Predictors of smoking cessation behavior among Bangladeshi adults: findings from ITC Bangladesh survey
Abu S. Abdullah 1, 2, 3  
,   Pete Driezen 4,   Anne C. K. Quah 4,   Nigar Nargis 5,   Geoffrey T. Fong 4, 6
More details
Hide details
Department of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, USA
Global Health Program, Duke Kunshan University, Kunshan, China
Duke Global Health Institute, Duke University, Durham, USA
Department of Psychology, University of Waterloo, Ontario, Canada
Department of Economics, University of Dhaka, Dhaka, Bangladesh
Ontario Institute for Cancer Research, Toronto, Canada
Abu S. Abdullah   

Department of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor (MISU), Boston, Massachusetts 02118, USA
Submission date: 2015-04-27
Acceptance date: 2015-08-05
Publication date: 2015-08-11
Tobacco Induced Diseases 2015;13(August):23
Research findings on the predictors of smoking cessation behavior identified in Western countries may not be generalizable to smokers in the Southeast Asian countries (i.e., Bangladesh). This study examined the factors associated with smoking cessation behavior (quit attempts and smoking cessation) among a representative sample of Bangladeshi adults.

Data from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control (ITC) Survey in Bangladesh, a face-to-face survey of adult smokers, were analysed. Households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Respondents included in the study are 1,861 adult daily smokers (cigarette only or dual use of cigarette and bidi) in the Wave 1 survey who completed the Wave 2 follow up.

Of the smokers (N = 1,861), 98 % were male, 18 % illiterate, 78 % married and 42 % were aged 40 or above; 89 % were cigarette smokers and 11 % were dual users (cigarette & bidi). Overall, 21.8 % of the baseline smokers made quit attempts (that is, making at least one quit attempt that lasted for at least 24 hours) during the 11- to 12-month interval between Waves 1 and 2 with only 4.1 % quitting successfully (that is, smokers who had stopped smoking for at least 6 months at the time of the Wave 2 survey). Significant predictors of attempts to quit included: residing areas outside Dhaka (OR = 3.41), being aged 40 or older (OR = 1.53), having a monthly income of above BDT10,000 (US$126) versus below BDT 5,000 (US$63) (OR = 1.57), intending to quit sometime in the future (OR = 1.73). Respondents not working indoors/outside the home were less likely to have made a quit attempt than those with no workplace restrictions on smoking (OR = 0.62). Predictors of successful smoking cessation included: being aged 40 or older (OR = 3.11), perceiving self-rated health as good or excellent (OR = 2.40), and an increased level of self-efficacy (OR = 1.75). Smokers who made a quit attempt not so recently (6 months ago or earlier) were less likely to quit than those who made a more recent (in last 6 months) quit attempt (OR = 0.23).

Among Bangladeshi smokers, different factors were associated with quit attempt or successful cessation. Population based smoking cessation programs should take these factors into consideration in the design of smoking cessation interventions. At the same time, measures are necessary to encourage more smokers to make quit attempts.

