Changes in prevalence and predictors of tobacco smoking and interest in smoking cessation in Turkey: Evidence from the Global Adult Tobacco Survey, 2008-2016

INTRODUCTION Turkey conducted three rounds of the Global Adult Tobacco Survey (GATS) in 2008, 2012, and 2016 to monitor tobacco use and key tobacco control indicators. The prevalence estimate of adult tobacco use was 31.2% in 2008 and it declined to 27.1% in 2012. METHODS GATS is a nationally-representative, cross-sectional household survey of tobacco-use and related behaviors among adults aged >= 15 years. Outcome measures were prevalence of current tobacco smoking and interest in quitting smoking. Multivariable logistic regression analyses assessed changes in the adjusted prevalence and predictors of the outcome variables. RESULTS The unadjusted prevalence of tobacco smoking among adults was 31.6% in 2016; a significant increase in the adjusted prevalence of 4.5% from 2012 to 2016. A significant 19.4% decline was observed in interest in quitting smoking from 2012 to 2016. Tobacco smoking was lower among women (adjusted prevalence ratio, APR=0.38) and rural residents (APR=0.79), and higher among adults aged 25-64 years compared to those aged 15-24 years (APR=1.63), and those who lived with other adults who smoke tobacco (APR=1.55). Predictors of increased interest in quitting smoking included rural residence (APR=1.13), higher education level (APR=1.21-1.36), awareness of anti-tobacco warnings and advertisements (APR=1.30), and belief that smoking causes severe health consequences (APR=1.57). CONCLUSIONS This study identified opportunities to reduce tobacco smoking and increase interest in quitting, including increasing awareness of the health consequences of smoking and of evidence-based cessation resources. This study highlights Turkey's commitment to assessing or monitoring tobacco use and key tobacco indicators to inform their policies and programs in a changing tobacco landscape.