Conflicting motivations and the decision to stop smoking gradually or abruptly – evidence from smokers clinics in Malaysia

Authors:
Lion Shahab, Lei Hum Wee and Robert West

Presenter:
Lion Shahab
Research Associate, University College London, UK

Abstract
Background: Little is known about the extent to which smokers attending stop smoking clinics experience conflicting motivations about their quit attempt and whether this is associated with a smoker’s decision to stop smoking gradually or abruptly.

Method: Sociodemographic, smoking characteristics and single item measures of attitudes towards smoking and smoking cessation were recorded in a cross-sectional survey of smokers attending quit smoking clinics in Malaysia.

Results: Five single-item attitudinal measures loaded onto a single factor that could be labeled ‘conflict about quitting’. The resultant
scale was moderately reliable (Cronbach’s and = 0.625). Most smokers exhibited conflicting motivations, with over half (52.0%, 95% CI 45.1 – 59.1) scoring 2 or higher on the 5-point scale. ‘Conflict about quitting’ was associated with the decision to stop smoking gradually controlling for baseline variables (OR 1.36, 95% CI 1.05 – 1.76).

Conclusion: ‘Conflict about quitting’ is prevalent even among smokers voluntarily attending stop smoking clinics. Smokers who display greater conflict about quitting were more likely to stop gradually, which may explain contradictory findings regarding the effectiveness of gradual vs abrupt cessation. It may not be the method of cessation but the conflicted attitude towards cessation underlying the decision to stop abruptly or gradually that determines the success of quit attempts.

Source of funding: CRUK

Declaration of interest: Lion Shahab has received an honorarium for a talk and travel expenses from Pfizer. Robert West undertakes research and consultancy for the following developers and manufacturers of smoking cessation treatments: Pfizer, J&J, McNeil, GSK, Nabi, Novartis and Sanofi-Aventis. Robert West also has a share in the patent of a novel nicotine delivery device.

About the presenter
Lion Shahab, PhD, is currently working as a postdoctoral research associate at the Cancer Research UK Health Behaviour Research Centre at University College London. His expertise lies in epidemiology, tobacco control, public health, and health psychology. Current research interests
focus on the detection of smoking-related diseases in the population, the use of smoking-related biomarkers to motivate smoking cessation, the development and impact of potential harm reduction strategies, and public attitudes to tobacco policy.