WITHDRAWN: Insomnia Was More Prevalent Among Cigarette Smokers Than Non-Smokers: Findings from Prevalence of Smoking in General Population in Hunan Province of China

Introduction: China is the biggest consumer of cigarettes in the world. Cigarette smoking remains a severe health burden, and contributes to a significant proportion of morbidity and mortality throughout the world. This study aimed to examine sleep quality and insomnia among cigarette smokers and non-smokers in the general population in central China.

Methods: In this population-based cross-sectional sampling survey, we used a community-based method to recruit participants from September 2012 to October 2012 in rural and urban areas of Hunan province, China. A total of 26,851 subjects were sampled from the general population and 26,282 completed the self-report of cigarette smoking characteristics. Cigarette smoking status was determined based on the number of smoked cigarette (more than 100 cigarettes in the life time). Cigarette smoking characteristics were obtained from smokers, including cigarette per day, years of smoking, quit attempts and smoking craving. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep quality and insomnia (PSQI score >5).

Results: The overall prevalence of cigarette smoking was 25.3%, with 45% smokers in males and 3% smokers in females, in general population. Among smokers, 94.5% were males and 5.5% were females. More than half (54.8%) of smokers were alcohol drinkers. The PSQI total score was 4.11±2.62 in nonsmokers and 4.72±2.75 in smokers (p<0.001). The overall insomnia rate was 26.5%, with 24.5% in nonsmokers and 32.7% in smokers (p<0.001). Significantly more smokers than non-smokers (at all different age stages, as well as from both rural and urban areas) demonstrated poor sleep quality and insomnia. Linear regression analysis showed that long-term smokers (p=.001) with stronger smoking craving (p<0.001) had poorer sleep quality (controlled for age and gender).

Conclusions: Poor sleep quality and insomnia was more prevalent among cigarette smokers than non-smokers. Smokers also varied in sleep problems on the basis of the characteristics of their smoking. Smokers should be informed about the link between cigarette smoking and poor sleep quality, and should be advised that one of a range of important health benefits from smoking cessation could be the improvement of your sleep quality.