Factors affecting smoking initiation and cessation amongadult smokers in Fiji: A qualitative study

25% of men and 5% of women smoked, globally. The smoking prevalence among the Pacific people, along with its illness related burden, remains high in other countries, especially in New Zealand. In the Fijian context, there is a decline in daily tobacco smoking in both sexes and all ethnicities over the past 30 years, however, prevalence remains high in men at around 27% 5 . The results of the NCD Steps Survey that was conducted in 2011 showed that the prevalence ABSTRACT INTRODUCTION Smoking as a public health challenge is globally considered the main risk factor of many non-communicable diseases (NCDs). Knowing factors contributing to smoking commencement and cessation is the necessary step to develop prevention strategies to combat this issue. To date, no study has been conducted in Fiji, therefore this study aimed to explore the reasons adult smokers initiate smoking and cessation in Fiji. METHODS A qualitative study was conducted among 35 current smokers who were interviewed between 1 May and 31 July 2020 in Suva, Fiji. Three health centers were chosen randomly to collect data and purposive sampling was applied to reach study participants. A semi-structured, open-ended questionnaire was used to guide the interviews. The content of in-depth interviews was transcribed and data were analyzed using content and thematic analysis. RESULTS The results of this study showed that most of the participants were male (57%), I-taukei (77%), single (54%), had attained tertiary education level (69%), were of Christian religion (77%), and unemployed (63%). Two main themes were identified including: 'factors affecting smoking initiation' and 'factors affecting smoking cessation'. 'Peer pressure', 'smoking myth', 'smoking as a fun', 'unpleasant event in life' and 'smoking establishes friendships' were factors affecting initiation of smoking; while 'knowledge on smoking harms', 'financial constraints', 'desire to improve health', 'constant request from family members', 'desire to save time', 'religious factors' and 'cultural factors', were factors affecting smoking cessation among smokers. CONCLUSIONS This study highlights the main factors affecting smoking among adult smokers in Fiji. Considering these factors in future health planning will help policy makers and decision makers to develop tailored interventions to combat this health issue.