Analysis of Quit-Smoking Motivation among Coffee Shop Visitors in

Aceh

Afni Yan Syah

1,2

, Said Usman

, Teuku Tahlil

Master Program of Nursing Science, Faculty of Nursing, Syiah Kuala University, Banda Aceh, 23111

Military Nursing Academy of Iskandar Muda, Banda Aceh 23121

Faculty of Medicine, Syiah Kuala University, Banda Aceh, 23111

Keywords: Smoking, Motivation to Quit Smoking, Coffee Shop visitors, Indonesia

Abstract: In controlling the tobacco problem, the government only concentrates on environmental factors that only

promote people to smoke and prevent them from quitting smoking. Ones' knowledge of the health impacts of

smoking coupled with a strong desire and motivation to implement it trigger their desire to quit smoking.

Thus, high motivation is essential in the quit-smoking process. The attainment of physiological, social,

achievement and maintenance need determine the motivation to quit-smoking. This study aimed at examining

the factors that influence the motivation level of coffee shop visitors in Aceh to quit smoking in term of

fulfilling physiological, social, achievement, and maintenance need. This study used an analytical survey

method. A total of 250 respondents were selected by purposive sampling at several coffee shops in one of the

districts in Aceh. Questionnaires were used to collect the data in the form of Likert scale and analyzed with

the Chi-square test. The findings showed that the respondents' level of motivation to quit smoking was

strongly influenced by physiological need (p = 0.004, Exp (B) = 0.605), social need (p = 0.000, Exp (B) =

0.975), achievement need (p = 0.000, Exp (B) = 0.862), and maintenance need (p = 0.004, Exp (B) = 0.605).

Community nurses are encouraged to distribute leaflets about the dangers of tobaccos in coffee shops and

work with coffee shop owners to establish no-smoking areas in the coffee shops.

1 INTRODUCTION

Smoking causes nearly 6 million people to die

every year (World Health Organization (WHO),

2013). More than 5 million people died from

smoking, while more than 600,000 people died

from the exposure of cigarette smoke (WHO, 2013).

In addition, WHO mentioned various types of

smoking-related disease.

Indonesia is one of the countries with the highest

smoking prevalence in the world. Around 34.8% of

Indonesian population are smokers, and 67% of

them are male (Global Adult Tobacco Survey

(GATS), 2011). Indonesia's Ministry of Health

estimated that the number of casualties caused by

smoking-related diseases reached 190,260 people or

around 12.7% population (MOH, 2015). A total of

1,163,800 out of 4.6 million people in Aceh said that

they regularly smoke 19 cigarettes every day (MOH,

2010).

The lack of awareness among Acehnese about

the dangers of smoking, both in active smokers and

passive smokers, contributes to the increasing

number of smokers in this province. Furthermore,

the regulation of non-smoking areas set by the

municipal government of Banda Aceh has not been

implemented to its full potential. Unrestricted

cigarette advertisements are also believed in

contributing to determine smoking as a "normal

behavior" in Aceh. Almost all groups of people in

Aceh seem to support this phenomenon. The

increasing number of new coffee shops in Aceh do

not only add up the list of new places for the

Acehnese to gather, but even create opportunities

for the community to continue , to get introduced to,

and to try smoking cigarettes (Perwira, 2008).

Meanwhile, motivation affects the success of the

quit-smoking process. One's knowledge about the

danger of smoking, which is accompanied by a

strong desire and motivation to achieve it,

influences their desire to quit smoking (Nainggolan,

2004, in Kumboyono, 2011). Owers & Ballard

(2008) who conducted a study on 560 respondents,

reported that motivation to quit smoking can be

Syah, A., Usman, S. and Tahlil, T.

Analysis of Quit-Smoking Motivation among Coffee Shop Visitors in Aceh.

DOI: 10.5220/0008394500002442

In Proceedings of the Aceh International Nursing Conference (AINC 2018), pages 58-63

ISBN: 978-989-758-413-8

divided into two categories, low and high. Owers &

Ballard also found that structural and cultural

barriers are two obstacles in the process of quit

smoking. Structural barriers include time, place and

cost, while cultural barriers include peer pressure,

smoking norms, and lack of support from the

environment and family.

