The state of smokeless tobacco cessation in a context lacking cessation services: Evidence from Ethiopia

Introduction Cessation attempts for smokeless tobacco (SLT) have been studied in the countries that provide comprehensive cessation services, but there is no evidence about SLT cessation in Ethiopia, where there are no comprehensive tobacco cessation services. The objective of this study was to determine cessation attempts and related factors among daily SLT users. Methods We analyzed the data obtained from a cross-sectional survey of SLT users in Borena zone, Ethiopia, focusing on a subset of 600 daily SLT users. Participants were adult SLT users aged ≥18 years. The dependent variable was SLT cessation attempt. Multivariable logistic regression was performed to identify association between cessation attempts and explanatory variables. Analyses were performed using SPSS version 20. Results Overall, 18.5%reported having tried to quit SLT in the past 12 months. In multivariable analyses, SLT cessation attempts were significantly associated with being male (AOR=1.96, 95%CI: 1.13-3.40), current dual-product user (AOR=2.11, 95%CI: 1.31-3.38), being advised by α health professional (AOR=1.82, 95%CI: 1.13-2.92), current knowledge (AOR=1.20, 95%CI: 1.00-1.44), and risk perception (AOR=1.06, 95%CI: 1.02-1.10). Conclusions A low cessation attempt rate among daily SLT users calls for comprehensive cessation intervention. More attention to factors such as knowledge of the health consequences of SLT use, risk perception and health workers advice will be required to encourage cessation attempts. ABBREVIATIONS AOR: adjusted odds ratio, DALY: disability adjusted life year, FCTC: Framework Convention on Tobacco Control, SLT: smokeless tobacco, WHO: World Health Organization.