Predicting Smoking Cessation

May 4th, 2008 | By quitsmoking-review | Category: Research



Many studies have been done in an attempt to find the predictors of smoking cessation. Does age matter? What about gender, or education level or even home ownership? This article will only focus on the behavioral and sociodemographical factors involved in predicting smoking cessations and will not review pharmacological approaches to a successful cessation attempt.

  • Smoking during the first 2 weeks of an attempt predicts lower success. In two separate trials, those who remained abstinent during the first 2 weeks while on a patch had an average quit rate or 44%. While for those without patches, their average quit rates were 37%. (Kenford 1995)
  • Another study of 2000 smokers found those with less than 5 previous cessation attempts as well as perceived helpful support from friends had a greater likelihood of successful smoking cessation. (Kowalski 1997)
  • The CEASE trial of 3575 smokers showed that being a homeowner and male gender increased likelihood of tobacco cessation at 6 months.
  • The Framingham study predicted that women who smoked less that 1 half-pack per day and males who were diagnosed with Chronic Airway Disease within the past 2 years were more likely to maintain abstinence 1 year after the cessation attempt. The table below summarizes results from 5 studies showing the effects of different factors on smoking cessation.
Studies Predicting success Predicting failure Non contributing
Lennox and Taylor Fewer previous attempts to stop
Increased preceived helpful support from friends
Increased motivation
Heavy smoker >1pack/day
Withdrawal symptoms
Cravings
Smoke exposure (i.e. in restaurants)
smoker 1/2-1 pack/day
Age, Sex, Type of support (non-smoker or smoker friends)
health issues
Reasons
Westman et al Quit date abstinance
Low tobacco dependence
   
Kenford et al. Abstinence of smoking at 2 weeks Any use of tobacco within 2 weeks of attempt Number of cigarettes/day
Number of years smoked
Freund et al. Men increased age, chronic airway disease diagnosed in past 2 years
Women low numbers of cigarettes, higher education level
Both married, hospitalized in past 2 years
  Diagnosis of cancer, Decreased FEV1, Baseline alcohol use, Gender, baseline weight
Monso et al Low number of cigarettes, older age, male, homeowners Chronic airway disease, Lung disease Chronic disease, Depression

What about counseling?

  • Counseling frequency and duration impact smoking cessation. In a review of 23 studies, the odds ratio for cessation was 1.3 for minimal counseling (<3 minutes), 1.6 for low-intensity counseling (3 to 10 minutes), and 2.3 for high-intensity counseling (>10 minutes). The likelihood of stopping smoking also increased as total contact time for all counseling sessions increased, peaking at 90 minutes (odds ratio 3.0) (Fiore 2000)
  • A meta-analysis of 62 studies found no impact of relaxation/breathing techniques, contingency contracting, weight/diet counseling, cigarette fading, or negative affect counseling on smoking cessation. (Fiore 2000) Successful counseling techniques included providing smokers with problem solving skills, providing intra-treatment social support, helping smokers obtain extra-treatment social support, aversive smoking techniques and the best was the use of rapid smoking (odds ratio 2.0)

Conclusions:
Just taking a look at the different studies, the important factors that will help cease smoking are: support from any friends, increased motivation, being married or having a supportive partner, avoiding smoking environments, minimalize cravings and withdrawal symptoms (using NRT) and having more than 8 counseling sessions lasting 90 minutes each; focusing on aversive smoking techniques, increasing social support and learning rapid smoking techniques


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