Applying Multi-Theory Model (MTM) in Determining Intentions to Smoking Cessation among male Health Worker Smokers in Kabul, Afghanistan

Abstract

Introduction: Globally, smoking causes lung cancer and a wide range of acute and chronic diseases. A fourth-generation behavioral framework, the multi-theory model (MTM) of health behavior change was used to predict the initiation and maintenance of smoking cessation among health worker smokers. Methods: By visiting different Health Centers, a convenience sample of male health worker smokers from west part of Kabul city, was invited to participate in this cross-sectional study. A valid and reliable 37-item MTM-based survey instrument was administered to the male participants who smoked. To explain smoking cessation behavior, stepwise multiple regressions were conducted. The entire value of the Cronbach alpha coefficient (α) of the subscales and the scale for the initiation of MTM variables was 0.80 and for the sustenance of MTM variables was 0.79. Results: The study was completed by 170 participants. Participants were averaging 29.33 years of age (SD = 6.21). The average number of years smokers reported (SD = 4.7), was 5.6. Smoking cigarettes was the median (SD = 5.21), with 5.64 cigarettes consumed per day. Changes in the physical environment (+0.2225, P = 0.029) and behavioral confidence (+0.441, P = 0.014) were significant predictors of smoking cessation initiation. The intention to sustain smoking cessation behavior was significantly influenced by emotional transformation (β = 0.222, P = 0.017) and practicing for change (β = 0.217, P = 0.015). Conclusions: There was moderate variance in smoking cessation behavior among health worker smokers in Kabul's western part explained by two MTM constructs ( behavioral confidence, physical environment) for initiation and two MTM constructs (emotional transformation ,practicing for change) for maintenance. Smoking cessation behavior can be assessed using MTM both at the initiation and maintenance stages. It is important to develop future interventions using MTM constructs aiming to change smokers' behavior in regard to quitting smoking. Keywords: smoking cessation, multi-theory model, initiation, sustenance, health workers