Predictors of intentions to quit smoking in Aboriginal tobacco smokers of reproductive age in regional New South Wales (NSW), Australia: quantitative and qualitative findings of a cross-sectional survey

Abstract

ObjectivesTo assess the predictors of intentions to quit smoking in a community sample of Aboriginal smokers of reproductive age, in whom smoking prevalence is slow to decline.Design, setting and participantsA cross-sectional survey involved 121 Aboriginal smokers, aged 18–45 years from January to May 2014, interviewed at community events on the Mid-North Coast NSW. Qualitative and quantitative data were collected on smoking and quitting attitudes, behaviours and home smoking rules. Perceived efficacy for quitting, and perceived threat from smoking, were uniquely assessed with a validated Risk Behaviour Diagnosis (RBD) Scale.Main outcome measuresLogistic regression explored the impact of perceived efficacy, perceived threat and consulting previously with a doctor or health professional (HP) on self-reported intentions to quit smoking, controlling for potential confounders, that is, protection responses and fear control responses, home smoking rules, gender and age. Participants’ comments regarding smoking and quitting were investigated via inductive analysis, with the assistance of Aboriginal researchers.ResultsTwo-thirds of smokers intended to quit within 3 months. Perceived efficacy (OR=4.8; 95% CI 1.78 to 12.93) and consulting previously with a doctor/HP about quitting (OR=3.82; 95% CI 1.43 to 10.2) were significant predictors of intentions to quit. ‘Smoking is not doing harm right now’ was inversely associated with quit intentions (OR=0.25; 95% CI 0.08 to 0.8). Among those who reported making a quit attempt, after consulting with a doctor/HP, 40% (22/60) rated the professional support received as low (0–2/10). Qualitative themes were: the negatives of smoking (ie, disgust, regret, dependence and stigma), health effects and awareness, quitting, denial, ‘smoking helps me cope’ and social aspects of smoking.ConclusionsPerceived efficacy and consulting with a doctor/HP about quitting may be important predictors of intentions to quit smoking in Aboriginal smokers of reproductive age. Professional support was generally perceived to be low; thus, it could be improved for these Aboriginal smokers. Aboriginal participants expressed strong sentiments about smoking and quitting.

Getting over the shock: taking action on Indigenous maternal smoking

“…Psychological threats of disgust, regret and stigma about smoking have also been reported (Gould et al 2015c). Those who consider the threat to lack immediacy, believing 'smoking is not doing me any harm right now', are less motivated to quit (OR 0.25; 95% CI 0.08-0.8) (Gould et al 2015c). High-perceived efficacy (self-efficacy and response efficacy) for quitting was strongly associated with intention to quit (OR 4.8; 95% CI 1.78-12.93) (Gould et al 2015b), whereas low-perceived efficacy coupled with lowperceived threat (in 16%) was associated with denial, avoidance or reactance to messages (Gould et al 2015d).…”

“…A community-based study revealed that a majority (77%) of Indigenous smokers of reproductive age perceived smoking to be highly threatening to physical health, implying that reflective motivation is occurring (Gould et al 2015c). Psychological threats of disgust, regret and stigma about smoking have also been reported (Gould et al 2015c).…”

“…A community-based study revealed that a majority (77%) of Indigenous smokers of reproductive age perceived smoking to be highly threatening to physical health, implying that reflective motivation is occurring (Gould et al 2015c). Psychological threats of disgust, regret and stigma about smoking have also been reported (Gould et al 2015c). Those who consider the threat to lack immediacy, believing 'smoking is not doing me any harm right now', are less motivated to quit (OR 0.25; 95% CI 0.08-0.8) (Gould et al 2015c).…”

“…(Gould et al 2013c(Gould et al , 2015c Explain the timeframe of cancer induction; that is, cancer can have been induced many years before it is diagnosed and that quitting does not bring on cancer -it is always better to stop smoking.…”

“…Smoking is OK in the car if children are not present (Gould et al 2013c(Gould et al , 2015c Educate on the concept of third-hand smoke particles and promote total smoke-free environments. (Gould et al 2013c(Gould et al , 2015c Explain the timeframe of cancer induction; that is, cancer can have been induced many years before it is diagnosed and that quitting does not bring on cancer -it is always better to stop smoking.…”