An initial data collection from three smokers

who visited the coffee shop in one of the cities in

Aceh indicated that the coffee shop was considered

as the best place to enjoy cigarettes. They admitted

that smoking is more enjoyable when they relax

with friends. One of the respondents stated that the

inhibiting factor of their desire to quit smoking was

their perception in which smoking is a necessity

they need to fulfil every day. Another visitor

reported that it was difficult to quit smoking

because his desire to smoke reappeared when he

gathered with friends. Based on the aforementioned

description, therefore this study aimed to examine

further the influencing factors on the motivation of

quit smoking among the coffee shop visitors in

Aceh.

2 METHODS

This study is an observational analytic study with

the cross-sectional approach, in which observation

or data collection is carried out at one time by using

one approach. A total number of 250 active smokers

were purposively selected from five coffee shops (50

people in each coffee shop) in Banda Aceh.

A questionnaire consisting of 3 parts was used

for data collection. Part A collected information on

the background of respondents, which includes age,

marital status, education, employment, income, and

smoking behavior. Part B consisted of 40 statements

in the form of a Likert scale measuring the factors

that influenced individual motivation to quit

smoking, encompassing physiological (10

statements), social (10 statements), achievement (10

statements), and maintenance needs (10 statement).

Part C incorporated 10 statements measuring the

motivation level of the respondents to quit smoking.

The Cronbach alpha’s reliability coefficient ranging

from 0.80-0.82 is yielding from the questionnaire

about the factors influencing the motivation to quit

smoking, and 0.83 from the questionnaire about the

individual motivation level to quit smoking.

The SPSS 16.0 for Windows was used for the

data analysis. The test included univariate analysis

to examine the percentage of each variable or sub-

variable, and bivariate analysis such as Chi-Square

test and logistic regression. This study passed ethical

review from the Institutional Review Board of

Faculty of Nursing, Syiah Kuala University.

Participation of respondent in this study is

confidential and voluntary.

3 RESULTS

Results of this study, including respondents’

demographic characteristics, level of motivation to

quit smoking viewing from aspect of fulfilling

physiological need, social need, achievement need,

and maintenance need.

3.1 Demographic Characteristics

Characteristics of respondents are described in Table

1. Respondents were primarily unmarried (79.6%),

entrepreneurs (50.4%), between 36-45 years old

(37.6%), and had a bachelor’s degree (40%). The

majority of respondents had smoked over six months

(66.8%), smoked more than five cigarettes per day

(74.8%), used clove cigarettes (83.6%), and got

money for smoking from their parents (54.0%).

3.2 Motivation to Quit Smoking and

Physiological Need

Tables 2 and 3 show motivation levels of

respondents to quit smoking based on physiological

need fulfillment. There was a significant difference

between the level of physiological need fulfillment

and the level of motivation to quit smoking (p-value

= 0.000). Further analysis indicates that the

physiological need factor had a significant effect on

the level of motivation to quit smoking (p = 0.004,

Exp (B) = 0.605).

3.3 Motivation to Quit Smoking and

Social Need

Table 2 and 3 show motivation of respondents to

quit smoking based on social need attainment. There

was a significant difference between the level of

social need attainment and the level of motivation to

quit smoking (p-value = 0.000). Further analysis

shows that social need attainment has a significant

influence on motivation to quit smoking (p = 0.000,

Exp (B) = 0.975).

Analysis of Quit-Smoking Motivation among Coffee Shop Visitors in Aceh

Table 1: Frequency Distribution of Respondents Based on Demographic Characteristics (n = 250).

