Abstract

INTRODUCTIONTobacco is the leading cause of preventable death in the world. Identification of factors associated with quit attempts and successful quitting can help strengthen tobacco cessation programs. In Ethiopia, no prior study of such factors exists. Our aim was to identify factors associated with quit attempts and successful quitting among adults who smoke tobacco in Ethiopia.METHODSWe used the Ethiopian 2016 Global Adult Tobacco Survey (GATS) data (n=10150). GATS is a nationally representative household survey that collects data on sociodemographic and tobacco-related characteristics. We calculated prevalence of reported past 12 months quit attempts and successful quitting and performed logistic regression to obtain prevalence ratios with 95% confidence intervals. A p<0.05 was considered statistically significant.RESULTSOverall 42.0% of people who smoked tobacco made a quit attempt. Men were more likely (APR=3.9; 95% CI: 1.4–10.7) to make a quit attempt compared to women but were less likely to successfully quit (APR=0.6; 95% CI: 0.3–0.9). Those aware of the health harms of tobacco were 2.5 (95% CI: 1.1–5.5) and 3.9 (95% CI: 1.8–8.5) times as likely to make a quit attempt and successfully quit, respectively, than those unaware. Receiving healthcare provider advice to quit was not associated with quit attempts.CONCLUSIONSMore than 4 in 10 people smoking tobacco in Ethiopia are making attempts to quit. Receipt of healthcare provider advice to quit is not yet associated with quit attempts in Ethiopia; however, awareness of the health harms of tobacco is a powerful predictor of quit attempt and success in quitting. Improved access to cessation support and expanded awareness of the health harms of tobacco are urgently needed to enhance both quit attempts and success across Ethiopia.

Highlights

  • Tobacco is the leading cause of preventable death in the world

  • More than half who made a quit attempt first smoked tobacco more than 60 minutes after waking (53.5%; 95% CI: 32.6–73.3), around 60% (59.2%; 95% CI: 39.9–75.9) received healthcare provider advice to quit smoking, and 90.8% had awareness of health harms of tobacco use

  • This study identified factors associated with quit attempts and with successful quitting using Ethiopia’s Global Adult Tobacco Survey (GATS) 2016 data

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Summary

Introduction

Tobacco is the leading cause of preventable death in the world. Identification of factors associated with quit attempts and successful quitting can help strengthen tobacco cessation programs. In Ethiopia, an LMIC in eastern Africa, the most recent nationally representative data from 2016 show that 3.7% of individuals aged ≥15 years (6.2% men and 1.2% women) currently smoked tobacco products, and 29.3% and 12.6% of adults were exposed to SHS at the workplace and home, respectively[3]. This indicates that about two and a half million Ethiopian adults are at risk of tobacco-related morbidity and mortality from tobacco use[3], and that numerous others may be at risk of morbidity and mortality from secondhand exposure. People attempting to quit tobacco use face challenges due to nicotine dependence, and there is a high incidence (up to 50%) of relapse after attempting to quit[4,5]; it is crucial to establish cessation support for successful quitting[6]

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