Biopsychosocial Factors Associated with Successful Smoking Cessation in Surakarta, Central Java

Abstract

Background: Smoking is the leading preventable cause of death worldwide. Seventy percent of smokers would like to quit smoking, and 50 percent report attempting to quit within the past year. Smoking cessation (also known as quitting smoking) is the process of discontinuing tobacco smoking. Tobacco cessation significantly reduces the risk of dying from tobacco-related diseases such as coronary heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer. This study aimed to determine the biopsychosocial factors associated with successful smoking cessation using Health Belief Model (HBM), PRECEDE-PROCEED model, and Theory of Planned Behavior (TPB). Subjects and Method: This was a cross-sectional study 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 by questionnaire and analyzed by path analysis. Results: Successful smoking cessation directly increased with strong intention (b= 2.39, SE= 0.51, p< 0.001). Successful smoking cessation directly decreased with 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). Successful smoking cessation indirectly increased with positive attitude, positive subjective norm, strong PBC, positive outcome expectation, and social support. Successful smoking cessation indirectly decreased with high purchasing power, duration of smoking (≥ 10 years), addiction, stress, and high income. Conclusion: Successful smoking cessation increases with strong intention, but decreases with smoking duration, stress, and access to a cigarette. Successful smoking cessation is indirectly affected by attitude, addiction, PBC, subjective norm, social support, outcome expectation, family income, and purchasing power. Keywords: smoking cessation, Health Belief Model, PRECEDE-PROCEED, Theory of Planned Behavior