Quit Intentions Research Articles

Factors influencing smoking cessation: Insights from Singapore's nationwide health and lifestyle survey.

Singapore has implemented an evidence-based smoking cessation framework to support smokers in quitting. Our study investigated the prevalence and correlates of (1) quit attempts (QA) and quit intentions (QI) among current smokers, and (2) smoking cessation (SC) among ever-smokers in Singapore. Data was collected from a nationwide survey conducted between 2020 and 2022. QA was defined as attempting to stop smoking at least once in the past 12 months, while QI was defined as planning to quit smoking within the next 30 days or the next 6 months. SC referred to individuals who quit smoking over 6 months ago. Sociodemographic factors, doctor's advice to quit and perceived harm from smoking were assessed using logistic regression among current smokers (n=1024) and ever-smokers (n=1457). Among current smokers, 31.3% and 41.2% reported QI and QA, respectively. Smokers with secondary or pre-tertiary education were less likely to report QI compared to those with a degree or higher. Doctor's advice to quit was associated with a higher likelihood of QA. Among ever-smokers, 25.3% reported SC, and this was more likely when they perceived smoking 1 or more packs of cigarettes daily as posing a moderate or high health risk. Educational campaigns should focus on simplifying messages for individuals with lower literacy levels. Smoking cessation training can be incorporated into medical education, and graphic health warnings on cigarette packs can help effectively communicate the dangers of smoking.

Symbolic self completion as mediator between nicotine dependence and quit intention: a nationally representative survey

ABSTRACT Background This study aims to investigate the relationship between nicotine dependence and quit intentions, and the degree to which symbolic completion of the self through smoking mediates this relationship. Symbolic self-completion theory assumes that a person seeks to display symbols in relation to how society would respond. Methods A survey was conducted among a population-based sample of smokers in Turkiye to measure nicotine dependence, intention to quit, and the absence of symbolic self-completion. Mediation analysis was conducted using the Hayes model #4 to investigate the degree to which (symbolic) smoking was linked to dependence and quit intention. Results Based on regression analyses, nicotine dependence was found to decrease the intention to quit (coeff = −.039**), while an absence of symbolic self-completion was found to increase quit intention (coeff = .6118**). Symbolic self-completion was found to be a significant (partial) mediator between dependence and quit intentions. Limitations Although the regression approach is utilized in the analysis, this study still relies on cross-sectional data, so further inquiry is needed to establish casual relationships. Conclusions Smoking is an activity that is publicly noticeable, thereby serving as a symbol of the self within a socio-cultural context. The symbolic power of smoking should be considered along with physical dependence.

Changes in Smoking Patterns in Turkey Before and After the Ban on Loose Cigarettes: An Ecological Perspective From Global Tobacco Surveillance Data.

Loose or individual cigarettes sold without packaging pose a unique challenge for tobacco control, which is the leading cause of premature and preventable mortality worldwide. This study aims to assess the changes in smoking patterns following the ban on loose cigarettes in 2008 in Turkey. Gender-stratified trend analysis of smoking patterns before and after the ban on loose cigarettes was done using the Global Tobacco Surveillance data (adults: Global Adult Tobacco Survey (GATS) 2008, 2012, and 2016; youth: Global Youth Tobacco Survey (GYTS) 2003, 2005, 2009, 2012, and 2017) from Turkey. The trends in smoking patterns were triangulated with the introduction of the loose cigarette ban and other laws in Turkey. From GATS 1 in 2008 to GATS 2 in 2012, there were initial declines in adult smoking patterns, including current smoking and daily smoking, with increased quit intentions. However, these trends were reversed by the time of the GATS 3 in 2016, when both current smoking and daily smoking measures were higher, especially among females. Monthly cigarette expenses consistently increased across all survey years. Among youths, the overall prevalence increased sharply from 6.9% in 2003 to 23% in 2005, then decreased to 8.4% in 2009, again increased to 10.4% in 2012, and finally returned to 7.7% in 2017. Triangulation of these trends against the implementation of the loose cigarette ban in 2008 produced no clear association between the ban and smoking patterns. The overall marginal decline in smoking behaviors over two decades in Turkey needs to be fast-tracked, specifically the rise of smoking among the female population, which needs to be addressed through evidence-based tobacco control interventions. The loose cigarette ban was implemented as part of a comprehensive tobacco control law, and the GATS or GYTS data is not sufficient to assess the effect of this provision. The tobacco control effort in Turkey should collect evidence for changes in smoking patterns following the implementation of tobacco interventions, which is also a mandate of the Global Tobacco Surveillance System (GTSS).

