RESEARCH PAPER
Factors determining intention to quit tobacco: exploring patient responses visiting public health facilities in India
 
More details
Hide details
1
Public Health Foundation of India, New Delhi, India
2
Division of Epidemiology and Public Health, University of Nottingham, Room B110 Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK
3
Indian Institute of Public Health, Gandhinagar, Sardar Patel Institute Campus, Ahmadabad, India
CORRESPONDING AUTHOR
Divya Persai   

Public Health Foundation of India, 2nd Floor, PHD House, August kranti Marg, 4/2 Siri Institutional Area, New Delhi 110016, India
Publish date: 2014-01-20
 
Tobacco Induced Diseases 2014;12(January):1
KEYWORDS
ABSTRACT
Background:
Intention to quit and setting a quit date are key steps in the process towards improving quit rates and are thus an integral part of tobacco cessation efforts. The present study examined various motivating factors of “intention to quit” and “setting a quit date” in patients visiting public health facilities in two states of India.

Methods:
A total of 1569 tobacco-users visiting public health facilities in 12 districts of the states of Andhra Pradesh and Gujarat were assessed through an interviewer-administered questionnaire. Bivariate and multivariable logistic regression was performed to assess the effect of socio-demographic characteristics, nicotine dependence, previous quit attempts and motivational factors on “intention to quit within 30 days” and “setting a quit date”.

Results:
Only 12% of patients intended to quit tobacco within 30 days and about 11% of them were ready to set a quit date. Respondents aged above 25 years were 53% less likely to quit tobacco within 30 days when compared to those below 25 years (95% Confidence Intervals [CI]: 0.22 to 0.99). Smokeless tobacco users were associated with an odds ratio (OR) of 2.05 (95% CI: 1.15 to 3.65) for “setting a quit date” when compared to smokers. Those with 1 to 5 previous quit attempts (in the past twelve months) were associated with an OR of 2.2 (95% CI: 1.38 to 3.51) for “intention to quit” and 2.46 (95% CI: 1.52 to 3.96) for “setting a quit date”. “Concern for personal health” and “setting an example for children” were associated with ORs of 3.42 (95% CI: 1.35 to 8.65) and 2.5 (95% CI: 1.03 to 6.03) respectively for “setting a quit date”.

Conclusions:
This study is amongst the first in India to explore factors associated with the “intention to quit” and “setting a quit date” among patients visiting public health facilities. Our findings suggest that socio-economic and individual-level factors are important factors depicting intention to quit and setting a quit date. We recommend the need for well-defined studies to understand the long term effects of factors influencing tobacco cessation for patients visiting public health facilities in India.

 
REFERENCES (31)
1.
World Health Organization: WHO Global Report Mortality Attributable to Tobacco. 2012, Geneva: World Health Organization.
 
2.
Gajalakshmi CK, Jha P, Ranson K, Nguyen S: Global patterns of smoking and smoking-attributable mortality. Tobacco control in developing countries. Edited by: Jha P, Chaloupka FJ. 2000, New York: Oxford University Press for the World Bank and WHO, 12-39.
 
3.
Ministry of Health and Family Welfare: Global Adult Tobacco Survey, India 2009-10. 2010,http://mohfw.nic.in/WriteReadD....
 
4.
Centers for Disease Control and Prevention: Best practices for comprehensive tobacco control programs. 2007, Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
 
5.
Balmford J, Borland R, Burney S: The influence of having a quit date on prediction of smoking cessation outcome. Health Educ Res. 2010, 25 (4): 698-706. 10.1093/her/cyq013. 10.1093/her/cyq013.
 
6.
Srivastava S, Malhotra S, Harries AD, Lal P, Arora M: Correlates of tobacco quit attempts and cessation in the adult population of India: secondary analysis of the Global Adult Tobacco Survey, 2009–10. BMC Public Health. 2013, 13: 263-10.1186/1471-2458-13-263. 10.1186/1471-2458-13-263.
 
7.
Yong HH, Borland R, Siahpush M: Quitting-related beliefs, intentions, and motivations of older smokers in four countries: findings from the International Tobacco Control Policy Evaluation Survey. Addict Behav. 2005, 30 (4): 777-788. 10.1016/j.addbeh.2004.08.023. Retrieved from: http://www.ncbi.nlm.nih.gov/pu....
 
