与戒烟行为的基本特征描述(n=550)"

Characteristics Whole participants, n (%) E-cigarette cessation intention E-cigarette cessation behavior
$\bar x \pm s$ t P Yes, n (%) No, n (%) χ2 P
Age/years 0.176 0.839 1.214 0.545
  18-24 56 (10.18) 3.59±0.95 20 (11.49) 36 (9.57)
  25-34 307 (55.82) 3.52±0.93 100 (57.47) 207 (55.05)
  35-44 187 (34.00) 3.50±1.01 54 (31.03) 133 (35.37)
Gender -0.909 0.364 0.252 0.616
  Male 395 (71.82) 3.50±0.96 122 (70.11) 273 (72.61)
  Female 155 (28.18) 3.58±0.95 52 (29.89) 103 (27.39)
Marital status 0.012 0.990 2.429 0.119
  Married 418 (76.00) 3.52±0.96 140 (80.46) 278 (73.94)
  Widowed/Divorced or separated/ Never married 132 (24.00) 3.52±0.96 34 (19.54) 98 (26.06)
Education level 1.082 0.339 1.528 0.466
  High school and below 27 (4.91) 3.26±1.02 9 (5.17) 18 (4.79)
  College or undergraduate 480 (87.27) 3.54±0.95 155 (89.08) 325 (86.44)
  Master and above 43 (7.82) 3.51±0.96 10 (5.75) 33 (8.78)
Region -0.172 0.864 0.501 0.479
  Rural 118 (21.45) 3.51±0.95 41 (23.56) 77 (20.48)
  Urban 432 (78.55) 3.53±0.96 133 (76.44) 299 (79.52)
Smoke cigarettes -0.405 0.686 1.164 0.281
  Yes 373 (67.82) 3.53±0.93 124 (71.26) 249 (66.22)
  No 177 (32.18) 3.50±1.01 50 (28.74) 127 (33.78)
Cessation behavior -8.002 < 0.001
  Yes 174 (31.64) 3.95±0.79
  No 376 (68.36) 3.32±0.96
Total 550 (100.00) 3.52±0.96 174 (31.64) 376 (68.36)

表2

PMT相关因素的描述性分析"

PMT variables Total, $\bar x \pm s$ Cessation intentiona(r) Cessation behavior, $\bar x \pm s$
Yes No P
Threat appraisal -3.75±6.49 0.32*** -1.55±6.62 -4.77±6.18 < 0.001
  Perceived threat 17.39±4.58 0.33*** 19.05±4.68 16.63±4.33 < 0.001
    Severity 8.87±2.46 0.32*** 9.78±2.52 8.46±2.31 < 0.001
    Vulnerability 8.52±2.60 0.28*** 9.28±2.57 8.17±2.54 < 0.001
  Perceived reward 21.15±3.84 -0.14** 20.60±4.12 21.40±3.68 0.029
    Intrinsic reward 11.19±2.09 -0.07 11.01±2.26 11.27±2.00 0.194
    Extrinsic reward 9.96±2.40 -0.16*** 9.59±2.58 10.13±2.29 0.018
Coping appraisal 11.75±4.50 0.34*** 11.89±4.56 11.69±4.47 0.633
  Perceived efficacy 20.21±3.80 0.40*** 20.68±3.77 19.99±3.79 0.045
    Response efficacy 9.55±2.53 0.30*** 9.58±2.61 9.53±2.49 0.837
    Self-efficacy 10.66±2.54 0.30*** 11.10±2.51 10.45±2.53 0.005
  Perceived cost 8.46±2.36 0.003 8.80±2.52 8.30±2.27 0.027
    Response cost 8.46±2.36 0.003 8.80±2.52 8.30±2.27 0.027

表3

基于PMT的电子烟戒断意愿多重线性回归分析"

