Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers

Abstract

ObjectivesThe number of quit attempts it takes a smoker to quit successfully is a commonly reported figure among smoking cessation programmes, but previous estimates have been based on lifetime recall in cross-sectional samples of successful quitters only. The purpose of this study is to improve the estimate of number of quit attempts prior to quitting successfully.DesignWe used data from 1277 participants who had made an attempt to quit smoking in the Ontario Tobacco Survey, a longitudinal survey of smokers followed every 6 months for up to 3 years beginning in 2005. We calculated the number of quit attempts prior to quitting successfully under four different sets of assumptions. Our expected best set of assumptions incorporated a life table approach accounting for the declining success rates for subsequent observed quit attempts in the cohort.ResultsThe estimated average number of quit attempts expected before quitting successfully ranged from 6.1 under the assumptions consistent with prior research, 19.6 using a constant rate approach, 29.6 using the method with the expected lowest bias, to 142 using an approach including previous recall history.ConclusionsPrevious estimates of number of quit attempts required to quit may be underestimating the average number of attempts as these estimates excluded smokers who have greater difficulty quitting and relied on lifetime recall of number of attempts. Understanding that for many smokers it may take 30 or more quit attempts before being successful may assist with clinical expectations.

Availability, price and promotions for cigarettes and non-cigarette tobacco products: an observational comparison of US Air Force bases with nearby tobacco retailers, 2016

“…Stopping smoking entirely is challenging, and most people require multiple attempts to do so successfully 40. The military services’ prohibition on tobacco use during basic military training and the early phase of technical training provides Airmen a unique opportunity to remain tobacco-free and hence to enjoy improved long-term health and fitness for service.…”

E-cigarettes and Adult Smoking

“…The increase in the probability of a successful quit is the result of more attempts by e-cig users than by non-e-cig users. According to Chaiton et al (2016), it can take six or more failed attempts before a smoker has a success. Thus, for many smokers a successful quit may only come after a number of failed attempts.…”

Observational Study on a Mindfulness Training for Smokers within a Smoking Cessation Program

“…Smoking is a major cause of lung and heart disease (CDC, 2008), is now associated with 13 types of cancer (Alberg, Shopland, & Cummings, 2014), and as much as two thirds of smoker will die from a smoking related illness. The population of smokers in the US has changed substantially over recent decades, with smokers today showing greater nicotine dependence, (Cokkinides et al, 2009; Goodwin, Keyes, & Hasin, 2009), higher incidence of psychiatric diagnosis (Annamalai, Singh, & O’Malley, 2015; CDC, 2013), more failed quit attempts (M. Chaiton et al, 2016; Hughes, 2011; Irvin, Hendricks, & Brandon, 2003), and greater resistance to available treatments (Ip et al, 2012; Irvin et al, 2003).…”