Regression analysis of variables in the model.

ObjectiveResearch on the mediating effect of smoking abstinence self-efficacy (SASE) on the relationship between health literacy and nicotine dependence is limited. This study examines the mechanisms through which health literacy influences addictive behavior and provides additional scientific evidence to inform smoking cessation interventions.MethodsA total of 500 participants were recruited from 20 communities in Qingdao between June 2023 and June 2024. Spearman correlation analysis was used to explore relationships between nicotine dependence and other factors. Linear regression analyses were conducted to examine the relationships between health literacy, SASE, and nicotine dependence. Path analysis was performed using AMOS to assess the interactions among nicotine dependence, SASE, and health literacy, with mediation effects tested using the bootstrap method.ResultsAfter adjusting for potential confounders such as age, marital status, education level, and occupation, path analysis revealed a significant positive correlation between health literacy and SASE in habitual/addictive situations (SASEH; β = 0.185, p ConclusionsSASEH partially mediates the relationship between health literacy and nicotine dependence. Increasing health literacy not only directly reduces nicotine dependence but also improves SASE, which in turn further reduces dependence.