Barriers and Determinants of Smoking Cessation Among Young Tobacco Users in Asia: A Cross-Sectional Study to Inform Clinical and Public Health Interventions
Smoking among young people remains a major public health concern in Asia. This cross-sectional study examined the barriers and determinants of smoking cessation among young tobacco users in Pakistan, Nepal, and Bangladesh. A total of 425 participants aged 18–30 years were recruited using a stratified multistage sampling technique. Data were collected through a structured self-administered questionnaire covering socio-demographic characteristics, tobacco use patterns, nicotine dependence, quit attempts, barriers, facilitators, and access to cessation services. Descriptive statistics, bivariate analysis, and multivariate logistic regression were used to analyse the data. Among participants, 56.2% (n=239) reported at least one quit attempt in the past 12 months. Cigarette smoking was the most common form of tobacco use (64.9%), and 43.3% had moderate nicotine dependence while 23.1% had high dependence. The main barriers to cessation were nicotine craving (70.8%), peer influence (59.3%), stress (57.6%), and limited access to cessation services (44.2%). Key facilitators included concern about future health risks (67.3%), exposure to anti-smoking campaigns (58.8%), family support (51.8%), and access to counselling services (37.2%). Logistic regression revealed that family support (AOR=2.11, 95% CI: 1.39–3.20), exposure to campaigns (AOR=1.87, 95% CI: 1.23–2.84), access to cessation services (AOR=1.76, 95% CI: 1.12–2.76), and older age (26–30 years: AOR=1.58, 95% CI: 1.01–2.47) positively predicted quit attempts. High nicotine dependence (AOR=0.31, 95% CI: 0.18–0.54), peer smoking (AOR=0.49, 95% CI: 0.32–0.74), and perceived stress (AOR=0.62, 95% CI: 0.41–0.94) reduced the likelihood of quitting. The findings suggest that smoking cessation among young tobacco users is influenced by biological, psychological, social, and environmental factors. Youth-focused cessation programs in Asia should combine behavioural counselling, stress-management support, family involvement, peer-focused strategies, and accessible cessation services.
