Introduction Providing smoking cessation treatment is an important intervention for tuberculosis (TB) patients. Mobile technologies, such as smartphone applications, have shown promising potential. However, there are few effective applications that could support TB patients in their efforts to quit smoking. To address this problem, we will develop a smartphone application ‘QinTB’ to help TB patients quit smoking, and we will evaluate the clinical efficacy of this application by using a randomised controlled trial (RCT). Methods and analysis This is a two-step study. In the first step, we will develop a smartphone application based on an interactive application of the transtheoretical model and protection motivation theory. Then, we will perform an RCT using a two-arm design; a total of 400 patients will be randomly assigned to the application group or the doctors’ advice group; both treatments will be 6 months and follow-up will be 12 months; the primary outcome is the biochemically verified 6 month sustained abstinence rate; data will be analysed on an intention-to-treat basis. Ethics and dissemination This study was approved by the Ethics Committee of Beijing Research Institute for Tuberculosis Control and Prevention. We will disseminate the findings of this study through peer-reviewed publications and conference presentations. Trial registration number This study was registered in the Chinese Clinical Trial Registry (ChiCTR1900022008) and the stage is Pre-results.

Objective: Studies have shown that smoke-free (SF) workplace policies can create an SF environment, but most of them have focused only on reducing secondhand smoke (SHS) exposure or changing smoking behavior. Our study aims to explore the effects of SF workplace policies and the pathway between workplace SF policies and SHS exposure. Method: 14 195 employees from 79 companies in China participated in this survey. Binary logistic regression is used to examine the direct effects of SF workplace policies. Structured Equation Modeling approach is used to test other indirect effects. The Sobel test is used to estimate the mediation effect. Results: Working in a company with SF policies was associated with lower SHS exposure (odds ratio = 0.56; 95% confidence interval = 0.51 to 0.60). Such policy were associated with lower smoking prevalence (Coef. = −0.05, p < .05) and positively associated with smoking harm awareness (Coef. = 0.07, p < .05) and SHS harm awareness (Coef. = 0.05, p < .05). Sobel test suggests that approximately 16.3% of the effects on SHS exposure reduction are mediated through the channel of lower smoking prevalence for males. For smokers, we did not identify a direct effect of such policies on quitting intentions, but a significant indirect effect via increased smoking harm awareness (Coef. = 0.07, p < .05) and lower smoking consumption (Coef. = −0.10, p < .05) were found. Conclusion: This study finds that SF workplace policies are not only associated with lower SHS exposure but also related to some indirect effects. Further mediation analyses for males confirmed that the effect on SHS exposure reduction is mediated through the channel of lower smoking prevalence. Implications: This study joins the debate in recent years on the effects of workplace SF policies and provides evidence with more comprehensive data from Asia Best Workplace Mainland China program. It shows that SF workplace policies not only can reduce SHS exposure but also are associated with lower smoking prevalence, fewer cigarettes smoked, and higher smoking harm-related awareness. These findings provide valuable evidence to promote such policies in all workplaces and underline the need for more stringent SF policies to be enacted in all countries.

Objective: Obesity is a well-established risk factor for disease. Controversy exists regarding the relative risk of morbidity and mortality in individuals who are overweight or underweight compared with individuals with a normal body mass index (BMI). In this study, we investigated the associations between BMI and three non-communicable diseases (hypertension, diabetes and heart disease) in older adults. Design: Cohort study. Setting: This study used data from the China Health and Retirement Longitudinal Study. The baseline survey was carried out in 2011, and follow-up surveys were conducted in 2013, 2015 and 2018. Participants: Participants who reported having no doctor-diagnosed chronic disease at baseline were included in this study. Main outcome measures: We analysed the association between baseline BMI and disease incidence using Cox proportional hazards models. Disease information included self-reported diagnosed conditions. BMI was categorised according to the standard Chinese criteria: underweight (<18.5 kg/m ² ), normal body weight (18.5–23.9 kg/m ² ), overweight (24.0–27.9 kg/m ² ) and obese (≥28.0 kg/m ² ). Results: A total of 5605 participants were included at baseline. Based on the Kaplan-Meier estimation, the participants who were obese had the highest incidence of all three diseases. Compared with normal weight participants, overweight participants had a greater disease incidence (log-rank tests are p<0.01). Cox regression models showed that with increasing BMI, the HRs of diseases increased accordingly (eg, for hypertension, compared with the BMI group <18.5 kg/m ² , the HRs for the BMI groups 18.5–23.9, 24.0–27.9 and ≥28.0 were 1.43 (95% CI 1.00 to 2.05), 2.19 (95% CI 1.51 to 3.18) and 2.89 (95% CI 1.91 to 4.36), respectively). Conclusion: A higher BMI was associated with an increased risk of hypertension, diabetes and heart disease in the population aged 45 years and older. Even within normal BMI ranges, a higher BMI was associated with an increased risk of disease. Actions are urgently needed at the population level to address the growing public health challenge of excess weight in the context of an ageing population.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Most mobile cessation studies have found that such interventions have a higher quitting rate than interventions providing minimal smoking cessation support. However, why such interventions are effective has been almost unstudied by researchers. Objective: This paper describes the principles of the personalized mobile cessation intervention-based WeChat app and used generalized estimated equations to assess why a personalized mobile cessation intervention was more likely to promote smokers from the preparation stage to the action stage than a nonpersonalized intervention. Methods: This is a 2-arm, double-blind, randomized controlled trial in five cities in China. The intervention group received a personalized mobile cessation intervention. The control group received a nonpersonalized SMS text message smoking cessation intervention. All information was sent by the WeChat app. The outcomes were the change in protection motivation theory construct scores and the change in transtheoretical model stages. Results: A total of 722 participants were randomly assigned to the intervention or control group. Compared with those who received the nonpersonalized SMS text message intervention, smokers who received the personalized intervention presented lower intrinsic rewards, extrinsic rewards, and response costs. Intrinsic rewards were determinants of stage change, thus explaining why the intervention group was more likely to promote smokers from the preparation stage to the action stage (odds ratio 2.65, 95% CI 1.41-4.98). Conclusions: This study identified the psychological determinants at different stages to facilitate smokers moving forward to the next stage of quitting behavior and provides a framework to explore why a smoking cessation intervention is effective. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100041942; https://tinyurl.com/2p8jppu7

Tuberculosis (TB) is the second leading cause of death from infectious diseases, with most deaths occurring in low- and middle-income countries. Despite a globally decreasing trend up to 2019, the total number of TB deaths increased in 2020 and 2021 [1]. This highlights a need for urgent action to mitigate the current trend of TB […]

Introduction: Smoking prevalence is disproportionately higher in those with psychiatric symptoms. Smokers with psychiatric symptoms are less likely to have an intention to quit smoking and attain eventual smoking abstinence. This study presents the relationship between depressive/anxiety...