Characteristics of Respondents f (%)

Age

17-25 years old 4 (1.6)

26 -35 years old 88 (35.2)

36 – 45 years old 94 (37.6

46 – 55 years old 56 (22.4)

56 – 65 years old 8 (3.2)

Marital status

Married 44 (17.6)

Unmarried 199 (79.6)

Widowed 7 (2.9)

Education

Secondary school 8 (3.2)

High school 50 (20.0)

Diploma 55 (22.0)

Undergraduate 101 (40.0)

Postgraduate 36 (14.4)

Occupation

Farmer 2 (0.8)

Private sector workers 65 (26.0)

Entrepreneur 126 (50.4)

Unskilled laborers 11 (4.4)

Civil servants 41 (16.4)

Merchandise 5 (2.0)

Duration of smoking

Less than 6 months 83 (33.2)

More than 6 months 167 (66.8)

Number of cigarettes smoked per day

Less than five cigarettes per day 187 (74.8)

5 – 15 cigarettes per day 26 (10.4)

More than 15 cigarettes per day 37 (14.8)

Type of Cigarette

Clove Cigarette 250 (100)

Brand of Cigarette Smoked

Mild 209 (83.6)

Dji Sam Soe 41 (16.4)

Source of Income

Working 115 (46.0)

Parent 135 (54.0)

AINC 2018 - Aceh International Nursing Conference

Table 2: The relationship between Motivation to Quit Smoking and the Physiological, Social, Achievement, and

Maintenance Factors of the Coffee Shop Visitors in Aceh (n = 250).

Type of need

Level of motivation to quit smoking

Total

(F,%)

p-value

High (F,%) Medium (F,%) Low (F,%)

Physiological Need

Good 67(60.4) 56(51.4) 5(16.7) 128(51.2)

0.000

Adequate 39(35.1) 48(44.0) 14(46.7) 101(40.4)

Poor 5(4.5) 5(4.6) 11(36.7) 21(8.4)

Social Need

Good 65(58.6) 53(48.6) 6(20.0) 124(49.6)

0.000

Adequate 45(40.5) 54(49.5) 14(46.7) 113(45.2)

Poor 1(9.0) 2(1.8) 10(33.3) 13(5.2)

Achievement Need

Good 83(74.8) 69(63.3) 6(20.0) 158(63.2)

0.000

Adequate 27(24.3) 35(32.1) 15(50.0) 77(30.8)

Poor 1(9) 5(4.6) 9(30.0) 15(6)

Maintenance Need

Good 83(74.8) 52(47.7) 10(33.3) 145(58.0)

0.000

Adequate 27(24.3) 53(48,6) 13(43.3) 93(37.2)

Poor 1(9.0) 4(3.7) 7(23.3) 12(4.8)

Table 3: Determinants of Motivation to Quit Smoking on Coffee Shop Visitors in Aceh.

Variable

Wald

Sig Exp {B}

95% CI

Lower Upper

Physiological Need 8.1 0.004 0.605 0.188 1.021

Social Need 16.7 0.000 0.975 0.508 1.442

Achievement Need 14.07 0.000 0.862 0.412 1.312

Maintenance Need 25.92 0.000 1.226 0.754 1.698

3.4 Motivation to Quit Smoking and

Achievement Need

Table 2 and 3 show motivation of respondents to

quit smoking in terms of achievement need

attainment. There was a significant difference

between the level of achievement need attainment

and the level of motivation to quit smoking (p-value

= 0.000). Further analysis shows that achievement

need attainment had a significant influence on the

motivation to quit smoking (p = 0.000, Exp (B) =

0.862).

3.5 Motivation to Quit Smoking and

Maintenance Need

Table 2 and 3 show motivation of respondents to

quit smoking in terms of maintenance need factors.

There was a significant difference between the

level of maintenance need attainment and the level

of motivation to quit smoking (p-value = 0.000).

Further analysis shows that maintenance need

attainment had a significant influence on the level

of motivation to quit smoking (p = 0.000, Exp (B)

= 1.226).

4 DISCUSSION

This study aimed to analyze the motivation level of

coffee shop visitors to quit smoking. This study

involved 250 respondents; most of whom were 36-

45 years old, unmarried, hold a bachelor’s degree,

working as entrepreneurs, smoking more than six

months, and smoking more than five cigarettes a

day. Wibowo (2015) argued that adults (aged 25-45)

are economically independent, independent in

making decisions, mindful and considerate in

making choices compared to teenagers. Adults tend

to quit smoking due to health considerations. They

are more aware of health problems and functions

than teenagers. Saputra & Sary (2013) suggested

that the motivation to quit smoking in teenagers may

arise and is often high due to the positive influence

of their surroundings such as family, peers and

Analysis of Quit-Smoking Motivation among Coffee Shop Visitors in Aceh

closest persons who do not smoke. Therefore, there

is no relationship between age and motivation to quit

smoking because, at every age level, motivation may

arise from different reasons.

