Professor John Hughes Dept of Psychiatry, University of Vermont, USA
Abstract
Aims: To provide a prospective, fine-grain description of the incidence and pattern of intentions to quit, quit attempts, abstinence, and reduction among smokers. Design: Prospective natural history study with no treatment provided.
Setting: Smokers participated via phone or internet. Participants: 152 smokers who planned to quit in the next 3 months. Measurement: Daily phone calls to an Interactive Voice Recording for 3 months to record smoking and intentions to quit the next day, and monthly questionnaires.
Results: Compliance was high. Most smokers (60%) had multiple transitions among smoking, abstinence and reduction episodes; e.g. 40% of smokers had 3 or more quit attempts during the three months. Half of quit attempts (48%) lasted less than one day. The majority of quit attempts (72%) were unintended. The duration of unintended quit attempts was shorter than that of intended quit attempts (< 1 vs 25 days). Over half (60%) of all lapses lead immediately to daily smoking.
Conclusions: Cessation is a more chronic, complex, dynamic process than many theories or treatments assume. For many smokers, the cessation process does not end with lapse/relapse; thus, treatment should focus, not just on a given quit attempt but also on continued attempts to stop smoking.
Source of funding: US National Cancer Institute
Declaration of interest: John Hughes has received consulting fees from many for profit and nonprofit organizations who develop or sell smoking cessation products or services or engage in tobacco education and advocacy. John Finger and Shelly Naud have no disclosures.
