The effects of smoking norms and attitudes on quitting intentions in Malaysia, Thailand and four Western nations: A cross-cultural comparison

Abstract

This research investigated the influence of smoking attitudes and norms on quitting intentions in two predominantly collectivistic countries (Malaysia and Thailand) and four predominantly individualistic Western countries (Canada, USA, UK and Australia). Data from the International Tobacco Control Project (N = 13,062) revealed that higher odds of intending to quit were associated with negative personal attitudes in Thailand and the Western countries, but not in Malaysia; with norms against smoking from significant others in Malaysia and the Western countries, but not in Thailand; and with societal norms against smoking in all countries. Our findings indicate that normative factors are important determinants of intentions, but they play a different role in different cultural and/or tobacco control contexts. Interventions may be more effective if they are designed with these different patterns of social influence in mind.

Keywords:

• smoking
• social norms
• attitudes
• collectivism

Acknowledgement

The ITC Project is supported by grants P50 CA111236 and R01 CA 100362 (Roswell Park Transdisciplinary Tobacco Use Research Center) from the National Cancer Institute of the United States, Robert Wood Johnson Foundation (045734), Canadian Institutes of Health Research (57897 and 79551), National Health and Medical Research Council of Australia (265903 and 450110), Cancer Research UK (C312/A3726), Canadian Tobacco Control Research Initiative (014578); Centre for Behavioural Research and Program Evaluation, National Cancer Institute of Canada/Canadian Cancer Society; the Thai Health Promotion Foundation and the Malaysian Ministry of Health. We would like to thank Marie Helweg-Larsen and two anonymous reviewers for their helpful comments on an earlier version of this manuscript. We also acknowledge the other members of the ITC team.

Notes

Note

1. In addition, a preliminary examination of the results of an in-depth cognitive interviewing study we conducted in Thailand, Malaysia and Australia revealed no appreciable differences between these countries in what smokers consider to be ‘important others’ or ‘society’. This suggests a degree of robustness of our measures to both issues of translation and cultural context.