Barriers to Cigarette Smoking Cessation in Pakistan: Evidence from Qualitative Analysis

Abstract

Background. With over 25 million tobacco users, Pakistan has one of the largest smoking populations in the world. Tobacco addiction comes with grave health consequences, especially for the poor and marginalized. Objective. This study explores barriers to smoking cessation in marginalized communities of Islamabad and the possibility of their use of Harm Reduction Products (HRPs), primarily e-cigarettes. Methodology. The study has used primary data of 48 respondents from marginalized communities. Several domains have been employed to evaluate the barriers to smoking cessation in these communities. Using qualitative technique, data was organized and categorized into objective themes. Conclusion. The experience of combustible smoking usually occurs in the 10-20 years’ age bracket. Regular smokers in marginalized areas of Islamabad smoke 20 cigarettes or a pack per day. Their choice of cigarette brand is largely driven by affordability. Most smokers have made at least one attempt to quit smoking. Peer pressure and friendship are major barriers to smoking cessation. Lack of knowledge seems to be the major reason for not seeking medical assistance for quitting smoking. Knowledge about HRPs, especially e-cigarettes, can best be described as vague. Higher prices of the alternatives to combustible smoking are a major hurdle preventing their use for smoking cessation.

Public Health Practitioners’ Knowledge towards Nicotine and Other Cigarette Components on Various Human Diseases in Pakistan: A Contribution to Smoking Cessation Policies

“…It reduces a complicated dataset to a lower dimension, revealing hidden and simpler patterns. The principal components are new variables formed by linearly combining or mixing the original variables [ 7 , 18 , 19 ].…”

“…Knowledge about nicotine replacement therapy (NRT) can best be described as vague. Higher prices of the alternatives to combustible smoking are a major hurdle preventing their use for smoking cessation [ 7 ].…”

Effect of socioeconomic status on smoking cessation behavior in selected African countries: Secondary analysis of Global Adult Tobacco Survey data (2014–2018)

“…Poverty and other social vulnerabilities compromise the access to smoking cessation support. A qualitative study of smokers from marginalized communities reported that higher price of alternatives to combustible tobacco was a major hurdle for smoking cessation among nicotine dependent smokers [ 50 ]. A study from Kerala, India reported the limited availability & unaffordability of tobacco cessation medications within the health system.…”

Beyond Cigarettes- Insights into Public Knowledge, Attitudes and Patterns of Use of Non-Cigarette Smoked Tobacco Products (NCSTPs): A National Cross-Sectional Study from Pakistan

“…One of the studies estimated a total of $3.85 billion smoking-attributable economic cost of all health complications in Pakistan (11). While there is substantial data available highlighting existing behaviors of cigarette smokers as well as the execution of tobacco control measures targeting cigarettes, there is very limited information available from developing countries like Pakistan where the landscape of smoked tobacco consumption is evolving, with newer forms of NCSTP gaining popularity among different demographics (12,13). It is therefore critical to understand people's perception towards the NCSTP forms to alleviate its consumption at the grassroot level.…”