Feel the Pressure? Normative Pressures as a Unifying Mechanism for Relational Antecedents of Employee Turnover

ABSTRACTRelational perspectives on turnover antecedents have gained momentum in recent years, highlighting three distinct relational forces underlying employees' turnover decisions—notably, job embeddedness, social capital, and turnover contagion. However, these distinct perspectives are typically examined independent of one another, with little theoretical integration or holistic understanding of the shared mechanisms through which these relational antecedents operate on turnover intentions and behavior. We propose a conceptual model integrating the three types of relational antecedents (specifying their unique effects), while positing normative pressures from work and nonwork relationships as a fundamental consideration underlying quit decisions that translates their effects on leaving. Our model tests find support for this common mediator, even when controlling for traditional mediating mechanisms (i.e., job attitudes and perceived alternatives). Our tests also include important cultural considerations, allowing for comparisons between national cultures in our sample of nearly 700 surveyed employees and their subsequent quit intentions and behaviors, spanning the USA, Hong Kong, and China. Our tests revealed that on‐ and off‐the‐job embeddedness reduces quit propensity while prospective colleague turnover boosts that propensity. Path analyses further determined that normative pressures predict quit propensity (beyond attitudes and alternatives), and that such pressures mediate how job embeddedness and prospective coworker turnover influence quit propensity. We tease apart these effects across national cultures and discuss theoretical and practical implications of our findings.

Tax increases as an incentive to quit smoking: is thinking about quitting due to a tobacco tax increase associated with post-tax increase smoking cessation?

BackgroundThe cost of tobacco is one of the most reported reasons to quit smoking. The Netherlands increased tobacco taxes twice in the span of nine months: a €1 increase per pack in April 2020, and a €0.12 increase per pack in January 2021. This study examines to what extent people report to think about quitting due to the upcoming tax increase(s), as well as how it relates to their age, income or educational level. Additionally, we examined whether thinking about quitting was associated with quit intention and quit behaviour, and whether these associations were different for the two tax increases.MethodsLongitudinal data from the International Tobacco Control (ITC) Netherlands Surveys, Cohort 2 were used (N = 5919 observations; wave 1 (February – March 2020): n = 2051; wave 2 (September – November 2020): n = 1919; wave 3 (June – July 2021): n = 1949). Generalised Estimating Equation (GEE) regressions were fit to test the associations between thinking about quitting due to the tax increase and post-tax increases in quit intention, serious quit attempts, and quitting smoking (≤ 1 cigarette a month), as well as sociodemographic variables.ResultsCirca half of the people who smoke reported thinking about quitting smoking due to the upcoming tax increase (Wave 1 = 51.3% (n = 1052); Wave 2 = 47.3% (n = 849)). Individuals who reported thinking about quitting smoking due to upcoming tax increase(s) were more likely to have increased their quit intention (aOR: 2.00, p ≤ .001) or have carried out a serious quit attempt (aOR:1.48, p ≤ .001) post-tax increase. More people attempted to quit smoking between wave 2 and 3 (post 2021 increase) than between wave 1 and 2 (post 2020 increase). We did not find an interaction effect between wave and thinking about quitting for quit intention, quit attempts, and quitting smoking.ConclusionsTax increases stimulate people to think about quitting. Thinking about quitting due to an upcoming tax increase was associated with more positive quit intention and serious quit attempts.

Longitudinal association between harm perceptions and tobacco behaviors among adults who smoke cigarettes: Differential associations across age groups using the PATH study.

