Abstract
This study attempts to identify factors that significantly encourage the cessation of smoking in the context of Pakistan. The study distributes a modified questionnaire among 421 respondents (current as well as former smokers) in the capital city of Pakistan, Islamabad. The binary regression method was employed to data for analyzing predictors of making quit attempts and successful smoking cessation. The result indicates that respondents having strong intentions to quit, high socioeconomic status, low nicotine dependency, and past quit attempts, and those having no-smoking friends, are more likely to quit cigarette smoking successfully. On the other hand, factors like social pressure to quit smoking, religious information against smoking, intention to quit smoking, and public regulation on smoking are more likely to encourage smokers to make quit attempts. The study calls for community and school-wide smoking cessation campaigns involving officials, peers and parents, religious leaders, and other influential individuals to inform people about the dangers of smoking. In addition, religious leaders should be encouraged to issue rulings against smoking especially during “Friday Prayer.” Furthermore, the government should pronounce more strict and comprehensive regulations on smoking by properly monitoring its implementation to encourage cessation of cigarette smoking.
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Data availability
The data sets used during the current study are available from the corresponding author upon reasonable request.
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AUK conceptualized this study, conducted the econometric analysis, wrote the original draft, and conducted the econometric analysis. AS did the supervision and the proofreading. MTM conceptualized this study and conducted the econometric analysis. SA wrote the literature review and reviewed the draft.
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Appendices
Appendix 1
Variables in the equation | B | S.E | Wald | df | Sig | Exp(B) | 95% CI for exp(B) | |
|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||
Socioeconomic status (SES) | 0.596 | 0.278 | 4.606 | 1 | 0.032 | 1.815 | 1.053 | 3.128 |
Nicotine dependency | − 0.816 | 0.236 | 11.982 | 1 | 0.001 | 0.442 | 0.279 | 0.702 |
Peer smoking pressure | − 0.674 | 0.202 | 11.192 | 1 | 0.001 | 0.510 | 0.343 | 0.756 |
Past quit attempts | 0.346 | 0.144 | 5.815 | 1 | 0.016 | 1.414 | 1.067 | 1.873 |
Social pressure to quit smoking | 0.506 | 0.284 | 3.183 | 1 | 0.074 | 1.658 | 0.951 | 2.891 |
Religious information against smoking | − 0.106 | 0.301 | 0.124 | 1 | 0.725 | 0.900 | 0.499 | 1.621 |
Public regulation on smoking | − 0.236 | 0.425 | 0.309 | 1 | 0.578 | 0.790 | 0.343 | 1.817 |
Individual’s attitude about smoking | 0.054 | 0.306 | 0.031 | 1 | 0.861 | 1.055 | 0.579 | 1.922 |
Smoker’s age | 3.925 | 3 | 0.270 | |||||
Smoker’s age (1) | − 0.387 | 0.883 | 0.192 | 1 | 0.661 | 0.679 | 0.120 | 3.832 |
Smoker’s age (2) | 0.213 | 0.699 | 0.092 | 1 | 0.761 | 1.237 | 0.314 | 4.870 |
Smoker’s age (3) | 0.663 | 0.708 | 0.875 | 1 | 0.349 | 1.940 | 0.484 | 7.779 |
Constant | − 0.259 | 1.658 | 0.024 | 1 | 0.876 | 0.772 | ||
Appendix 1 shows effects of nine independent predictors on successful smoking cessation. The result indicates that “religious information against smoking” and “public regulation on smoking” may motivate an individual for making quit attempt; however, their role in maintenance of smoking abstinence is statistically insignificant. This further explains that pictorial health warning on cigarette packages and other public regulations on smoking may motivate an individual to take prompt action of quitting cigarette smoking. Similarly, when an individual gets to know that smoking is “Haram or Makrhu” in Islam, he or she may immediately decide to stop smoking. That is, religious information against smoking and strict public regulation on smoking may motivate an individual for making quit attempt. However, only motivation to stop smoking is not sufficient for maintaining non-smoking status. A multi-component smoking cessation strategy in the form of ensuring smoke-free homes as well social and environmental pressure against smoking will produce the desirable outcome of smoking abstinence. Furthermore, the result obtained shows that individual perception about smoking and individual’s age has no significant relation with smoking cessation.
