Factors Predicting Smoking Cessation among Smokers in Pakham District, Buriram Province, Thailand

Abstract

Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular diseases) such as hypertension and diabetes. The World Health Organization has a global monitoring framework on non-communicable diseases (NCDs) and implementation of the NCD global action plan through monitoring and reporting on the attainment of the 9 global targets for NCDs by 2025. One target is a 30% relative reduction in the prevalence of current tobacco use in people aged ≥15 years. Therefore, in Thailand, smoking cessation has been one of the national strategies for tobacco control to decrease smoking prevalence since the last decade. This evaluation research aimed to study the factors related to successful smoking cessation and to analyze the predictive factors of smoking cessation among participants in the smoking cessation program at Ban Thep Pattana Subdistrict Health Promoting Hospital, Kokmamuang Subdistrict, Pakhum District, Buriram Province, Thailand, from 2013 to 2016.

The concept of health promotion strategies with the Ottawa Charter was used to design the research conceptual framework. The Ottawa Charter was composed of five elements: build a healthy public policy, create a supportive environment, strengthen community action, develop personal skill and reorient health services. The samples consisted of 299 respondents who were divided into 2 groups of 153 respondents who could stop smoking successfully and 146 respondents who could not stop smoking. Data was collected by using an interviewing questionnaire and analyzed by using analytical statistics; Bivariate analysis, Chi-square test, independent t-test and Binary Logistic Regression.

The research results showed that 20 variables were significantly related to successful smoking cessation by bivariate analysis (p<0.025). They were personal characteristics, predisposing, enabling and reinforcing factors as follows: occupation, not being close to a person who smoked, smoking frequency, time-duration of smoking, intention to quit smoking, opinions and participation in establishing a policy on a smoke-free community, perceptions about the development environment conducive to health, opinions toward several dimensions for smoking cessation, perceived dangers and adverse effects of smoking, opinions toward the methods for quitting smoking, opinions toward the breath carbon monoxide measurement, opinions toward goal setting for smoking cessation,  perception and participation in health screening and smoking cessation in the mobile-clinic, provision of a mobile-clinic for health screening and smoking cessation, organizing the smoking cessation-service system in the health office, provision of proactive services in the community, and monitoring the activities of health personnel. With regards to the predictive variables of successful smoking cessation, the following three factors were found to be significant by binary logistic regression: intention to quit smoking (p<0.001), not being close to a person who smoked (p=0.010), total time-duration of smoking (p=0.024). These factors could precisely predict successful smoking cessation by 49.2% and the overall predictive percentage was 82.6.

The recommendations for successful smoking cessation are as follows. The Subdistrict Health Promoting Hospital should provide both defensive and proactive smoking cessation services in the health office and in the community. Village health volunteers should build capacity for supporting smokers to quit smoking. In case of limited financial support, smoking cessation services should be prioritized for the smokers who intend to quit smoking.