- 125 Downloads
Objective:To describe why medical patients quit smoking and the methods they use.
Design:Cross-sectional and prospective cohort design. Patient smokers were enrolled in a study of physician counseling about smoking. One year later, 2,581 of the patients were asked about quit attempts and methods used. Of those, 245 former smokers whose quitting had been biologically validated were interviewed about why and how they had quit.
Setting:Offices of internists and family practitioners in private practice and a health maintenance organization.
Subjects:Consecutive sample of ambulatory patients who smoked.
Measurements and main results:Baseline questionnaires included demographic data, smoking history, and symptoms and diagnoses related to smoking. After one year, subjects were interviewed about smoking status and methods used in attempting to quit. Cessation was confirmed by biochemical testing. Those who had quit were asked about reasons for quitting. Seventy-seven percent of successful quitters gave health-related reasons for quitting and the quitters ranked “harmful to health” as the most important reason for quitting. In a multivariate analysis, those who had a college education, who had social pressures to quit, and who had greater confidence in being able to quit were more likely to have quit smoking one year later, while those who smoked their first cigarette within 15 minutes of awakening and who had more diagnoses related to smoking were less likely to have quit smoking one year later. Participation in a treatment program and having been counseled by a physician or nurse practitioner were positively related to successful quitting, while use of filters or mouthpieces was negatively related.
Conclusions:Concerns about health are the most common reason patients give for quitting, and addiction is the most important barrier to quitting. Education, social pressure, provider advice, and formal programs, but not over-the-counter devices, appear to increase the chances that smokers will quit.
Key wordssmoking cessation counseling
Unable to display preview. Download preview PDF.
- 1.Office on Smoking and Health. Tobacco use in 1986—methods, & basic tabulations from adult use of tobacco survey. DHHS Publication No. OMM 90-2004. Bethesda, MD: National Centers for Disease Control, 1986.Google Scholar
- 2.Green DE. Psychological factors in smoking. In: Jarvick ME, Cullen JW, Gritz ER, Vogt TM, West CG (eds.). Research on smoking behavior (NIDA Research Monograph 17). DHRW Publication No. ADM 78-581. Washington, DC: U.S. Government Printing Office, 1977.Google Scholar
- 4.Barnes GE, Vulcano BA, Greaves L. Characteristics affecting successful outcome in the cessation of smoking. Int J Addict. 1985;9:1429–34.Google Scholar
- 7.Cummings SR, Coates T, Richard RJ, et al. Training physicians in counseling about smoking cessation: a randomized trial of the “Quit for Life” program. Ann Intern Med. 1989;110:641–7.Google Scholar
- 9.Jacob P, Wilson M, Benowitz NL. Improved gas chromatographic methods for the determination of nicotine and cotinine in biologic fluids. J Chromatogr. 1981;221:61–70.Google Scholar
- 12.SAS Institute, Inc. SAS user’s guide: statistics, version 5 edition. Cary, NC: SAS Institute, Inc., 1985.Google Scholar
- 18.Hall SM, Muñoz RF, Reus VI. Depression, dysphoria and smoking cessation. In: Scientific meetings of the Committee on the Problems of Drug Dependence. Richmond, VA: National Institute on Drug Abuse, 1992 (In press).Google Scholar
- 26.Cohen S, Lichenstein E, Mermelstein RJ, McIntyre-Kingsolver KO, Baer JS, Kamarck TW. Social support interventions for smoking cessation. In: Gottlieb BH (ed.). Marshalling social support: formats, processes and effects. New York: Sage, 1988:211–40.Google Scholar