The relationship between e-cigarette and cigarette harm perceptions and tobacco behaviors may vary by age. We examined longitudinal associations of harm perceptions with tobacco use behaviors among adults who smoke cigarettes. Data were from Waves 4 (2016-2018) and 5 (2018-2019) of the Population Assessment of Tobacco and Health survey. Weighted multivariable logistic regressions identified independent associations between relative and absolute e-cigarette and cigarette harm perceptions at baseline and continued smoking, dual use, complete switching, and quit intention at follow-up, stratified by age (young adults [YAs] 18-24, middle-aged adults [MAs] 25-44, and older adults [OAs] ≥45) among U.S. adults who smoke (n=8,231). Perceiving e-cigarettes as less harmful than cigarettes was associated with higher odds of complete switching from cigarettes to e-cigarettes (aORs overall: 1.52; MAs: 1.68). Perceiving e-cigarettes as very/extremely harmful was associated with lower odds of dual use (overall aOR: 0.75; MAs: 0.72) and higher odds of quit intention (aOR among OAs: 1.34). Perceiving cigarettes as very/extremely harmful was associated with lower odds of continued smoking (overall aOR: 0.69; MAs: 0.76; OAs: 0.53), and higher odds of complete switching (overall aOR: 1.65; MAs: 1.86) and quit intention (overall aOR: 1.58; MAs: 1.42; OAs: 1.80). No findings reached significance for YAs. E-cigarette relative and absolute harm perceptions were associated with different tobacco behaviors by age. Low cigarette harm perceptions were similarly associated with continued smoking and lower quit intentions in MAs and OAs. Future research should explore what beliefs inform these perceptions and age-related differences. The associations between harm perceptions and subsequent tobacco behaviors differed by age among adults who smoke. This study adds that low relative harm perceptions of e-cigarettes can promote complete switching among MAs who smoke. High absolute harm perceptions of e-cigarettes may deter dual use among MAs. Additionally, high absolute harm perceptions of cigarettes may reduce smoking and increase cigarette smoking quit intentions among MAs and OAs. Future research is needed to understand the beliefs that support harm perceptions among different age groups and why their effects differ by age, and what factors influence YAs' tobacco use behaviors.

Differential Responses to Cigarette Package Labeling Alternatives Among Adults Who Smoke: Results From a Randomized Trial

Abstract Introduction Little experimental research has evaluated whether the effects of cigarette package inserts with efficacy messages and/or pictorial health warning labels (PHWLs) differ across key subgroups of adults who smoke. Aims and Methods Adults who reported currently smoking (n = 367) were randomly assigned to one of four groups: Small text-only HWLs on pack sides (control); inserts with efficacy messages and small HWLs (inserts-only); PHWLs showing harms of smoking (PHWLs-only); both (inserts + PHWLs). Participants received a 14-day supply of cigarettes labeled to reflect their group. Every evening over 2 weeks, participants reported forgoing and stubbing out cigarettes before they finished smoking over the prior 24 hours, combined into a binary indicator of either behavior (eg, forgoing/stubbing). Separate mixed-effects logistic models were estimated to evaluate moderation of labeling group contrasts (ie, PHWLs vs not; inserts vs. not; inserts-only vs. inserts + PHWLs; PHWLs-only vs. inserts + PHWLs) by baseline covariates (self-efficacy to quit, intention to quit, education, health literacy, and time discounting), predicting day-level forgoing/stubbing. Results Education moderated PHWL effects, with PHWLs predicting more forgoing/stubbing only among those with low education (OR = 4.68, p < .001). Time discounting moderated insert effects, with inserts promoting forgoing/stubbing only among those with low time discounting (ie, lower impulsivity; OR = 4.35, p < .001). Conclusions Inserts with efficacy messages appear effective mostly among people with low time discounting, whereas PHWLs appear most effective among those with low education, suggesting their potential to address education-related disparities. Labeling strategies appeared equally effective across subgroups defined by self-efficacy to quit, quit intention, and health literacy. Combining inserts with PHWLs did not appear to mitigate moderation effects. Implications This randomized trial with adults who smoke suggests that cigarette packs with inserts describing cessation benefits and tips can promote cessation-related behaviors (ie, forgoing or stubbing out cigarettes) among those with low-time discounting (ie, low impulsivity). Alternative interventions may be needed for people with high-time discounting, as found in cessation trials. PHWLs appear most effective among those with low education, potentially addressing education-related disparities. No differential effects were found for those with different levels of self-efficacy to quit, quit intentions, or health literacy. Combining inserts and PHWLs may not be more effective than either alone.

Impact of Smoking Cessation Motivations and Barriers on Quit Intentions Following a Hypothetical Flavor Ban Among African American/Black Individuals Who Use Menthol Cigarettes: A Mixed-Methods Study.