8.
Bock BC, Becker BM, Partridge R, Niaura R: Are emergency chest pain patients ready to quit smoking?. Prev Cardiol. 2007, 10 (2): 76-82. 10.1111/j.1520-037X.2007.06443.x. 10.1111/j.1520-037X.2007.06443.x.
 
9.
Bernstein SL, Boudreaux ED, Cabral L, Cydulka RK, Schwegman D, Larkin GL, Rhodes KV: Nicotine dependence, motivation to quit, and diagnosis in emergency department patients who smoke. Addict Behav. 2007, 31 (2): 288-297. 10.1080/14622200802239272.
 
10.
Stockings E, Bowman J, McElwaine K, Baker A, Terry M, Clancy R, Wiggers J: Readiness to quit smoking and quit attempts among Australian mental health inpatients. Nicotine Tob Res. 2012, 15 (5): 942-949.
 
11.
Surani NS, Gupta PC, Fong TG, Pednekar MS, Quah AC, Travers MB: Intention to quit among Indian tobacco users: Findings from International Tobacco Control Policy evaluation India pilot survey. Indian J Cancer. 2012, 49 (4): 431-437. 10.4103/0019-509X.107752. 10.4103/0019-509X.107752.
 
12.
Raute LJ, Sansone G, Pednekar MS, Fong GT, Gupta PC, Quah AC, Sinha DN: Knowledge of health effects and intentions to quit among smokeless tobacco users in India: Findings from the International Tobacco Control Policy Evaluation (ITC) India Pilot Survey. Asian Pac J Cancer Prev. 2011, 12 (5): 1233-1238.
 
13.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO: The Fagerstrom Test for nicotine dependence: A revision of the Fagerstrom tolerance questionnaires. Br J Addict. 1999, 86: 1119-1127.
 
14.
Government of India. Ministry of Home Affairs. Office of Registrar General and Census Commissioner: Census of India. 2011,http://censusindia.gov.in/.
 
15.
Biener L, Abrams DB: Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991, 10: 360-365. Retrieved from: http://www.ncbi.nlm.nih.gov/pu....
 
16.
Rani M, Bonu S, Jha P, Nguyen SN, Jamjoum L: Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tob Control. 2003, 12: 4-10.1136/tc.12.4.e4.
 
17.
Ministry of social justice and environment: Government of India.http://socialjustice.nic.in/.
 
18.
StataCorp: Stata Statistical Software: Release 12. 2011, College Station, TX: StataCorp LP.
 
19.
Sansone GC, Raute LJ, Fong G, Pednekar MS, Quah ACK, Bansal MT, Gupta PC, Sinha DN: Knowledge of health effects and intentions to quit among smokers in India: Findings From the Tobacco Control Policy (TCP) India Pilot Survey. Int J Environ Res Public Health. 2012, 9 (2): 564-578.
 
20.
Siahpush M, Borland R, Yong HH, Kin F, Sirirassamee B: Socio-economic variations in tobacco consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia: results from the International Tobacco Control-South-East Asia (ITC-SEA) survey. Addiction. 2008, 103 (3): 502-508. 10.1111/j.1360-0443.2007.02113.x. 10.1111/j.1360-0443.2007.02113.x.
 
21.
Li L, Borland R, Yong HH, Fong GT, Travers BM, Quah A, Fotuhi O: Predictors of smoking cessation among adult smokers in Malaysia and Thailand: Findings from the International Tobacco Control South-East Asia Survey. Nicotine Tob Res. 2010, 12: 34-44. 10.1093/ntr/ntq030. 10.1093/ntr/ntq030.
 
22.
Vidal PM, Cerveira JM, Paccaud F, Waeber G, Vollenweider P, Cornuz J: Prevalence and factors associated with difficulty and intention to quit smoking in Switzerland. BMC Public Health. 2011, 11 (1): 277-10.1186/1471-2458-11-277. 10.118.
 
23.
Haddad LG, Petro-Nustas W: Predictors of intention to quit smoking among Jordanian university students. Can J Public Health. 2006, 97: 9-13.
 
24.
Hyland A, Borland R, Li Q, Yong HH, McNeill A, Fong GT, O’Connor RJ, Cummings KM: Individual-level predictors of cessation behaviours among participants in the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006, 15 (3): 83-94.
 
