Determinants of Successful Smoking Cessation in Surakarta

Abstract

Background: Smoking cessation is a difficult effort since the smoker has to fight against tobacco addiction. Tobacco addiction is a behavioral, cognitive, and physiological phenomenon that causes the affected individual psychologically and physiologically dependent. 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 Methods: This was an analytic observational study with a cross-sectional design. It was conducted in Surakarta, in December 2017, with a sample of 165 study subjects consisting of 68 ex-smokers who were successful and 97 smokers who were unsuccessful in smoking cessation. The sample was selected 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 a cigarette. The data were collected using questionnaire and analyzed using path analysis. Results: Successful smoking cessation was positively affected by strong intention (b=2.39, SE=0.51, p<0.001). Successful smoking cessation was negatively affected by 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 to quit smoking was increased by positive attitude (b=0.79, SE=0.39, p=0.046), positive subjective norm (b=1.38; SE=0.40; p=0.001), and strong PBC (b=1.89, SE=0.40; p<0.001). The intention to quit smoking was decreased by high purchasing power (b=-1.23; SE=0.39; p=0.002). PBC was decreased by duration of smoking (>=10 years) (b=-2.32; SE=0.47; p<0.001) and addiction (b=-2.96; SE=0.49; p<0.001). PBC was increased by positive outcome expectation (b=1.04; SE=0.49; p=0.035). Positive attitude was increased by positive expectation outcome (b=1.09; SE=0.34; p=0.001). Both 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 increased by social support. Smoking duration was increased by stress (b=0.09; SE=0.04; p=0.018). Cigarette purchasing power was increased by high income (b=2.78; SE=1.43; p=0.053). Conclusion: Intention to quit smoking increases the likelihood of successful of smoking cessation. Smoking duration, stress, and access to a cigarette decrease the likelihood of successful smoking cessation. Successful smoking cessation is indirectly affected by attitude, addiction, PBC, subjective norm, social support, outcome expectation, family income, and purchasing power.