Effect of tobacco control policies on intention to quit smoking cigarettes: A study from Beirut, Lebanon
Monique Chaaya 1  
Rima Nakkash 2
Dahlia Saab 1
Lina Kadi 1
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Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
Department of Community and Behavioral Health, The University of Iowa, Iowa City, United States
Monique Chaaya   

Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
Publish date: 2019-09-02
Tob. Induc. Dis. 2019;17(September):63
In Lebanon, the tobacco control policy, Law 174, became effective in 2011. Using the International Tobacco Control Policy Evaluation Project (ITC) conceptual model, this study aims to assess the association between exposure to control measures related to the policy and the intention to quit, which is a mediator in the pathway leading to behavioral change (quitting).

This is a secondary data analysis of 154 cigarette smokers from a crosssectional survey that assessed compliance with Law 174 among Beirut residents aged 15–65 years. Data were collected face-to-face, three months after the implementation of indoor public places and tobacco advertisement/promotion bans. Intention to quit smoking was the main outcome. Exposure to policy control measures such as seeing smokers in restaurants, and noticing warning labels on cigarette packs were the explanatory variables. Sociodemographics, past smoking behavior, and psychosocial variables were also considered for their moderating and mediating effects, respectively. Crude and adjusted odds ratios (ORs) were generated. Sobel test was used to check for possible mediation.

Intention to quit was reported by 24% of cigarette smokers. The association between noticing warning labels and having intentions to quit was statistically significant (adjusted OR=6.27). Concerns about influencing children’s smoking behavior had a statistically significant mediation effect on the relationship. After adding the interaction term between noticing the warnings and previous quit attempts, the OR was inflated to 12.92, suggesting a possible interaction.

This study offers preliminary insight into how Lebanese smokers are influenced by policy related control measures like health warning labels on cigarette packs. Tobacco control policy advocates should push for stronger enforcement of public smoking bans in general. Behavioral intervention should work on the mediator variables to influence smoking behavior and encourage quitting. Further prospective studies modelling quitting as outcome are needed.

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
This work was supported by the University Research Board (URB) of the American University of Beirut and Issam Fares Institute for Public Policy and International Affairs.
Not commissioned; externally peer reviewed.
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