25.
Fiore MC, Jaen CR, Baker TB: Treating tobacco use and dependence: 2008 Update. 2008, Rockville (MD): US Department of Health and Human Services. Public Health Service.
 
26.
Hyland A, Li Q, Bauer JE, Giovino GA, Steger C, Cummings KM: Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res. 2004, 6: 363-369. 10.1080/14622200412331320761.
 
27.
Hymowitz N, Cummings K, Hyland A, Lynn W, Pechacek T, Hartwell T: Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997, 6 (2): 57-62.
 
28.
Yang J, Hammond D, Driezen P, Fong GT, Jiang Y: Health knowledge and perception of risks among Chinese smokers and non-smokers: Findings from the Wave 1 ITC China Survey. Tob Control. 2010, 19: 18-23. 10.1136/tc.2009.029710. 10.1136/tc.2009.029710.
 
29.
Sieminska A, Buczkowski K, Jassem E, Lewandowska K, Ucinska R, Chelminska M: Patterns of motivations and ways of quitting smoking among Polish smokers: a questionnaire study. BMC Public Health. 2008, 8 (4): 274-10.1186/1471-2458-8-274.
 
30.
Arora M, Tewari A, Nazar GP, Gupta VK, Shrivastav R: Ineffective pictorial health warnings on tobacco products: Lessons learnt from India. Indian J Public Health. 2012, 56: 61-64. 10.4103/0019-557X.96978.
 
31.
Kaur J, Jain DC: Tobacco control policies in India: Implementation and challenges. Indian J Public Health. 2011, 55: 220-227. 10.4103/0019-557X.89941.
 
 
CITATIONS (8):
1.
High Tobacco Use among Presumptive Tuberculosis Patients, South India: Time to Integrate Control of Two Epidemics
Kunal Pradip Kanakia, Marie Gilbert Majella, Pruthu Thekkur, Gomathi Ramaswamy, Divya Nair, Palanivel Chinnakali
Osong Public Health and Research Perspectives
 
2.
Intention to Quit Smoking among Intermediate and Secondary School Students in Saudi Arabia
Al-Zalabani Abdulmohsen Hamdan, Abdallah Ayat Roushdy, Alqabshawi Reem Ibrahim
Asian Pacific Journal of Cancer Prevention
 
3.
Knowledge, attitudes and beliefs towards e-cigarettes among e-cigarette users and stop smoking advisors in South East England: a qualitative study
Nancy Tamimi
Primary Health Care Research & Development
 
4.
Changes in Vietnamese Male Smokers' Reactions Towards New Pictorial Cigarette Pack Warnings Over Time
Thu Ngan Tran, Vu Anh Le, Thi Tuyet My Nguyen, Ngoc Bich Nguyen
Asian Pacific Journal of Cancer Prevention
 
5.
Evaluation of a brief counseling for tobacco cessation in dental clinics among Swedish smokers and snus users. A cluster randomized controlled trial (the FRITT study)
Suvi E. Virtanen, Zangin Zeebari, Izla Rohyo, Maria R. Galanti
Preventive Medicine
 
6.
Determination of Nicotine Content and Delivery in Disposable Electronic Cigarettes Available in the United States by Gas Chromatography-Mass Spectrometry
Todd Pagano, A. Gary DiFrancesco, Susan B. Smith, Jerrin George, Gloria Wink, Irfan Rahman, Risa J. Robinson
Nicotine & Tobacco Research
 
7.
Stop Smoking Practitioners’ understanding of e-cigarettes’ use and efficacy with particular reference to vapers’ socioeconomic status
Rosemary Hiscock, Deborah Arnott, Martin Dockrell, Louise Ross, Andy McEwen
Journal of Smoking Cessation
 
8.
Salience and Impact of Health Warning Label on Cigarette Packs in Vietnam: Findings From the Global Adult Tobacco Survey 2015
Nguyen Ngoc Bich, Tran Thu Ngan, Kim Bao Giang, Phan Thi Hai, Doan Thi Thu Huyen, Luong Ngoc Khue, Nguyen Tuan Lam, Hoang Van Minh, Pham Thi Quynh Nga, Nguyen The Quan, Vu Hoang Loan
Behavioral Medicine
 
eISSN:1617-9625