Intentions and motivation may influence

someone to quit smoking. Motivation is a

psychological process that reflects the interaction

between attitudes, needs, perceptions, and decisions

in a person (Ayu, 2014). Intrinsic and extrinsic

factors modify the motivation to quit smoking. The

intrinsic factors include age, knowledge, value,

perception, and experience while extrinsic factors

consist of the environment, closest persons (family),

and economy (Marquis and Huston, 2000 cited in

Barus, 2012). The current study found that the level

of motivation to quit smoking was determined by

physiological, social, achievement and maintenance

need factors.

The study further found that the motivation level

to quit smoking on coffee shop visitors in Aceh was

mostly in the good category. The findings also

indicate that their motivation to quit smoking is

related to the fulfillment of physiological needs.

Physiological and biological needs are the primary

needs that everyone must fulfill. For some people,

their daily habits have become primary needs such

as food, breathing and rest and sleep. Maslow (2003)

considers physiological needs as the primary needs

in which someone must fulfill in order to gain other

needs. Physiological needs significantly influence

ones' smoking behavior because their daily habits

have integrated with them and affect their desire to

quit smoking. The current findings are in contrast

with a similar study conducted by Febrijanto (2012)

in a male student dormitory. Febrijanto (2012)

reported that biological factors did not influence

smoking behaviors in male students.

The current study also indicates a relationship

between social needs and motivation to quit

smoking. When smokers gather with their friends,

who are also smokers, they presume comfort among

them. Findings from the previous study by Farid

(2005) reported that the factors influencing

teenagers to quit smoking were mostly in the poor

category. It means that most respondents have

friends who support their smoking habit and

encourage them to keep smoking. Farid (2005)

mentioned some behaviors related to teenage

smoking habit such as smoking together in the

canteen, buying cigarettes around schools, giving

cigarettes to friends, and smoking in the community

security post (poskamling). A study conducted by

Waramatias (2014) revealed that the factors that

influence the motivation to quit smoking in

teenagers are the personal relationship, self-

perception, self-image, and environmental influence

and influence from other people.

The findings also show that there is a significant

relationship between fulfilling achievement need and

motivation to quit smoking. A similar account was

observed between maintenance need and the

motivation to quit smoking. Maintenance need are

factors associated with the nature of humans to gain

physical contentment. This fitness need, such as

addiction or dependence on cigarettes, is an endless

demand because it will reset itself after being

fulfilled. Cigarettes have a lot of chemical

substances such as nicotine which is addictive and

dangerous. Nicotine is released when someone lights

a cigarette and inhales its smoke. It enters the lungs

and reaches the brain within seconds.

The maintenance need is the factor that most

influences the level of motivation to quit smoking.

Maintenance factors will provide satisfaction if

fulfilled. Conversely, failing to fulfill the craving

may cause dissatisfaction and lead to a desire to

consume until the craving is satisfied. The system

will repeat itself if it is not satisfied until it reaches

the physical tranquility. At this point, smokers will

not quit smoking before they satisfy the craving.

Smoking will become a recurring cycle to satisfy the

needs and made the smokers addicted.

5 CONCLUSION

Motivation to quit smoking is affected by

physiological, social, achievement, and maintenance

needs. The maintenance need is the factor that most

influences the level of motivation to quit smoking.

ACKNOWLEDGEMENT

The authors would like to express their gratitude to

the board of thesis examiners, Dr. Mudatsir, M. Kes

and Dr. rer. Med. Ns. Marthoenis, M. Sc., MPH, for

their valuable advice, and to the director of the

Military Nursing Academy of Iskandar Muda, Banda

Aceh for the financial support for this study.

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Analysis of Quit-Smoking Motivation among Coffee Shop Visitors in Aceh