Factors Influencing Intention to Quit Tobacco Use Among Patients With Non‐Communicable Diseases in Bangladesh: A Multilevel Analysis

INTRODUCTION: Tobacco use is a major risk factor for non-communicable diseases (NCD), contributing to disease progression, comorbidities and reduced quality of life. This study aimed to assess the distribution and correlates of intention to quit tobacco use among patients with NCDs attending selected government sub-district hospitals in Bangladesh. METHODS: A cross-sectional study was conducted among 660 patients aged ≥ 18 years attending NCD corners in eight selected government sub-district hospitals in Bangladesh. Data were collected using a structured questionnaire covering sociodemographic, clinical and healthcare, and tobacco use characteristics from 26 May to 14 June 2025. Patients were nested within sub-district hospitals, and multivariable multilevel logistic regression was used to identify the factors associated with quit intentions while accounting for clustering of patients within hospitals. RESULTS: In the multilevel multivariable logistic regression model, patients with moderate to high levels of knowledge of cessation services (adjusted odds ratio [AOR] 2.2; 95% confidence interval [CI] 1.19-4.24), heart disease (AOR 2.0; 95% CI 1.18-3.59), stroke (AOR 2.4; 95% CI 1.09-5.12) and ≤ 10 years of tobacco use (AOR 2.1; 95% CI 1.24-3.38) were more likely to express an intention to quit. Among facility-level factors, being asked about tobacco use by healthcare providers (AOR 2.2; 95% CI 1.29-3.69) and receiving advice to quit (AOR 1.8; 95% CI 1.10-2.96) were associated with higher odds of intending to quit. DISCUSSION AND CONCLUSIONS: Addressing both individual- and facility-level factors through structured cessation support integrated into routine NCD care could strengthen tobacco control efforts in Bangladesh.