Variables E-cigarette cessation intention
Seven primary PMT sub-elements [Model 1, β (95%CI)]
  Severity 0.14 (0.02, 0.26)**
  Vulnerability 0.12 (0.01, 0.23)**
  Intrinsic rewards -0.07 (-0.19, 0.05)
  Extrinsic rewards -0.12 (-0.22, -0.01)**
  Response efficacy 0.26 (0.16, 0.35)***
  Response cost -0.01 (-0.10, 0.09)
  Self-efficacy 0.28 (0.20, 0.37)***
Four perceptions [Model 2, β (95%CI)]
  Perceived threat 0.26 (0.16, 0.36)***
  Perceived rewards -0.19 (-0.31, -0.08)***
  Perceived efficacy 0.54 (0.42, 0.66)***
  Perceived cost -0.01 (-0.11, 0.08)
Two pathways [Model 3, β (95%CI)]
  Threat appraisal 0.27 (0.20, 0.34)***
  Coping appraisal 0.22 (0.14, 0.29)***

表4

基于PMT的电子烟戒断行为二元Logistic回归分析"

Variables E-cigarette cessation behavior
Seven primary PMT sub-elements [Model 1, OR (95%CI)]
  Severity 1.58 (1.12, 2.23)***
  Vulnerability 1.03 (0.76, 1.39)
  Intrinsic rewards 0.97 (0.70, 1.35)
  Extrinsic rewards 0.85 (0.63, 1.15)
  Response efficacy 1.00 (0.77, 1.31)
  Response cost 1.27 (0.96, 1.68)
  Self-efficacy 0.77 (0.59, 1.00)
  Quitting intention 2.16 (1.66, 2.81)***
Four perceptions [Model 2, OR (95%CI)]
  Perceived threat 1.60 (1.20, 2.14)***
  Perceived rewards 0.84 (0.60, 1.16)
  Perceived efficacy 0.80 (0.56, 1.13)
  Perceived cost 1.32 (1.01, 1.73)**
  Quitting intention 2.13 (1.64, 2.77)***
Two pathways[Model 3, OR (95%CI)]
  Threat appraisal 1.41 (1.15, 1.72)***
  Coping appraisal 0.76 (0.62, 0.94)**
  Quitting intention 2.21 (1.71, 2.84)***

表5

不同吸烟状况下电子烟戒断意愿的亚组分析"

Variables Exclusive e-cigarette users Dual users
Seven primary PMT sub-elements (Model 1,β)
  Severity 0.03 0.21***
  Vulnerability 0.14 0.10
  Intrinsic rewards -0.11 -0.05
  Extrinsic rewards -0.06 -0.13**
  Response efficacy 0.17** 0.31***
  Response cost 0.00 -0.02
  Self-efficacy 0.37*** 0.23***
Four perceptions (Model 2,β)
  Perceived threat 0.17* 0.31***
  Perceived rewards -0.19 -0.19***
  Perceived efficacy 0.53*** 0.55***
  Perceived cost -0.03 -0.01
Two pathways (Model 3,β)
  Threat appraisal 0.20*** 0.31***
  Coping appraisal 0.23*** 0.21***

表6

不同吸烟状况下电子烟戒断行为的亚组分析"

Variables Exclusive e-cigarette users Dual users
Seven primary PMT sub-elements (Model 1, OR)
  Severity 2.18** 1.40
  Vulnerability 0.77 1.21
  Intrinsic rewards 0.86 1.09
  Extrinsic rewards 0.54 0.93
  Response efficacy 1.30 0.90
  Response cost 1.58 1.13
  Self-efficacy 0.66 0.82
  Quitting intention 2.10*** 2.30***
Four perceptions (Model 2, OR)
  Perceived threat 1.60 1.69***
  Perceived rewards 0.52 1.01
  Perceived efficacy 0.96 0.74
  Perceived cost 1.70** 1.14
  Quitting intention 1.87*** 2.30***
Two pathways (Model 3, OR)
  Threat appraisal 1.72*** 1.33**
  Coping appraisal 0.71 0.81
  Quitting intention 1.96*** 2.35***
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