Determinants of Successful Smoking Cessation in Surakarta
Abstract
Background: Smoking cessation is not an easy endeavor as tobacco addiction is a group of behavioral, cognitive and physiological phenomena. This study aimed to analyze the determinants of successful smoking cessation using health belief model (HBM), PRECEDE-PROCEED model, and theory of planned behavior (TPB).
Subjects and Method: This was an analytic observational study with cross-sectional design. It was conducted in Surakarta, in December 2017. A sample of 165 study subjects consisting of 68 ex-smokers who were successful in smoking cessation and 97 smokers who were unsuccessful in smoking cessation, by snowball sampling. The dependent variable was smoking cessation. The independent variables were intention to quit smoking, attitude toward smoking cessation, outcome expectation, addiction, stress, perceived behavioral control (PBC), subjective norm, social support, family income, purchasing power, smoking duration, and access to cigarette. The data were collected using questionnaire and analyzed using path analysis.
Results: Successful smoking cessation was directly affected by strong intention (b= 2.39, SE= 0.51, p <0.001), duration of smoking (≥10 years) (b= -3.46; SE= 0.57; p <0.001), and easy access to cigarettes (b= -1.28; SE= 0.52; p= 0.008). Intention is was affeced by positive attitude (b = 0.79, SE= 0.39, p= 0.046), positive PBC (b= 1.89, SE= 0.40; p<0.001), high purchasing power (b= -1.23; SE= 0.39; p= 0.002), and positive subjective norm (b= 1.38; SE= 0.40; p= 0.001). Positive PBC was affected by duration of smoking (≥10 years) (b= -2.32; SE= 0.47; p<0.001), positive outcome expectation (b= 1.04; SE= 0.49; p= 0.035), and addiction (b= -2.96; SE= 0.49; p<0.001). Positive attitude was affected by positive expectation outcomes (b= 1.09; SE= 0.34; p= 0.001). Positive subjective norm (b= 0.77; SE = 0.33; p= 0.020) and positive outcome expectation (b= 0.77; SE= 0.33; p= 0.020) were affected by social support. Smoking duration was affected by stress (b= 0.09; SE=- 0.04; p= 0.018). Cigarette purchasing power was affected by high income (b=2.78; SE= 1.43; p= 0.053).
Conclusion: Successful smoking cessation is directly affected by intention, smoking duration, stress, and access to cigarette. Success smoking cessation is indirectly affected by attitude, addiction, PBC, subjective norm, social support, outcome expectation, family income, purchasing power.
Keyword: smoking cessation, HBM, PRECEDE-PROCEED, TPB
Correspondence: Joko Tri Atmojo. School of Health Sciences Mamba'ul 'Ulum, Surakarta, Jl. Ring Road Utara, Tawangsari, Mojosongo, Jebres, Surakarta, Central Java. Email: jokotriatmojo1@gmail.com. Mobile: 081393319000.
Journal of Health Promotion and Behavior (2017), 2(4): 332-344
https://doi.org/10.26911/thejhpb.2017.02.04.05
References
Cook K, Bhatti L, Tursan d’Espaignet E (2016). WHO Tobacco Knowledge Summaries: Tobacco and stroke. WHO: Geneva. Diakses dari http://-apps.who.int/iris/bitstream/10665/250278/1/WHO-NMH-PND-CIC-TKS-16.1-eng.pdf?ua=1 pada 27 Sep-tember 2017.
Driezen P, Abdullah AS, Quah ACK, Nargis N, Fong GT (2016). Determinants of intentions to quit smoking among adult smokers in Bangladesh: findings from the International Tobacco Control (ITC) Bangladesh wave 2 survey Global Health Research and Policy, 1: 11.
Fagan P, Augustson E, Backinger CL, et al (2007). Quit attempts and intention to quit cigarette smoking among young adults in the United States. Am J Public Health, 97: 1412-20.
Hyland A, Li Q, Bauer JE, et al. (2004). Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res, 6(3): S363e9.
Hyland A, Levy DT, Rezaishiraz H, et al. (2005). Reduction in amount smoked predicts future cessation. Psychol Addict Behav, 19: 221e5.
Hyland A, Borland R, Li Q, et al. (2006). Individual level predictors of cessation behaviours among participants in the International Tobacco Control (ITC) Four Country Survey. Tob Control, 15(3): iii83e94.
Jha P, Peto R (2014). Global effects of smoking, of quitting, and of taxing tobacco. N Engl J Med., 370(1): 60–8. doi:10.1056/NEJMra1308383.
Murray CJ, Lopez AD (2013). Measuring the global burden of disease. N Engl J Med.369(5): 448–57 doi: 10.1056/NEJMra1201534 PMID: 23902484.
Peretti Watel P, Halfen S, Gremy I (2007). Risk denial about smoking hazards and readiness to quit among French smokers: an exploratory study. Addict Behav, 32: 377-383.
Tucker JS, Ellickson PL, Orlando M, et al (2005). Predictors of attempted quitting and cessation among young adult smokers. Prev Med., 41: 554e61.
Vidal PM, Cerveira JM, Paccaud F, Waeber G, Vollenweider P, Cornuz J (2011). Prevalence and factors associated with difficulty and intention to quit smoking in Switzerland. BMC Public Health, 11: 227.
WHO (2008). WHO Report on the Global Tobacco Epidemic, 2008 The MPO WER package, Geneva.
_____ (2010). Gender, Women, and the Tobacco Epidemic: Quitting Smoking and Beating Nicotine Adiction. ISBN 978 92 4 159951 1. Diakses dari http://apps.who.int/iris/bitstream/10665/44342/1/9789241599511_eng.pdf pada 5 Oktober 2017.
_____ (2016). World Health Statistics data visualizations dashboard. Diakses dari http://apps.who.int/gho/data/view.sdg.3adatactry?lang=en pada 30 Oktober 2017.
_____ (2017). Tobacco Free Initiative (TFI). Quitting tobacco. Diakses dari http://www.who.int/tobacco/quitting/en/ pada 30 Oktober 2017.
