Gender Differences among Hardcore Smokers: An Analysis of the Tobacco Use Supplement of the Current Population Survey

Abstract

Background: Despite significant declines in smoking rates in the United States, a substantial percentage of adults continue to smoke. Improved understanding of current smokers and their contact with sources of cessation support future tobacco control efforts. Recent evidence suggests that hardcore smokers, established smokers without a history of quit attempts, have less contact with cessation support. Although gender is among the major factors that influence smoking cessation, no research is available on gender differences among hardcore smokers. Methods: Demographic, environmental, and smoking-related characteristics of female hardcore smokers and male hardcore smokers and other female smokers were examined. Data from 17,777smokers from the 2003 Current Population Survey Tobacco Use Supplement were analyzed. Results: Compared with female hardcore smokers, male hardcore smokers were more likely to have contact with smoking restrictions at work (OR ϭ 1.69) and at home (OR ϭ 1.45). Compared with female hardcore smokers, female other smokers were more likely to have seen a healthcare provider during the past year who advised them to quit smoking (OR ϭ 1.39) and more likely to have smoking restrictions at work (OR ϭ 1.25) and at home (OR ϭ 2.32)). Measures of nicotine dependence suggested that female hardcore smokers were less dependent than male hardcore smokers but more dependent than other female smokers. Conclusions: The sociodemographic and healthcare access variations in tobacco use identified in our analyses have significant public health implications and underscore the vital need for clinical and scientific advances in tobacco use prevention and control efforts.

Effectiveness of smoking reduction intervention for hardcore smokers

“…As no universal definition of hardcore smoker is available, the following criteria which have been commonly used in previous studies were used to define hardcore smokers: (1) aged 26 years or above; (2) smoked daily for 5 or more years; (3) smoked 15 cigarettes or more a day; (4) had no intention to quit; and (5) had never attempted to quit [ 8 , 10 , 20 - 22 ]. The threshold for age and the years of smoking were included because youth smokers and smokers with short smoking history have not reached to a stable level of average daily assumption [ 3 ].…”

Prevalence of hardcore smoking in the Netherlands between 2001 and 2012: a test of the hardening hypothesis

“…We categorized respondents as non-smoker, non-hardcore smoker or hardcore smoker. We determined smoking status by asking: ‘Do you ever smoke or do you not smoke at all?’ Smokers were ‘hardcore’ if they a) smoked every day [ 11 , 14 ], b) smoked on average 15 cigarettes or more per day [ 6 , 10 ], c) had not attempted to quit in the past 12 months [ 15 , 16 ], and d) did not intend to quit within 6 months [ 8 , 9 ]. All other smokers, who did not meet the criteria for being a hardcore smoker, were considered non-hardcore smokers.…”

“…Compared to other smokers, such hardcore smokers are more likely to be male, to live alone and to have a lower socioeconomic status [ 6 ]. There are different definitions of hardcore smokers [ 7 ], but they generally share certain characteristics: smoking consumption, quitting history and intention to quit [ 6 , 8 – 17 ].…”

“…On consumption, most studies agree that smokers can be classified as hardcore smokers if they smoke daily [ 6 , 8 – 16 ] and have a minimum consumption of 15 cigarettes per day [ 6 , 8 – 10 , 12 , 15 , 16 ]. On quitting history and intention to quit, many of the studies on hardcore smoking only include smokers who have been smoking in the past 12 months [ 6 , 9 , 11 – 16 ] and who have no intention to quit within the next six months [ 8 – 11 , 15 , 16 ]. Finally, most studies aim to included smokers who have reached a stable smoking consumption only.…”

“…Finally, most studies aim to included smokers who have reached a stable smoking consumption only. They therefore limit the group of hardcore smokers to those older than 25 years [ 6 , 8 – 12 , 15 , 16 ].…”