The Food and Drug Administration (FDA) has proposed banning cigarettes and cigars with characterizing flavors-products used disproportionately by African American/black (AA/B) individuals. Little is known about how AA/B individuals who smoke menthol cigarettes will respond to flavor bans or how to amplify the intended benefits. This study explored predictors of quit intentions following a hypothetical flavor ban and further probed anticipated ban-related responses. We recruited 213 AA/B individuals who use menthol cigarettes from Richmond, VA (September 2021-August 2022) for a mixed-methods study. Participants rated seven motivations for quitting and six barriers to quitting (Not a motivation or challenge[1]-Major motivation or challenge[4]), then reported how likely they were to quit smoking if characterizing flavors were banned in cigarettes and cigars. A subsample of 31 participants completed semi-structured interviews to further explore reactions to flavor restriction policies. Multivariable linear regressions suggested that participants who were more motivated to quit smoking because of "information about health hazards" and the "cost of cigarettes" reported higher quit intentions following a hypothetical menthol ban (p < .05). Additionally, those with cessation-related weight concerns reported lower post-ban quit intentions (p < .05). Interview themes highlighted smoking for stress reduction, harm/addiction perceptions of flavored tobacco products, trusted sources of tobacco-related information (including testimonials from people who formerly smoked), potential ban responses, and varying experiences with cessation strategies. Culturally specific cessation strategies that emphasize the health-related benefits of quitting, particularly those featuring the experiences of people who formerly smoked, may help AA/B individuals who smoke menthol cigarettes quit following a menthol ban. For the FDA's proposed bans on characterizing flavors in cigarettes and cigars to advance racial health equity, they must maximize cessation among African American/black (AA/B) individuals who use menthol cigarettes. This work suggests information on the health hazards and costs of smoking, as well as concerns over gaining weight, were predictors of quit intentions in a hypothetical flavor ban. Qualitative data suggest messaging highlighting the experiences of individuals who successfully quit may constitute an effective communication strategy. These insights can be used in the development of culturally specific cessation strategies for AA/B individuals who smoke menthol cigarettes.

Factors associated with intentions to quit vaping and quit attempts among Adolescents: A structural equation modeling approach

ObjectivesPrevious youth tobacco research has identified multiple factors relating to intentions to quit vaping and quit attempts among current e-cigarette users in adolescents. The pathways in the complex associations with vaping cessation behaviors remain unclear. MethodsUsing data from the 2022 National Youth Tobacco Survey (NYTS) (grades 6–12), structural equation models (SEMs) are developed to examine the associations of social environment, vaping risk perceptions, e-cigarette marketing, vaping characteristics, and demographics with two outcome measures – intentions to quit vaping and past year quit attempts among current e-cigarette users. ResultsThe national sample of current e-cigarette users (n = 2,701) consisted of 52.7 % females, 47.0 % non-Hispanic Whites, 80.1 % high school students, and 56.2 % heterosexual individuals. Among them, 70.2 % reported intentions to quit vaping and 66.3 % reported past year quit attempts. The protective factor for quit intentions was vaping risk perceptions (p < 0.001). Risk factors included e-cigarette marketing (p = 0.04), dual use of e-cigarettes and other tobacco products (p = 0.003), vaping due to feeling anxious or stressed (p = 0.01), vaping for nicotine buzz (p = 0.002), nicotine dependence (p = 0.02), identifying as Gay or Lesbian (p < 0.001), bisexual (p = 0.03), or Hispanic (p = 0.04). Similar associations were observed with quit attempts except that e-cigarette marketing, vaping due to feeling anxious or stressed, vaping dependence, and identifying as Hispanic were not significant. Besides, high vaping frequency (p < 0.001), grade level (p < 0.001) and not sure about sexual orientation (p = 0.01) were also negatively associated with quit attempts. ConclusionsThis study provided insights into factors influencing vaping cessation outcomes among adolescent current e-cigarette users. Developing tailored vaping cessation programs based on these findings could enhance quit success.

