Predictors and reasons for starting and sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers

Abstract

Introduction and Aims The national prevalence of daily smoking among the Aboriginal and Torres Strait Islander population is 39% but falling. We explore factors associated with starting and sustaining quit attempts, and reasons given for quitting. Design and Methods We analysed data from the nationally representative quota sample of 759 Aboriginal and Torres Strait Islander adults who reported smoking at least weekly in the Talking About The Smokes baseline survey (April 2012–October 2013) who completed a follow‐up survey a year later (August 2013–August 2014). Results Having made more quit attempts, more recent quit attempts in the past, motivational attitudes, having been encouraged to quit by a health professional and having noticed tobacco advertising were associated with making a quit attempt between surveys. Having made longer quit attempts in the past, non‐daily smoking and quit self‐efficacy were associated with sustaining abstinence. But neither having made more quit attempts in the past nor dependence was associated with sustaining abstinence. Health concerns, price and setting an example to children were the most common reasons given by smokers and ex‐smokers for quitting. Discussion and Conclusions Different factors predict making and sustaining quit attempts among Aboriginal and Torres Strait Islander smokers. We need to rethink current messages that just encourage Aboriginal and Torres Strait Islander smokers to keep making quit attempts by increasing motivation to quit, as motivation and making more quit attempts does not predict eventual success. We could focus more on increasing smokers’ confidence that they can successfully quit.

Social networks and quitting in a national cohort of Australian Aboriginal and Torres Strait Islander smokers

“…The present paper extends those analyses by testing whether: (i) smoking in participants’ social network was associated with smoking status at baseline; (ii) social disadvantage was associated with smoking in participants’ social network and perceived social support for quitting at baseline; (iii) baseline (and changes in) smoking in participants’ social network and perceived social support for quitting were associated with making a quit attempt and sustaining abstinence (for ≥1 month if made an attempt) between baseline and follow‐up; and (iv) baseline smoking in participants’ social network was associated with baseline and follow‐up social norms about smoking (which has been suggested as a mechanism for social networks to reduce smoking) and smoking quit self‐efficacy (which has been shown to be associated with sustaining abstinence in this and other populations) .…”

“…But neither the number of friends and family who smoke nor whether the closest of these smokes (or has recently quit) was significantly associated with wanting to quit . At follow‐up a year later, the majority of smokers and ex‐smokers agreed that the disapproval by their close friends and family of the participant's smoking was a reason for quitting or staying quit .…”

Do stress, life satisfaction, depression and alcohol use predict quitting among Aboriginal and Torres Strait Islander smokers?

“…At baseline, we assessed two attitudes that are known to predict making a quit attempt in this population, which are worry and regret about smoking. We asked: “How worried are you that smoking will damage your health in the future?” (very worried vs. not at all, a little or moderately worried) and “If you had to do it over again, you would not have started smoking” (agree vs. disagree, neither agree nor disagree or don't know) 33 . We also asked “How easy or hard would it be for you to quit smoking/ stay off the smokes?” (very hard vs. very easy, somewhat easy, neither easy or hard, a little bit hard or don't know); i.e.…”

“…We also asked “How easy or hard would it be for you to quit smoking/ stay off the smokes?” (very hard vs. very easy, somewhat easy, neither easy or hard, a little bit hard or don't know); i.e. quit self‐efficacy, which predicts sustaining abstinence ≥1 month 33 …”

“…We derived a variable to control for variation in the number of months between the baseline and follow‐up surveys (with four categories of similar sample size: <11 months, ≥11 months and <12 months, ≥12 months and <14 months, ≥14 months). We used covariates known to predict making quit attempts (gender, smoking‐induced deprivation [whether in the past six months, money spent on cigarettes left not enough money for food or other household essentials], having made a quit attempt in the past year, having noticed anti‐tobacco advertising in the past six months and having been advised to quit by a health professional in the past year) and sustaining abstinence ≥1 month (smoking‐induced deprivation, having previously sustained attempts ≥1 month and non‐daily smoking) 33 …”