Tobacco cessation attempts among Turkish adolescents: a structural equation model analysis

BACKGROUND: 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 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. METHODS: This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, school-based study carried out among adolescents. The study population (n = 18,985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9,735 students remained for analysis. The outcome was an attempt to quit smoking within the past year. Structional Equation Model was used for analysis. The model included dependence level, sociodemographic factors, exposure to second-hand smoking, promoting factors for tobacco use (exposure to advertising in stores, at events, or on the internet), and anti-tobacco policies (sale restrictions, exposure to anti-tobacco media messages, TV spots) as latent factors. (The model fit; CFI=0.917, TLI=0.900, RMSEA=0.032). RESULTS: Students were 11-17 years and 66.4% were male. In the past 12 months, 56.3% (95%CI:55.3%-57.3%) of smokers attempted to quit. Dependency (ß=0.037, p = 0,008) and exposure to anti-tobacco policies (ß=0.114, p < 0.001) had positive direct effects, whereas sociodemographic factors (ß=-0.086, p < 0.001) and exposure to second-hand smoke (ß=-0.051, p < 0.001) had negative direct effects on quit attempts. Promoting factors weren't significant (p = 0.14). CONCLUSIONS: More than half of smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to second-hand smoke decreased cessation attempts. Anti-tobacco policies as sale restrictions and warnings of the dangers of tobacco should be enforced fully since they are the strongest predictors of quit attempts. KEY MESSAGES: • Quit attempts are prevalent, highlighting the need for cessation programs for adolescents in Turkey. • Anti-tobacco policies are the most accurate predictor of quit attempts and should be fully enforced.