“All employees are equal … but some are more equal than others”. Role identity and nonfamily member discrimination in family SMEs

PurposeThis paper aims to investigate if, under which conditions, and with which consequences, nonfamily members have the perception of being discriminated against as a consequence of nepotism and adverse selection practices. This research also aims to investigate whether the carried-out role influences the perception of being discriminated against among nonfamily member employees.Design/methodology/approachA quantitative approach was carried out by adopting a structural equation model (SEM) analysis. The survey investigated a sample of Italian family SMEs (participating companies N = 186, total questionnaires collected N = 838).FindingsDrawing on the multiple identities theory, findings show that role salience (RS) effectively contributes to reducing the unwanted effects of perceived discrimination (PD) among nonfamily member employees. In doing so, this study deepens the knowledge of nonfamily member employment conditions and their consequences on strategic outcomes such as organizational commitment (OC), organizational justice (OJ) and intention to quit (ITQ).Research limitations/implicationsBy adopting a self-categorization approach, this study also advances current theoretical literature, as this methodological lens could help scholars further understand diversity in family business.Practical implicationsThis study suggests it would be advisable to implement human resource management practices based on job rotation to promote cohesion and reduce perceived distances.Social implicationsSMEs are the most widespread type of firm in the world; as a consequence, avoiding PD among nonfamily member employees has general ethical relevance.Originality/valueThis study expands current literature by showing that RS plays an important role in determining levels of PD. This study also advances current literature by focusing on the impact of multiple identities on fairness and commitment at individual and group levels of analysis of family businesses.

Changes in Smoking Behavior in the COVID-19 Pandemic: A Single Center Study in Family Practice

Objective: There are controversial studies on smoking addiction in the COVID-19 pandemic. While some studies show increased tobacco use during the pandemic, others report increased smoking cessation attempts. This study examined changes in tobacco use and quit intentions during the COVID-19 pandemic compared to pre-pandemic. Methods: A cross-sectional study was designed and three groups were formed by including patients over 18 years of age, who were smokers, and who presented to the Education Family Health Center and had RT-PCR test results for COVID-19. Among these patients, patients with COVID-19 symptoms and complaints and positive RT-PCR test results constituted the COVID-19 positive group, patients who were COVID-19 negative but isolated due to their contacts constituted the contact group, and healthy people without any COVID-19 contact and symptoms constituted the healthy group. Demographic characteristics, smoking status before the COVID-19 pandemic, change in smoking status after COVID-19 test result or contact, and Fagerström nicotine dependence test results were compared. Results: Of the total 131 participants enrolled in the study, 70 were in the healthy group, 31 were in the COVID-19 negative group, and 30 were in the COVID-19 positive group. Men were predominant in three groups (60%, 83.9%, and 73.3% in normal, COVID-19-neg, and COVID-19-positive groups, respectively) with a small significant difference (p=0.048). The mean ages were 41.09±12.85, 38.21±11.69, and 39.47±11.66 years in the healthy, COVID-19 negative, and COVID-19 positive groups, respectively, with no significant difference (p&gt;0.05). Fagerström dependence scores were 1.82±1.05, 1.53±0.86, and 1.40±0.72 in the healthy, COVID-19 negative, and COVID-19 positive groups, respectively, and were not statistically different (p&gt;0.05). Smoking prevalence decreased by 1.13 (±4.17) cigarettes per day in the healthy group, by 3.97 (±5.31) cigarettes in the COVID negative group, and by 10.14 (±7.86) cigarettes in the COVID positive group, with a statistically significant decrease in smoking prevalence in all three groups (p

Prevalence, Reach of Anti-smokeless Tobacco Messages and Quit Attempts by Product Type: A Secondary Data Analysis from the Global Adult Tobacco Survey (GATS - 2016-17).

