Are changes in dependence and motivation to quit in England from 2007-2012 consistent with the hardening hypothesis?
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Author(s)
Graeme Docherty, Dr Jamie Brown, Professor Robert West and Professor Ann McNeill.
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| Presenter(s) |
Graeme Docherty Research Coordinator, University of Nottingham, City Hospital, Nottingham |
Abstract Aims
‘Hardening’ in the case of cigarette smoking refers to two distinct features of smokers: motivation to stop and dependence. This study assesses whether there was any evidence for hardening over the period 2007-2012, a time when smoking prevalence fell by one fifth.
Methods
Data from monthly household surveys of nationally representative samples of smokers (n=500+ per month) and those who had stopped in the past year (the Smoking Toolkit Study) were used. Dependence was measured by the Heaviness of Smoking Index (HSI). Motivation was indexed by the proportion who had tried to quit in the past year. The proportion of last-year smokers who were currently ex-smokers was also assessed.
Results
Dependence as measured by HSI declined (mean 2.52 – 2.33; trend p < 0.001) due of a reduction in number of cigarettes smoked. The proportion making a quit attempt declined over the period, as did the number quitting successfully (trend p < 0.001). There was no change in strength of urges to smoke.
Conclusions
There is some evidence for a reduction in motivation to quit from 2007-2012 but no evidence for increased dependence among remaining smokers. If hardening has occurred it appears to be due to a reduction in motivation.
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Presenter biography Graeme Docherty is research coordinator for the UK Centre for Tobacco Control Studies. Having spent several years in NHS R&D, he now supports the work of the UKCTCS and his research interests include smokers who do not want/are unable to quit in smoking populations and methods to assist these types of smokers.
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Source of funding: The Smoking Toolkit Study is currently funded by Cancer Research UK and the Department of Health.
The work was undertaken by partly or fully funded members the UK Centre for Tobacco Control Studies, a UKCRC Public Health Research: Centre of Excellence. Funding from Centre from British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
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Declaration of interest: Robert West undertakes research and consultancy for companies that develop and manufacture smoking cessation medications. He has a share of a patent for a novel nicotine delivery device. He is a trustee of QUIT. His research is funded mostly by Cancer Research UK.
Ann McNeill is a member of the Royal College of Physician's Tobacco Advisory Group and a member of the Action on Smoking and Health Council.
Graeme Docherty and Jamie Brown have no conflicts of interest to declare.
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