{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:26:33Z","timestamp":1779891993741,"version":"3.53.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11-12","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Tobacco kills half of its users. Despite this, there are over 1.1 billion smokers worldwide. Its harmful effects impair performance and readiness. Unfortunately, smoking has deeply ingrained in the military culture, as evidenced by the high prevalence. Hence, this study aims to identify the barriers to smoking cessation among this population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A study involving two groups of current smokers (commissioned officers and non-commissioned officers) was conducted using the modified nominal group technique (mNGT), a qualitative research method of judgmental decision-making involving four phases: Generating ideas, recording, evaluation, and prioritization. The mNGT was used to solicit respondents\u2019 barriers to smoking cessation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mNGT yielded seven main barriers to smoking cessation: (1) Addiction, (2) difficulty in staying focused without the usage of cigarettes, (3) smoking has been incorporated into an individual\u2019s lifestyle, (4) environmental influence, (5) coping mechanism, (6) the long-interval period between orders and duties exacerbates the desire to smoke, and (7) smoking has evolved into a permanent habit. Although nicotine addiction and habit were ranked as the most important barriers, the military working environment and nature of the job exposed them physically and mentally to unfavorable situations, complicating the quitting attempt. Furthermore, the acceptance of smoking in military culture leads to a positive smoker identity, further hindering cessation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The findings indicate that in addition to barriers affecting the general population, military-specific barriers related to the nature of the job exist, complicating cessation. Hence, any intervention program should address these barriers to achieve positive outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad268","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T07:52:25Z","timestamp":1690876345000},"page":"e3386-e3392","source":"Crossref","is-referenced-by-count":3,"title":["\u201cWe\u2019re tough, but so is quitting.\u201d Barriers to Smoking Cessation: The Royal Malaysian Navy Perspective"],"prefix":"10.1093","volume":"188","author":[{"given":"Muhamad Arham bin","family":"Hashim","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Jalan Hospital , Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia"},{"name":"The Malaysian Armed Forces , Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikmal Hisham bin","family":"Ismail","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Jalan Hospital , Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Budi Aslinie binti","family":"Md Sabri","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Jalan Hospital , Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"2023110723523748100_R1","volume-title":"The Tobacco Atlas","author":"Drope","year":"2018"},{"key":"2023110723523748100_R2","article-title":"WHO Global Report on\u00a0trends in\u00a0prevalence of\u00a0tobacco smoking 2000-2025","volume-title":"Second Edition","author":"World Health 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