India has the highest number of smokeless tobacco (SLT) products available in different forms, consumed in various ways. The current study aimed to understand the pattern of daily SLT use according to different product categories and whether Quit intention and Quit attempts vary by SLT type and exposure to media messages. Data from Global Adult Tobacco Surveys (GATS), 2016-17, was used to find access to media messages and warning labels by SLT type. Quit attempt and Quit intention were calculated for each of the SLT types. Logistic regression analyses were employed to identify whether access to media messages, warning labels influenced, quit intention and attempts vary by SLT type. Khaini or tobacco lime mixture was the most common SLT type consumed by 37% of SLT users, whereas SLT users consuming more than one product accounted for 23% of SLT users. Exposure to media messages and warning labels was high among Gutkha/ paan masala tobacco users (74.7% and 81.2%) and low among oral tobacco (Mishri, Gul, Gudakhu) users (56.1% and 60.0%). Quit attempts and quit intention were high among Gutkha/ paan masala tobacco users (38.3% and 22.3%) and low among oral tobacco (Mishri, Gul, Gudakhu) users (25.3% and 13.6%). Users of Oral tobacco and khaini or tobacco-lime mixture were significantly less likely to attempt quitting (AOR 0.806(95%CI: 0.676-0.962), 0.839(95%CI: 0.736-0.956), and have quit intention (AOR 0.681(95%CI: 0.702-0.976), 0.733(95%CI: 0.627-0.857) compared to Gutkha/ paan masala with tobacco users. The reach of media messages and warning labels varies by SLT type. Quit intention and attempts vary by SLT type and access to media messages and warning labels. There is a need to re-strategise the tobacco control Information, Education and Communication (IEC) to reach out with effective messaging to the most unreached.

Financial stress and quit intention: the mediating role of entrepreneurs’ affective commitment

One primary reason why entrepreneurs abandon their entrepreneurial goals is due to pressing financial difficulties. In one experimental and two field studies, we investigated the relationship between entrepreneurs’ financial stress and their intention to quit their businesses. In line with the challenge–hindrance stressor (CHS) framework, all three studies showed a positive link between financial stress and quit intention, both concurrently and over time. Furthermore, drawing on self-determination theory (SDT), we found support for affective commitment (but not continuance commitment) to the entrepreneurial endeavors as a mediator of the relationship. The findings provide novel insights into financial stress as a relevant entrepreneurial hindrance stressor and the role of the emotional bond formed (and dissolved) between entrepreneurs and their jobs as the mediating mechanism. Practical suggestions include considering the affective commitment levels of entrepreneurs to enhance consultancy and decision-making in entrepreneurship.

Impact of Traditional and New Media on Smoking Intentions and Behaviors: Secondary Analysis of Tasmania's Tobacco Control Mass Media Campaign Program, 2019-2021.

Tasmania, the smallest state by population in Australia, has a comprehensive tobacco control mass media campaign program that includes traditional (eg, television) and "new" channels (eg, social media), run by Quit Tasmania. The campaign targets adult smokers, in particular men aged 18-44 years, and people from low socioeconomic areas. This study assesses the impact of the 2019-2021 campaign program on smokers' awareness of the campaign program, use of Quitline, and smoking-related intentions and behaviors. We used a tracking survey (conducted 8 times per year, immediately following a burst of campaign activity) to assess campaign recall and recognition, intentions to quit, and behavioral actions taken in response to the campaigns. The sample size was approximately 125 participants at each survey wave, giving a total sample size of 2000 participants over the 2 years. We merged these data with metrics including television target audience rating points, digital and Facebook (Meta) analytics, and Quitline activity data, and conducted regression and time-series modeling. Over the evaluation period, unprompted recall of any Quit Tasmania campaign was 18%, while prompted recognition of the most recent campaign was 50%. Over half (52%) of those who recognized a Quit Tasmania campaign reported that they had performed or considered a quitting-related behavioral action in response to the campaign. In the regression analyses, we found having different creatives within a single campaign burst was associated with higher campaign recall and recognition and an increase in the strength of behavioral actions taken. Higher target audience rating points were associated with higher campaign recall (but not recognition) and an increase in quit intentions, but not an increase in behavioral actions taken. Higher Facebook advertisement reach was associated with lower recall among survey participants, but recognition was higher when digital channels were used. The time-series analyses showed no systematic trends in Quitline activity over the evaluation period, but Quitline activity was higher when Facebook reach and advertisement spending were higher. Our evaluation suggests that a variety of creatives should be used simultaneously and supports the continued use of traditional broadcast channels, including television. However, the impact of television on awareness and behavior may be weakening. Future campaign evaluations should closely monitor the effectiveness of television as a result. We are also one of the first studies to explicitly examine the impact of digital and social media, finding some evidence that they influence quitting-related outcomes. While this evidence is promising for campaign implementation, future evaluations should consider adopting rigorous methods to further investigate this relationship.

