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Background <p>Cigarette craving is a central driver of nicotine dependence and relapse, yet limited research has examined craving using cognitive–behavioural health frameworks. This study investigated the predictors of smoking craving among Malaysian adults by integrating cognitive perceptions, cue exposure, and socio‑demographic factors.</p> Methods <p>A cross‑sectional online survey was conducted with 370 adult tobacco smokers residing in Selangor. Measures included Health Belief Model (HBM) constructs, smoking cue exposure, and socio‑demographic variables. Hierarchical multiple regression analysis was used to evaluate the incremental predictive effects of these factors on smoking craving.</p> Results <p>The final model accounted for 38.3% of the variance in craving (R² = 0.383). Higher self‑efficacy was associated with lower craving (β = −0.301; <i>p</i> = 0.001). Perceived barriers (β = 0.330; <i>p</i> = 0.001), cues to action (β = 0.302; <i>p</i> = 0.001), and cue exposure (β = 0.136; <i>p</i> = 0.001) were positively associated with craving. Income showed a significant negative association (β = −0.119; <i>p</i> = 0.05), indicating stronger cravings among lower‑income smokers.</p> Conclusion <p>Smoking craving among Malaysian adults is shaped by cognitive perceptions, environmental cue exposure, and economic factors. Strengthening self‑efficacy, reducing perceived barriers, and limiting exposure to smoking‑related cues may improve cessation outcomes. These findings provide practical direction for targeted public health interventions aiming to reduce craving‑driven smoking behaviour.</p>

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Applying the health belief model to understand smoking craving among adults in Selangor, Malaysia

  • 期刊论文

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  • 发表日期：

    2026年6月24日

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  • Subramaniam Munusamy,
  • Shaufique F. Sidique,
  • Norashidah M. Nor,
  • Ezamin A. Rahim

摘要

Background

Cigarette craving is a central driver of nicotine dependence and relapse, yet limited research has examined craving using cognitive–behavioural health frameworks. This study investigated the predictors of smoking craving among Malaysian adults by integrating cognitive perceptions, cue exposure, and socio‑demographic factors.

Methods

A cross‑sectional online survey was conducted with 370 adult tobacco smokers residing in Selangor. Measures included Health Belief Model (HBM) constructs, smoking cue exposure, and socio‑demographic variables. Hierarchical multiple regression analysis was used to evaluate the incremental predictive effects of these factors on smoking craving.

Results

The final model accounted for 38.3% of the variance in craving (R² = 0.383). Higher self‑efficacy was associated with lower craving (β = −0.301; p = 0.001). Perceived barriers (β = 0.330; p = 0.001), cues to action (β = 0.302; p = 0.001), and cue exposure (β = 0.136; p = 0.001) were positively associated with craving. Income showed a significant negative association (β = −0.119; p = 0.05), indicating stronger cravings among lower‑income smokers.

Conclusion

Smoking craving among Malaysian adults is shaped by cognitive perceptions, environmental cue exposure, and economic factors. Strengthening self‑efficacy, reducing perceived barriers, and limiting exposure to smoking‑related cues may improve cessation outcomes. These findings provide practical direction for targeted public health interventions aiming to reduce craving‑driven smoking behaviour.