Predictors of cessation in a cohort of current and former smokers over 13 years

Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Nicotine & Tobacco Research (Impact Factor: 3.3). 01/2005; 6 Suppl 3(Suppl 3):S363-9. DOI: 10.1080/14622200412331320761
Source: PubMed


The present study attempted to identify predictors of smoking cessation in a cohort of cigarette smokers followed over 13 years. Data are reported on 6,603 persons who resided in one of 20 U.S. communities involved in the National Cancer Institute's Community Intervention Trial for Smoking Cessation (COMMIT) study, were current smokers in the COMMIT trial in 1988, and completed detailed tobacco use telephone surveys in 1988, 1993, and 2001. A person was classified as a former smoker if at the time of follow-up he or she reported not smoking for at least 6 months prior to the interview. Reasons and methods for quitting also were assessed in 1993 and 2001. Among smokers in 1988, 24% had stopped smoking by 1993 and 42% were not smoking by 2001. The most frequently cited reasons for quitting were health and cost reasons, while assisted methods to quit were more common in more recent years. Measures of nicotine dependence were much more strongly associated with cessation than measures of motivation. Other predictors included male gender, older age, higher income, and less frequent alcohol consumption, although the gender effect no longer existed when cessation from cigarettes as well as other tobacco products was considered as the outcome. The present study shows that nicotine dependence is a major factor predicting long-term cessation in smokers. This finding has implications for tobacco control policy and treatment approaches.

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    • "Initial sustained abstinence from tobacco during a quit attempt is a robust predictor of long-term smoking cessation (e.g., Hughes, Kreely, & Naud, 2004). As such, a large body of research has focused on identifying factors that impede early abstinence (e.g., Caponnetto & Polosa, 2008; Garvey & Bliss, 1992), as well as those that promote long-term maintenance (e.g., Agboola, McNeill, Coleman, & Bee, 2010; Hyland et al., 2004). " Milestone " research has focused on short-term cessation trials (e.g., 10 weeks in length or less) where initial abstinence is characterized by any day of non-smoking occurring within the first two weeks of a cessation attempt (Japuntich, Leventhal, Piper, Bolt, & Roberts, 2011a; Shiffman et al., 2006; Wileyto et al., 2004). "
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    ABSTRACT: Introduction: Most cigarette smoking cessation research has aimed to clarify characteristics associated with initial and sustained abstinence, with less attention paid to predictors of gaining abstinence following an initial failure. Methods: The current investigation explored pre-treatment demographic, smoking, and psychiatric characteristics related to gaining abstinence among smokers who failed to attain initial abstinence. Participants were 809 individuals enrolled in extended, 52-week, smoking cessation interventions. Of these, 287 (62.4%) failed to achieve initial abstinence. Gaining abstinence following initial abstinence failure was defined as achieving seven-day point prevalent abstinence at any post-initial abstinence assessment. Results: Those who gained abstinence (Gainers) were more likely to have a live-in partner (χ(2)(1, N=283)=3.8, p=.05, Cramér's V=.12), identify as Hispanic (χ(2)(1, N=281)=7.8, p<.01, Cramér's V=.17), evidence lower baseline expired breath carbon monoxide (F(1, 284)=5.7, p=.02, η(2)=.02), report less cigarette dependence (F(1, 278)=7.1, p<.01, η(2)=.03), and report past week cannabis use (χ(2)(1, N=284)=5.6, p=.02, Cramér's V=.14). A logistic regression model suggested that having a live-in partner (OR=5.14, 95% CI=1.09-3.02, p=.02) and identifying as Hispanic (OR=4.93, 95% CI=1.20-18.77, p=.03) increased the odds of gaining abstinence. Discussion: Having a live-in partner, Hispanic status, greater cigarette dependence, and recent cannabis use were associated with gaining abstinence. These findings provide insight into an understudied area, contributing an initial framework toward understanding gaining abstinence following initial failure.
    Addictive Behaviors 06/2015; 45. DOI:10.1016/j.addbeh.2015.01.024 · 2.76 Impact Factor
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    • "Awareness of risks is the most commonly cited motivation to quit smoking, both by current and former smokers. It is also a better predictor for longterm abstinence before quitting (Hammond et al., 2004a; Hyland et al., 2004) and adopting healthy life styles has ever been associated with decreased development of chronic morbidities related to smoking (Tayyem et al., 2013; Luqman et al., 2014). "
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    ABSTRACT: Background: Smoking tobacco is considered as a leading cause of preventable death, mostly in developing countries like India. One of the primary goals of international tobacco control is to educate smokers about the risks associated with tobacco consumption. Tobacco warning labels (TWLs) on cigarette packages are one of the most common statutory means to communicate health risks of smoking to smokers, with the hope that once educated, they will be more likely to quit the habit. Materials and methods: The present survey was conducted to assess the effectiveness of TWLs in communicating health risks of tobacco usage among 263 adult smokers working as bus drivers in Karnataka State Road Transport Corporation (KSRTC), Mangalore, India. Information was collected on demographic details, exposure and response to health warnings on tobacco products, intention to quit and nicotine dependency. Results: The majority (79.5%) of the respondents revealed negative intentions towards quitting smoking. Nearly half of the participants had a 'low' nicotine dependency (47.5%) and 98.1% of the respondents had often noticed warning labels on tobacco packages. These health warnings made 71.5% of the respondents think about quitting smoking. Respondents who noticed advertisement or pictures about dangers of smoking had better knowledge, with respect to lung cancer and impotence as a consequence of tobacco. A higher exposure to warning labels was significantly associated with lower nicotine dependency levels of smokers among the present study population. A significantly higher number of respondents who noticed advertisement or pictures about the dangers of smoking thought about the risks of smoking and were more inclined to think about quitting smoking. As exposure increased, an increase in the knowledge and response of participants was also observed. Conclusions: Exposure to tobacco warning labels helps to educate smokers about health risks of tobacco smoking. It may be possible to promote oral health among bus drivers by developing strategies to educate them about these risk factors.
    Asian Pacific journal of cancer prevention: APJCP 10/2014; 15(19):8265-70. DOI:10.7314/APJCP.2014.15.19.8265 · 2.51 Impact Factor
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    • "An estimated 75–80% of smokers who attempt to quit will relapse within six months of initiating abstinence (Zhou et al., 2009). Predictors of smoking quit attempts and relapse include demographic, psychological, biological and behavioural factors (Hyland et al., 2004; Vangeli, Stapleton , Smit, Borland, & West, 2011). Sleep disturbance is emerging as a potential neurobiological factor in smoking relapse (Brower & Perron, 2010; Peters, Fucito, Novosad, Toll, & O'Malley, 2011). "
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    ABSTRACT: Introduction: Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure. Aims: The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group. Methods: Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date. Results: There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence. Conclusions: This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.
    The Journal of Smoking Cessation 06/2014; 9(1):31-38. DOI:10.1017/jsc.2013.19
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