Behavioral smoking cessation outcomes among industrial workers in Myanmar following a health belief model-based health education and mobile phone short message service intervention

Introduction Evidence on theory-based workplace smoking cessation interventions in low- and middle-income countries remains limited, particularly regarding longitudinal behavioral outcomes. Our study aimed to examine the longitudinal associations between a Health Belief Model-based smoking cessation intervention and smoking-related behavioral outcomes among industrial workers in Myanmar. Methods A quasi-experimental, two-group longitudinal study was conducted in an industrial zone in Mandalay, Myanmar (2018–2019). Two industries were selected and assigned at the industry level to intervention or control groups to minimize contamination. Current male cigarette smokers ( n = 292; 146 per group) were assessed at baseline, immediately post-intervention (3 months), and 3 months post-intervention. Outcomes included number of cigarettes smoked per week, intention to quit, number of quit attempts, and self-reported 7-day point prevalence abstinence. Between-group comparisons used t-tests and chi-square/Fisher’s exact tests. Adjusted associations over time were estimated using generalized estimating equations (GEE), controlling for age, marital status, education, income, age at smoking initiation, and smoking duration. Results Compared with the control group, the intervention group had significantly lower cigarette consumption and higher intention to quit and abstinence at follow-up. In adjusted GEE models, significant group × time associations were observed for cigarette smoked per week ( β = −5.358, p < 0.001), intention to quit (AOR = 3.221, p < 0.001), and 7-day point prevalence abstinence (AOR = 1.825, p = 0.006). Quit attempts increased over time in both groups (time effect AOR = 1.741, p < 0.001), with no significant group × time association. Given the quasi-experimental design with only two industries, findings should be interpreted with caution. Conclusion An HBM-based intervention combining workplace health education and mobile phone short message service support was associated with improvements in smoking-related behavioral outcomes among industrial workers in Myanmar, including reduced cigarette consumption, increased quit intention, and higher short-term abstinence. Integration of theory-based workplace health education with mobile messaging may support smoking cessation efforts in low- and middle-income countries.