Appendix 2. Quit attempt vs no quit attempt
Variables in the equation | B | S.E | Wald | df | Sig | Exp(B) | 95% CI for exp(B) | |
|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||
Religious information against smoking | 0.535 | 0.235 | 5.189 | 1 | 0.023 | 1.708 | 1.078 | 2.707 |
Public regulation on smoking | 0.836 | 0.322 | 6.727 | 1 | 0.009 | 2.307 | 1.227 | 4.340 |
Nicotine dependency | − 0.102 | 0.163 | 0.395 | 1 | 0.530 | 0.903 | 0.656 | 1.242 |
Socioeconomic status (SES) | − 0.081 | 0.215 | 0.142 | 1 | 0.707 | 0.922 | 0.605 | 1.406 |
Individual’s perception about smoking | 0.100 | 0.229 | 0.190 | 1 | 0.663 | 1.105 | 0.706 | 1.731 |
Smoker’s age | 3.887 | 3 | 0.274 | |||||
Smoker’s age (1) | 0.968 | 0.536 | 3.267 | 1 | 0.071 | 2.633 | 0.922 | 7.521 |
Smoker’s age (2) | 0.750 | 0.426 | 3.096 | 1 | 0.079 | 2.117 | 0.918 | 4.881 |
Smoker’s age (3) | 0.778 | 0.444 | 3.067 | 1 | 0.080 | 2.178 | 0.911 | 5.204 |
Constant | − 2.282 | 1.104 | 4.270 | 1 | 0.039 | 0.102 | ||
The result found in Appendix 2 shows that religious information against smoking and public regulation on smoking have a significant effect on motivating individuals to quit smoking. However, socioeconomic status of an individual, heavy dependence on smoking, and individual perception about smoking are unrelated with smoking quit attempt. Similarly, age is a categorical variable and is not significantly associated with smoking quit attempt. However, as shown in the following table, “age” variable shows a statistically significant sign in a parsimonious model of smoking quit attempts.
Variables in the equation | B | S.E | Wald | df | Sig | Exp(B) | 95% CI for exp(B) | |
|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||
Public regulation on smoking | 0.957 | 0.309 | 9.581 | 1 | 0.002 | 2.603 | 1.420 | 4.771 |
Smoker’s age | 5.092 | 3 | 0.165 | |||||
Smoker’s age (1) | 1.091 | 0.525 | 4.323 | 1 | 0.038 | 2.979 | 1.065 | 8.334 |
Smoker’s age (2) | 0.852 | 0.410 | 4.319 | 1 | 0.038 | 2.344 | 1.050 | 5.233 |
Smoker’s age (3) | 0.796 | 0.436 | 3.329 | 1 | 0.068 | 2.216 | 0.943 | 5.209 |
Constant | − 1.322 | 0.513 | 6.631 | 1 | 0.010 | 0.267 | ||
Appendix 3. Model 1 multi-collinearity
Unstandardized coefficients | Standardized coefficients | t | Sig | Collinearity statistics | |||
|---|---|---|---|---|---|---|---|
B | Std. error | Beta | Tolerance | VIF | |||
Constant | − 0.178 | 0.154 | − 1.158 | 0.248 | |||
Intention to quit smoking | 0.057 | 0.026 | 0.105 | 2.147 | 0.032 | 0.940 | 1.064 |
Regulation on smoking | 0.160 | 0.069 | 0.112 | 2.317 | 0.021 | 0.960 | 1.042 |
Religion & smoking | 0.107 | 0.050 | 0.102 | 2.128 | 0.034 | 0.969 | 1.032 |
Social environmental restrictions | 0.099 | 0.043 | 0.112 | 2.288 | 0.023 | 0.945 | 1.058 |
Model 2 multi-collinearity
Unstandardized coefficients | Standardized coefficients | t | Sig | Collinearity statistics | |||
|---|---|---|---|---|---|---|---|
B | Std. error | Beta | Tolerance | VIF | |||
Constant | 0.198 | 0.145 | 1.367 | 0.172 | |||
Intention to quit smoking | 0.048 | 0.022 | 0.108 | 2.173 | 0.030 | 0.832 | 1.202 |
Peer pressure | − 0.087 | 0.027 | − 0.158 | − 3.254 | 0.001 | 0.878 | 1.138 |
Social & environmental factors | 0.071 | 0.034 | 0.096 | 2.050 | 0.041 | 0.932 | 1.072 |
Quit attempts | 0.039 | 0.018 | 0.102 | 2.179 | 0.030 | 0.938 | 1.066 |
Nicotine dependency | − 0.089 | 0.030 | − 0.150 | − 3.023 | 0.003 | 0.844 | 1.184 |
Socioeconomic status | 0.091 | 0.037 | 0.114 | 2.449 | 0.015 | 0.951 | 1.051 |
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Khan, A.U., Shah, A., Majeed, M.T. et al. Predictors of quitting smoking behavior: evidence from Pakistan. Environ Sci Pollut Res 31, 30886–30901 (2024). https://doi.org/10.1007/s11356-024-32920-y
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DOI: https://doi.org/10.1007/s11356-024-32920-y