Effectiveness of health education and counseling on stages of change, decisional balance, and smoking cessation self-efficacy: A prospective self-control study

ObjectiveTo examine the effectiveness of health education and counseling on the stages of change, decisional balance, and smoking cessations elf-efficacy in smokers with no intention of quitting. MethodsA prospective self-controlled design was conducted between December 2020 and December 2022. The research period was divided into a control stage (first to fourth weeks) and an experimental stage (fifth to eighth weeks). Patients with coronary artery disease (CAD) and habitually smoked were recruited. Pearson correlation and a one-factor repeated-measurement analysis were performed to assess the effectiveness of the intervention. ResultsIn total, 108 male CAD patients with a mean age of 58.1 years were recruited. After 4 weeks of the intervention, 55 (51%) exhibited behavior change (X 2 = 18.03, p = .001). The decisional balance and smoking cessation self-efficacy scores significantly improved in the experimental stage. No significant differences were observed in the control stage. ConclusionsFour weeks of health education and counseling could effectively improve participants’ stage of change, decisional balance, and smoking cessation self-efficacy. Practice implicationHealthcare professionals can play key roles in helping CAD patients successfully quit smoking through individual education and counseling.

Examining Intention to Quit Vaping among Australian Young Adults Using Social Cognitive Theory: A Cross-Sectional Survey Analysis

This study examined how Social Cognitive Theory (SCT) constructs help explain the intention to quit e-cigarettes in young Australian adults aged 18–24 years to inform vaping cessation programs. A cross-sectional survey of young adult vapers (n = 422) between March and the end of May 2023 examined personal, environmental, and behavioural factors of vaping cessation. Hierarchical multiple regression analysis examined the effects of SCT constructs on intention to quit vaping, controlling for covariates. Results found, in our sample consisting of 68% (n = 360) females, 18% (n = 95) males and 14% (n = 77) others, almost two-thirds (59.7%) of participants reported a quit attempt in the last year; with quit attempts being associated with quit intention (p ≤ 0.001). Model 1 (past year quit attempt, gender, educational attainment) accounted for 28.7% of the variance in quit intentions, with the addition of Model 2 SCT constructs adding a further significant 6.3% variance. Self-efficacy (B = 0.164, p ≤ 0.001), benefits (B = −0.106, p = 0.041) and social norms (B = −0.086, p = 0.035) had significant independent associations with quit intention. Findings demonstrate the SCT theoretical framework is suitable for use when developing vaping cessation programs, identifying the SCT constructs as important factors for quit intention. The findings can be used to inform the development of evidence-based vaping cessation programs to encourage vapers to quit and/or better support them in the quitting process.

Performance of the Heaviness of Smoking Index in Indian Settings.

Background and objective The heaviness of smoking index (HSI) is a popular tool to assess nicotine dependence in clinical and community settings. Low cigarette consumption and concurrent use of other tobacco products raise concerns about its validity in Indian settings. This study explores the performance of HSI in Indian settings. Methods This study analyzed daily manufactured cigarette smoker data from the cross-sectional Global Adult Tobacco Surveys (GATS) from its first (GAST-1, 2009) and second waves (GATS-2, 2016), both of which were available in the public domain. The HSI scores were calculated based on the number of cigarettes smoked per day (CPD) and time to first smoke (TTFS) after waking up among the current daily cigarette users. This study examined the utility of the HSI scale in Indian settings by estimating the predictability of low dependence on quit attemptsand quit intentions using the likelihood ratio parameter. Results About nine in 10 cigarette users in India consumed less than 10 cigarettes per day, yielding a low score on the HSI scale for most of the daily cigarette users. The majority of daily cigarette smokers scored ≤ 1 (low dependence) on the HSI scale both in GATS-1 and GATS-2, irrespective of their exclusive cigarette use status. The absolute value and the 95% confidence limit of positive likelihood ratios (falling below and above one) suggest that the predictability of low dependence on quit attempts and quit intention in the Indian setting is limited. Conclusions The utility of the HSI scale in assessing nicotine dependence among cigarette users in India is limited. This may be attributed to low average cigarette consumption, concurrent use of various tobacco products, and the sociocultural milieu of Indian smokers. This highlights the need for a new rapid nicotine dependence scale tailored to the specific patterns of tobacco use behavior prevalent in the Indian context.

Effects of Pictorial Health Warning Labels on Intention to Quit Waterpipe in Lebanon: A Mediation Analysis.