World Health Organization (WHO). WHO report on the global tobacco epidemic, 2008. The MPOWER Package. Geneva, Switzerland: World Health Organization, 2008. Available at Accessed on May 26, 2010.
U.S. Department of Health and Human Services (USDHHS). Reducing tobacco use: A report of the surgeon general. Atlanta, GA: Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. USDHHS; 2000.
WHO. 2009. Global adult tobacco survey (GATS): Bangladesh. World Health Organization. Available from:
ITC Project (June 2011). ITC Bangladesh Wave 2 Technical Report. University of Waterloo, Waterloo, Ontario, Canada, and University of Dhaka, Dhaka, Bangladesh.
World Health Organization (WHO). Impact of tobacco-related illnesses in Bangladesh. New Delhi, India: World Health Organization, South East Asia Region; 2007.
Alam DS, Jha P, Ramasundarahettige C, et al. Smoking-attributable mortaility in Bangladesh : proportional mortality study. Bull World Health Organ. 2013;91:757–64.
Jolicoeur DG, Ahluwalia JS, Richter KP, et al. The use of nicotine patches with minimal intervention. Prev Med. 2000;30:504–12.
Town GI, Fraser P, Graham S, et al. Establishment of a smoking cessation programme in primary and secondary care in Canterbury. N Z Med J. 2000;113:117–9.
Freund KM, D’Agostino RB, Belanger AJ, et al. Predictors of smoking cessation: the framingham study. Am J Epidemiol. 1992;135:957–64.
Yang T, Abdullah AS, Mustafa J, Chen B. Factors associated with smoking cessation among Chinese adults in rural China. Am J Health Behavior. 2009;33(2):125–34.
Fong GT, Cummings KM, Borland R, Hastings G, Hyland A, Giovino G, et al. The conceptual framework of the International Tobacco Control (ITC) policy evaluation project. Tob Control. 2006;15:i3–11. doi:10.1136/tc.2005.015438.
Abdullah AS, Hitchman SC, Driezen P, Nargis N, Quah AC, Fong GT. Socioeconomic differences in exposure to tobacco smoke pollution (TSP) in Bangladeshi households with children: findings from the International Tobacco Control (ITC) Bangladesh Survey. Int J Environ Res Public Health. 2011;8(3):842–60.
ITC Project (April 2010). ITC Bangladesh Wave 1 Technical Report. University of Waterloo, Waterloo, Ontario, Canada, and University of Dhaka, Dhaka, Bangladesh.
Borland R, Yong H-H, Balmford J, et al. Motivational factors predict quit attempts but not maintenance of smoking cessation: Findings from the International Tobacco Control Four country project. Nicotine Tob Res. 2010;12 Suppl 1:S4–S11.
Yang G, Ma J, Chen A, et al. Smoking cessation in China: findings from the 1996 national prevalence survey. Tob Control. 2001;10:170–4.
Hymowitz N, Cummings MK, Hyland A, Lynn WR, Pechacek TF, Hartwell TD. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997;6 suppl 2:S57–62.
Hatziandreu EJ, Pierce JP, Lefkopoulou M, et al. Quitting smoking in the United States in 1986. J Natl Cancer Inst. 1990;82:1402–6.
Tucker JS, Ellickson PL, Orlando M, et al. Predictors of attempted quitting and cessation among young adult smokers. Prev Med. 2005;41:554–61.
Abdullah AS, Yam HK. Intention to quit smoking, attempts to quit, and successful quitting among Hong Kong Chinese smokers: population prevalence and predictors. Am J Health Promot. 2005;19(5):346–54.
Abdullah AS, Ho LM, Kwan YH, Cheung WL, McGhee SM, Chan WH. Promoting smoking cessation among the elderly: what are the predictors of intention to quit and successful quitting? Aging Health. 2006;18(4):552–64.
Abdullah AS, Lam TH, Chan SK, Leung GM, Chi I, Ho WW, et al. Effectiveness of a mobile smoking cessation service in reaching elderly smokers and predictors of quitting. BMC Geriatr. 2008;8:25. doi:10.1186/1471-2318-8-25.
Haas JS, Linder JA, Park ER, Gonzalez I, Rigotti NA, Klinger EV, et al. Proactive tobacco cessation outreach to smokers of low socioeconomic status: a randomized clinical trial. JAMA Intern Med. 2015;175(2):218–26. doi:10.1001/jamainternmed.2014.6674.
Siahpush M, Borland R, Scollo M. Factors associated with smoking cessation in a national sample of Australians. Nicotine TobRes. 2003;4:597–602.
Farkas JA, Gilpin EA, Distefan MJ, Pierce JP. The effects of household and workplace smoking restrictions on quitting behaviors. Tob Control. 1999;8:261–5.
Weinberger AH, Mazure CM, McKee SA. Perceived Risks and Benefits of Quitting Smoking in Non-Treatment Seekers. Addict Res Theory. 2010;18(4):456–63. doi:10.3109/16066350903145072.
Borrelli B1, Hayes RB, Dunsiger S, Fava JL. Risk perception and smoking behavior in medically ill smokers: a prospective study. Addiction. 2010 Jun;105(6):1100–8. doi: 10.1111/j.1360-0443.2010.02900.x.
