Contrasting trends of smoking cessation status: insights from the stages of change theory using data from the global adult tobacco survey
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CDC, Office of Smoking and Health, United States of America
World Health Organization, Turkey
Hanoi Medical University, Institution for Preventative Medicine and Public Health, Viet Nam
Instituto Nacional de Salud Pública, Jefe Departamento de Investigación sobre Tabaco, Mexico
Mahidol University, Faculty of Public Health, Thailand
Department of Health, Philippines
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A248
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Quitting tobacco use can reduce smokers' risks for disease and premature death. We used the trans-theoretical behavior change model to examine temporal differences in readiness to quit smoking among adults in five countries.

We analyzed two independent samples from the Global Adult Tobacco Survey, a standardized national adult household survey of persons aged ≥15 years, for five countries: Mexico (2009, 2015), Philippines (2010, 2016), Thailand (2009, 2011), Turkey (2008, 2012), and Vietnam (2010, 2016). Response rates ranged 82.5%-96.3% and sample sizes ranged 8,996-20,606. Current smokers were defined as adults who smoked tobacco on a daily or non-daily basis. Using responses to questions assessing intention to quit cigarette smoking, we categorized current smokers into the following stages of change: pre-contemplation, contemplation, and preparation. Relative change was compared using z-tests (p< 0.05).

No significant change in smoking prevalence between wave 1 and 2 occurred for Mexico (15.9% to 16.4%), Thailand (23.7% to 24.0%), or Vietnam (23.8% to 22.5%). In contrast, smoking prevalence declined for Philippines (28.2% to 22.7%) and Turkey (31.2% to 27.1%). There was an increase in the proportion of smokers in the pre-contemplation stage in Thailand (76.1% to 85.4%) and Vietnam (70.8% to 82.3%), while a decline occurred in Turkey (31.2% to 27.1%); no significant change occurred in Mexico or Philippines. The proportion of smokers in the contemplation stage declined in Thailand (17.6% to 12.0%) and Vietnam (21.6% to 14.1%), but increased in Turkey (21.2% to 26.9%); no significant change occurred in Mexico or Philippines. The proportion in the preparation stage declined in Thailand (6.3% to 2.6%) and Vietnam (7.6% to 3.6%); no significant changes occurred in, Mexico, Philippines, or Turkey.

Using the stages of change model, smokers' readiness to quit varies by country. Tailored interventions towards specific stages of cessation might help motivate quitting behavior.