The association between smokers’ self-reported health problems and quitting: Findings from the ITC Four Country Smoking and Vaping Wave 1 Survey

Abstract

INTRODUCTION This study aimed to systematically examine whether having health conditions or concerns related to smoking are associated with quitting activities among smokers across four western countries. METHODS Data came from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey conducted in Australia, Canada, England and US. We asked smokers and recent quitters (n=11838) whether they had a medical diagnosis for heart disease, cancer, chronic lung disease, depression, anxiety, alcohol problems, diabetes, severe obesity and chronic pain (nine conditions), and whether they believed smoking had harmed/would harm their health, along with questions on quitting activities. RESULTS General concerns about smoking harming health and all specific health conditions, except for alcohol problems, were positively associated with quit attempts, but the relationships between health conditions and other quitting measures (being abstinent, planning to quit, use of quitting medications) were less consistent. Positive associations between conditions and use of quitting medications were only significant for depression, anxiety and chronic pain (adjusted odds ratios ranged from 1.4 to 1.5). There was a general tendency to report lower self-efficacy for quitting among those with the health conditions. CONCLUSIONS While those with smoking related conditions are somewhat more aware of the links to their smoking, and are largely taking more action, the extent of this is lower than one might reasonably expect. Enhanced awareness campaigns are needed and health professionals need to do more to use health conditions to motivate quit attempts and to ensure they are made with the most effective forms of help.

Are health conditions and concerns about health effects of smoking predictive of quitting? Findings from the ITC 4CV Survey (2016–2018)

“…The results show that believing smoking had harmed/would harm their health and reported specific health conditions, except for alcohol problems, were positively associated with quit attempts. However, associations between health conditions and planning to quit in the future and use of quitting medications were less consistent 9 . These cross-sectional findings need to be tested longitudinally to see if the same associations apply.…”

“…Research shows that quitting rates remain low among many patients with COPD and other chronic conditions, despite being aware of the specific link between their condition and smoking 5 . An earlier cross-sectional study 9 showed that levels of use of the strongest possible cessation help was disappointingly low. Coupled with our new findings, it suggests a pressing need to find better ways to support smokers with smoking-related conditions to use the strongest possible tools to maximize their capacity to quit successfully.…”

“…Studies have also found that cessation rates are lower for smokers diagnosed with mental health conditions (e.g. depression, anxiety) than the general population of smokers 7 , although they may have made more quit attempts 8,9 . Identified mechanisms that underline persistent smoking among smokers with depression include low positive affect, high negative affect, and cognitive impairment 7 .…”

“…At the population level, there are very limited studies that have examined the associations between multiple health conditions and quitting. An earlier cross-sectional study 9 examined whether having health conditions (including nine physical and mental health conditions) and concerns about the harmful effects of smoking were associated (individually and combined) with making quit attempts and remaining abstinent. The results show that believing smoking had harmed/would harm their health and reported specific health conditions, except for alcohol problems, were positively associated with quit attempts.…”

The Effects of Text Message and Infographic on Reducing the Number Cigarettes Consumption: A Randomized Controlled Trial

“…This study was based on a community setting where participants were healthy. However, evidence reported successful smoking cessation intervention in unhealthy volunteers (Samaan et al, 2012;Pires-Yfantouda et al, 2013;Guilleminault et al, 2018) and observational study shows the association between unhealthy status and quit smoking (Li et al, 2019). We observed the significance of the number of cigarettes smoked per day.…”