Factors contributing to smoking cessation among young adult smokers aged 18-35 in Bulgaria
General Medicine, 2024, 26(4), 3-10.
E. Naseva1, D. Sabev2, P. Antonov3, M. Gavrailova4, Y. Pavlova5, G. Geshanova6
1 Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University – Sofia
2 Economic Research Institute, the Bulgarian Academy of Sciences
3 BlueLink Foundation
4 Association “Bulgaria without Smoke”
5 Association for Prevention and Work with Addictions “Only Today”
6 Smoke-free Life Coalition
Abstract. Introduction: Smoking in Bulgaria, including among young people, is alarmingly high. The aim of the current study was to characterize the young adult people who already have stopped smoking against those who continue to use tobacco and nicotine products. Materials and methods: In the period 1 December 2020 – 2 January 2021, an anonymous online survey among people aged 18-35 was conducted using Google forms actively promoted on different social media. The questions in the survey were related to the general opinions and attitudes of the young adult people towards cigarettes and smoking. Data were collected on 644 respondents with a median age of 26 years (IQR 21-30), with a female predominance (65.4%). Current smokers among the participants were 45.7%, former smokers 21.0%, and never smokers 33.4%. Statistical analysis included only current and former smokers (429 individuals in total). Results: The share of quitters among both sexes is similar: 19.7% of men and 21.6% of women (p > 0.05). Men quitted smoking significantly more often due to financial reasons (31.8%) compared to 16.5% of women (p = 0.042). In addition, men quitted smoking significantly more often with the help of a friend (9.1% compared to 1.1% for women, p=0.039). Smoking experimentation starting with hookah increases 2.8 times the odds of remaining in the current smoker group (OR = 0.354, p = 0.044). Having people who smoke in the respondent immediate environment – both in their homes and at their workplaces – improves their odds of switching to the group of ex-smokers by 10.8 and 11.5%, respectively (OR = 1.108, p < 0.001 and respectively OR = 1.115, p = 0.001). An increase in age by one year resulted in a 7.4% higher odds of quitting smoking (OR = 1.074, p = 0.002). Conclusion: As the age of the young adult smokers advances, so do their chances of quitting – but this exposes them for longer to the adverse effects of tobacco smoke. The efforts of the prevention programs should be aimed in the first place at preventing youth from starting to smoke. Information campaigns focused on young people and on the broader society about the harm of hookahs and the possibility of creating a subsequent addiction to cigarettes are needed, as well as a more comprehensive use of tax control measures. General practitioners (GPs) have a key role in forming of intention to quit, and in supporting of quitting itself. The GPs are the professionals (or institution) most suitable for health promotion activities, since they stand in closest connection to the patients, yet they need additional support in this respect.
Key words: smoking, young adults, general medical practice, smoking cessation
Address for correspondence: Emiliya Naseva, PhD, e-mail: e.naseva@foz.mu-sofia.bg