Murray RP, Gerald LB, Lindgren PG, Connett JE, Rand CS, Anthonisen NR. Characteristics of participants who stop smoking and sustain abstinence for 1 and 5 years in the Lung Health Study. Prev Med. 2000;30:392–400.
Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence, Clinical Practice Guideline. Rockville, Md: Public Health Service; 2000.
Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health. 1994;84:1086–93.
Klebanoff MA, Levine RJ, Clemens JD, DerSimonian R, Wilkins DG. Serum cotinine concentration and self-reported smoking during pregnancy. Am J Epidemiol. 1998;148:259–62.
Caraballo RS, Giovino GA, Pechacek TF, Mowery PD. Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years or older: Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol. 2001;153:807–14.
Hyland A, Borland R, Li Q, Yong H-H, McNeill A, Fong GT, et al. Individual-level predictors of cessation behaviours among participants in the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006;15:83–94. doi:10.1136/tc.2005.013516.
Determinants of intentions to quit smoking among adult smokers in Bangladesh: findings from the International Tobacco Control (ITC) Bangladesh wave 2 survey
Pete Driezen, Abu S. Abdullah, Anne C. K. Quah, Nigar Nargis, Geoffrey T. Fong
Global Health Research and Policy
Success rates in smoking cessation: Psychological preparation plays a critical role and interacts with other factors such as psychoactive substances
Bertrand Joly, Jean Perriot, Philippe d’Athis, Emmanuel Chazard, Georges Brousse, Catherine Quantin, Mark Allen Pershouse
Correlates of unsuccessful smoking cessation among adults in Bangladesh
Shariful Hakim, Muhammad Abdul Baker Chowdhury, Md Jamal Uddin
Preventive Medicine Reports
Prevalence and factor/s associated with smoking among adults in Malaysia - Findings from the National Health and Morbidity Survey (NHMS) 2015
Kuang Lim, Chien Teh, Sayan Pan, Miaw Yn Ling, Muhammad Yusoff, Sumarni Ghazali, Chee Kee, Kuang Lim, Kar Chong, Hui Lim
Tobacco Induced Diseases
Manutenção da abstinência do tabaco por ex-fumantes: estudo fenomenológico
Vanderleia Soéli de Barros Zampier, Marcelo Henrique da Silva, Rodolfo Ribeiro de Jesus, Paloma Prata de Oliveira, Maria Cristina Pinto de Jesus, Miriam Aparecida Barbosa Merighi
Revista Gaúcha de Enfermagem
Smoking cessation after engagement in HIV care in rural Uganda
Julian A. Mitton, Crystal M. North, Daniel Muyanja, Samson Okello, Dagmar Vořechovská, Bernard Kakuhikire, Alexander C. Tsai, Mark J. Siedner
Factors Correlated with Success Rate of Outpatient Smoking Cessation Services in Taiwan
Wei-Hsin Huang, Hsin-Yin Hsu, Betty Chang, Fong-Ching Chang
International Journal of Environmental Research and Public Health
Factors associated with quit attempts and smoking cessation in Brazil: findings from the International Tobacco Control Brazil Survey
L. Casado, J.F. Thrasher, C. Perez, Thuler Santos, G.T. Fong
Public Health
The state of smokeless tobacco cessation in a context lacking cessation services: Evidence from Ethiopia
Mamusha Hussen, Edao Etu
Tobacco Induced Diseases
Effect of tobacco control policies on intention to quit smoking cigarettes: A study from Beirut, Lebanon
Monique Chaaya, Rima Nakkash, Dahlia Saab, Lina Kadi, Rima Afifi
Tobacco Induced Diseases
Socioeconomic patterns of smoking cessation behavior in low and middle-income countries: Emerging evidence from the Global Adult Tobacco Surveys and International Tobacco Control Surveys
Nigar Nargis, Hua-Hie Yong, Pete Driezen, Lazarous Mbulo, Luhua Zhao, Geoffrey Fong, Mary Thompson, Ron Borland, Krishna Palipudi, Gary Giovino, James Thrasher, Mohammad Siahpush, Manu Mathur
Prevalence and Factors Associated With Attempts to Quit and Smoking Cessation in Malaysia
Kuang Lim, Pei Heng, Mohamed Nik, Chien Teh, Yusoff Mohd, Jane Ling, Nizam Baharom, Lei Wee, Caryn Chan, Bee Ho, Zuraini Robson, Samsul Draman, Rahman Ab, Mira Kartiwi, Rahman Ab
Asia Pacific Journal of Public Health
Expanding Horizons in Health Communication
Aantaki Raisa, Carma Bylund, Sabrina Islam, Janice Krieger
Smoking-Related Social Control in Indonesian Single-Smoker Couples
DA Ayuningtyas, Marrit Tuinman, Yayi Prabandari, Mariët Hagedoorn
International Journal of Behavioral Medicine
Characteristics and Predictors of Abstinence Among Smokers of a Smoking Cessation Clinic in Hunan China
Yina Hu, Jianghua Xie, Xiaochang Chang, Jianhua Chen, Wei Wang, Lemeng Zhang, Rui Zhong, Ouying Chen, Xinhua Yu, Yanhui Zou
Frontiers in Public Health