Associations of sociodemographic and smoking characteristics with intention to quit among Chinese adults aged 20-69 years who smoke: Findings from nationwide China Health Literacy Survey during 2018-19.

Objective: To identify factors influencing the intention to quit (ItQ) among Chinese who smoke, focusing on 10th Revision of the International Classification of Diseases (ICD-10) Nicotine dependence. Additionally, to estimate the number of individuals with ItQ, supporting optimal allocation of cessation resources.

Methods: This study used data from the 2018 China Health Literacy Survey, a nationally representative cross-sectional study with 20,288 participants who smoke currently aged 20-69 years. The ItQ proportions were estimated overall and by subgroup. Logistic regression was employed to estimate ORs and 95 % CIs for ItQ. The number of people who smoke with ItQ was estimated based on the census data.

Results: In China, 41.34 % of individuals who smoke had ItQ, higher in females (44.89 %) than males (41.34 %). Provincial proportions ranged from 23.53 % to 63.56 %. ItQ was significantly associated with smoking characteristics, including occasional smoking (OR = 2.08, 95 % CI = 1.88-2.20), fewer pack-years (OR = 0.70, 95 % CI = 0.68-0.73), older smoking initiation age (OR = 1.22, 95 % CI = 1.18-1.27), and ICD-10 Nicotine dependence (OR = 1.12, 95 % CI = 1.06-1.19), as well as age, sex, socioeconomic factors, and health status. Withdrawal symptoms were positively associated with ItQ in individuals who smoke without ICD-10 Nicotine dependence but negatively in those with ICD-10 Nicotine dependence. An estimated 100.3 million adults aged 20-69 in China have ItQ, with 52.14 million suffering from ICD-10 Nicotine dependence.

Conclusions: The intention to quit smoking among Chinese who smoke is low and varies by ICD-10 Nicotine dependence and region, underscoring the need for targeted smoking cessation interventions across diverse smoking populations.