Pictorial health warning labels (HWLs) on waterpipe (WP) tobacco packages represent a better strategy for communicating the health risks associated with WP use and promoting quit intention than text-only. However, the mechanism by which these warnings lead to higher intentions to quit remains unknown. This study explores how pictorial warnings versus text-only induces higher quit intention among a sample of young adult WP smokers in Lebanon. An online randomized cross-over experimental study was conducted in August 2021 among 276 young adult WP smokers who were exposed to two conditions: pictorial HWLs and text-only warnings on WP tobacco packages in random order. After each image, participants completed post-exposure assessments of health communication outcomes (eg, attention and negative affect). Using serial and parallel mediation analysis, we examined the role of attention, negative affect, cognitive elaboration, and perceived harm in mediating the relationship between exposure to HWLs and intention to quit. Using serial mediation, exposure to pictorial warnings versus text-only was found to affect intention to quit through the following pathways: attention and negative affect, which accounted for 17.28% of the total effect, and through negative affect and cognitive elaboration, which accounted for 21.53% of the total effect. Results of parallel mediation showed that the indirect effect pathways via negative affect (β = 0.063; [95% bootstrap CI = 0.004 to 0.149]) and cognitive elaboration (0.047; [0.001 to 0.114]) were statistically significant. The findings call on designing and implementing attention-grabbing, emotionally evocative, and cognitively persuasive pictorial warnings in Lebanon and other countries to curb WP tobacco smoking. This is among the first experimental studies looking at multiple mediators underlying the effect of exposure to pictorial HWLs on intention to quit in a sample of current WP smokers in Lebanon. The findings showed that using attention-grabbing, emotionally evocative, and persuasive pictures with a clear textual warning is crucial to maximizing the impact of implementing WP-HWLs regulations in Lebanon and other countries to curb WP tobacco smoking.

An ensemble learning model for predicting the intention to quit among employees using classification algorithms

Employees are often more likely to use social media for job searching, which sometimes causes withdrawal behaviour. This study proposes an ensemble learning model for predicting the intention to quit (IQ) based on selected features, such as job Involvement (JI), organizational commitment (OC), activities on professional networking sites (APNS), and updating profiles on job portals (PJP). The Receiver Operator Curve (ROC) examines the model’s accuracy. We show the best relationship to predict intention to quit is between activities on professional networking sites and updating one’s profiles on job portals on social media. Seven classification algorithms of Gradient Boosting, Random Forest, K-Nearest Neighbour, Logistic Regression, Neural Network, Support Vector Machine, and Naïve Bayes are used to build the classification model. In addition, four combinations of the above-mentioned methods are used to construct an ensemble learning classification model. The performance comparison indicates that the combination of Gradient Boosting, Logistic Regression, and K-Nearest Neighbour produced the best ensemble learning model for predicting the intention to quit. The study’s contribution incorporates the stimulus organism response theory to predict the intention to quit through information gain, emphasizing social media features. Based on these features, the classification tool is utilized to identify between those who intend to resign and those who do not.

Perception of Threat and Efficacy in Contracting COVID-19 Infection among Tobacco Users - A Cross-sectional Analytical Study from Four Indian States.

To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at higher risk of COVID-19 infection and should be at higher efficacy to practice preventive measures for the disease as compared to nonusers of tobacco. This community-based cross-sectional analytical study was conducted from April 2020 to May 2020 among 1203 adult participants to compare the threat and efficacy perception among users and nonusers of tobacco. Perception of threat was assessed using three questions on perceived threat and one question on perceived susceptibility; whereas perception of efficacy was assessed using four questions each on self-efficacy and response efficacy through telephonic interview. There was no significant difference in the overall threat perception among users and nonusers of tobacco. However, state-wise analysis showed that tobacco users had higher perception of threat for SARS-CoV-2 infection in all the states except Telangana. The overall perception of efficacy among tobacco users was significantly higher as compared to nonusers of tobacco. The study calls for active collaboration between tobacco control enthusiasts and the Government to promote awareness of a higher risk of COVID-19 disease among tobacco users. In essence, the study's implications extend beyond COVID-19 and can guide targeted efforts to promote awareness, behavior change, and collaboration in the context of other infectious diseases among tobacco users.