Intention to quit smoking and associated factors among outpatients at a tertiary hospital in semi-urban Nepal: a cross-sectional study

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Abstract
Introduction: Quitting tobacco is challenging and often requires multiple attempts. Effective tobacco cessation programmes depend on understanding the factors associated with the intention to quit in specific contexts. The study aimed to determine the prevalence of intention to quit and its associated factors among people who smoke currently visiting the outpatient department of a tertiary hospital in a semi-urban area of Nepal. Methods: An analytical cross-sectional study was conducted from 1 May to 30 June 2021, among 375 people who smoke currently selected using purposive sampling from the outpatient department of Dhulikhel Hospital. Intention to quit was assessed using a question on whether participants planned to quit smoking, with response options: (1) within the next month, (2) within the next 6 months, (3) sometime in the future but not within 6 months and (4) not planning to quit. Data on socio-demographic characteristics, nicotine dependence, motivational factors and awareness of cessation aids and services were collected using a standard structured questionnaire. Multivariate logistic regression was used to determine the factors associated with intention to quit smoking. Results: Overall, 72.5% (95% CI 67.8% to 76.8%) of participants reported an intention to quit smoking, with 64.8% in the pre-contemplation stage, 24.8% in the contemplation stage and 10.4% in the preparation stage. Higher education (high school or above), longer duration of smoking and moderate nicotine dependence were significantly associated with higher intention to quit, whereas having a history of family member smoking was associated with lower likelihood of intending to quit. Conclusions: A substantial proportion of patients reported an intention to quit, with most in the pre-contemplation stage. These findings highlight the need for targeted outpatient cessation strategies, including brief advice from healthcare workers, mobile or telephone-based quit-line services and family-centred educational campaigns, to support quitting efforts and inform culturally appropriate tobacco control interventions in Nepal.

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