Factors Related to Tobacco Cessation Attempts Among Turkish Adolescents: A Structural Equation Model Analysis

Abstract

Objective: The Turkish Global Youth Tobacco Survey (GYTS) 2017 revealed that 17.9% of students aged 13-15 used tobacco products and 7.7% smoked cigarettes. Given the high prevalence of smoking, it is important to evaluate the factors associated with quit attempts among adolescents. This study aimed to identify the factors associated with Turkish adolescents’ attempts to quit smoking using Structural Equation Model (SEM) analyses. Material and Methods: This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, schoolbased study carried out below 18-year-olds. The study population (n = 18 985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9735 students remained for the analysis. The outcome was an attempt to quit smoking within the past year. Structural Equation Model (SEM) was used for data analysis. The model had good fit (CFI = 0.917, TLI = 0.900, RMSEA = 0.032). Results: Of the 9735 students, 66.4% were male. In the past 12 months, 56.3% (95%CI: 55.3%-57.3%) of smokers attempted to quit. Exposure to anti-tobacco policies (β = 0.114. P < .001) had positive direct effects, whereas sociodemographic factors (β = −0.086. P < .001), nicotine dependency (β = −0.037. P = .008) and exposure to second-hand smoke (β = −0.051. P < .001) had negative direct effects on quit attempts. Conclusion: More than half of the smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to secondhand smoke decreased cessation attempts. Anti-tobacco policies such as sale restrictions and warnings of the dangers of tobacco products should be given high priority and enforced fully since they are the strongest predictors of quit attempts.