Motivation to Quit Tobacco and Its Determinants Among Adult Tobacco Users: A Primary Health Center-Based Cross-Sectional Study From Dehradun District, Uttarakhand, India

Background Motivation to quit tobacco is a key determinant of cessation behavior and successful abstinence. However, evidence regarding factors influencing motivation to quit among rural tobacco users in India remains limited. Objectives The objectives of this study are to assess the level of motivation to quit tobacco and identify factors associated with motivation to quit among tobacco users attending a rural primary health center (PHC) in Uttarakhand and to assess the correlation between the nicotine dependence score and motivation to quit. Methods The current analysis is a secondary analysis of information gathered as part of a cross-sectional study evaluating tobacco users' reliance on tobacco. Between February and May 2026, adult tobacco smokers who visited Primary Health Center Raiwala, Uttarakhand, participated in a cross-sectional analytical study. A standardized questionnaire that assessed clinical profile, tobacco use history, and sociodemographic characteristics was used to collect data. The Richmond Scale was used to measure motivation for tobacco cessation. To identify predictors of motivation to stop smoking, a logistic regression analysis was conducted. Results Overall, 80 (30.0%; 95% confidence interval {CI}: 24.5-35.8) participants had moderate/high motivation to quit tobacco, while 187 (70.0%) had low motivation. Bivariate analysis showed significant associations with age, education, occupation, socioeconomic status, diabetes, age at initiation, the duration of tobacco use, and nicotine dependence (p<0.05). Multivariable logistic regression identified skilled/sales occupation (adjusted odds ratio {AOR}=2.66; 95% CI: 1.05-6.70), tobacco use for 10-20 years (AOR=0.25; 95% CI: 0.08-0.77) and >20 years (AOR=0.13; 95% CI: 0.03-0.52), and moderate/high nicotine dependence (AOR=0.38; 95% CI: 0.19-0.77) as significant predictors. Motivation was weakly and negatively correlated with nicotine dependence. Conclusion Approximately one-third of tobacco smokers in rural areas showed moderate to high motivation to stop. Lower motivation was linked to longer tobacco use duration and increased nicotine dependency, underscoring the need for focused cessation therapies at the primary healthcare level.