Abstract
Objective
Despite the widespread awareness of the harms of smoking, millions continue to smoke around the world partly due to the difficulty it takes to quit smoking. Identifying the factors associated with making quit attempts is an essential pillar to reach successful quitting. The purpose of this study is to assess the factors associated with the past quit attempts and their past length of abstinence in a Lebanese sample of cigarette smokers.
Methods
This study was conducted between March 2014 and March 2015, involving 382 patients randomly chosen from 5 outpatient clinics in 5 hospitals in Lebanon. A standardized questionnaire was completed including socio-demographic characteristics, smoking behavior, chronic respiratory symptoms, Fagerstrom scale, Mondor scale, packaging perception, quitting behavior and readiness to quit ladder. Results: Smokers who have chronic allergies (ORa = 2.45, p = 0.03), those who have ever stopped smoking for at least one month due to the warnings implemented on the packages (ORa = 4.6, p < 0.0001) and smokers with an intention to quit in 2 months (ORa = 2.49, p < 0.0001) had significantly more past quit attempts.
Results
Furthermore, longer quit attempts duration (more than 1 month) were significantly associated with low-nicotine dependent smokers (ORa = 0.56, p = 0.02), higher-motivated smokers (ORa = 1.85, p = 0.01), people with chronic allergies (ORa = 2.07, p = 0.02), smokers who have ever stopped smoking for at least one month due to the warnings (ORa = 3.72, p < 0.0001) and those with an intention to quit in 2 months (ORa = 1.98, p = 0.05).
Conclusion
The promoters of smoking cessation services should consider these factors when designing comprehensive tobacco control initiatives and in service planning.
Article PDF
Avoid common mistakes on your manuscript.
References
Jha P. Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer 2009;9(9):655–64.
Health UDo, Services H. 2001. Women and smoking: A report of the surgeon general. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
Chaiton M, Diemert L, Cohen JE, Bondy SJ, Selby P, Philipneri A, Schwartz R. Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open 2016;6(6):e011045.
Richmond RL, Kehoe LA, Webster IW. Multivariate models for predicting abstention following intervention to stop smoking by general practitioners. Addiction 1993;88(8):1127–35.
Hebert JR, Kristeller J, Ockene JK, Landon J, Luippold R, Goldberg RJ, Kalan K. Patient characteristics and the effect of three physician-delivered smoking interventions. Prev Med 1992;21(5):557–73.
Senore C, Battista RN, Shapiro SH, Segnan N, Ponti A, Rosso S, Aimar D. Predictors of smoking cessation following physicians’ counseling. Prev Med 1998;27(3):412–21.
Gourlay SG, Forbes A, Marriner T, Pethica D, McNeil JJ. Prospective study of factors predicting outcome of transdermal nicotine treatment in smoking cessation. BMJ 1994;309(6958):842–6.
Farkas AJ, Gilpin EA, Distefan JM, Pierce JP. The effects of household and workplace smoking restrictions on quitting behaviours. Tob Control 1999;8(3):261–5.
Horn D. A model for the study of personal choice health change. Int J Health Educ 1976;19:88–97.
Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: Toward an integrative model of change. J Consult Clin Psychol 1983;51(3):390–5.
Prochaska JO, DiClemente CC, Velicer WF, Ginpil S, Norcross JC. Predicting change in smoking status for self-changers. Addict Behav 1985;10(4):395–406.
Prochaska JO, Velicer WF, DiClemente CC, Fava J. Measuring processes of change: applications to the cessation of smoking. J Consult Clin Psychol 1988;56(4):520–8.
DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 1991;59(2):295–304.
Layoun N, Hallit S, Waked M, Aoun Bacha Z, Godin I, Dramaix M, Salameh P. Predictors of readiness to quit stages and intention to quit cigarette smoking in 2 and 6 months in Lebanon. J Res Health Sci 2017;17(2).
Fischer PM, Richards Jr JW, Berman EJ, Krugman DM. Recall and eye tracking study of adolescents viewing tobacco advertisements. JAMA 1989;261(1):84–9.
Borland R. Tobacco health warnings and smoking-related cognitions and behaviours. Addiction 1997;92(11):1427–35.
Hammond D, Fong GT, McNeill A, Borland R, Cummings KM. Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the international tobacco control (ITC) four country survey. Tob Control 2006;15(Suppl 3). iii19–25.
Association WM. 2008. World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects: 59th wma general assembly, Seoul 2008 [article online], 2008. Available from http://www.wma.net/en/30publications/10policies/b3/index.html Accessed. 23.
Ferris BG. Epidemiology standardization project (American thoracic society). Am Rev Respir Dis 1978;118(6 Pt 2):1–120.
Waked M, Salameh P, Aoun Z. Water-pipe (Narguile) smokers in Lebanon: a pilot study. East Mediterr Health J 2009;15(2):432–42.
Waked M, Khayat G, Salameh P. Chronic obstructive pulmonary disease prevalence in Lebanon: a cross-sectional descriptive study. Clin Epidemiol 2011;3:315–23.
Hallit S, Assi TB, Hallit R, Salameh P. Allergic diseases, smoking, and environmental exposure among university students in Lebanon. J Asthma 2017:1–8.
Hallit S, Raherison C, Waked M, Salameh P. Validation of asthma control questionnaire and risk factors affecting uncontrolled asthma among the Lebanese children’s population. Respir Med 2017;122:51–7.
Hallit S, Salameh P. Exposure to toxics during pregnancy and childhood and asthma in children: A pilot stud. J Epidemiol Glob Health 2017;7(3):147–54.
Mannocci A, Colamesta V, Conti V, Cattaruzza MS, Paone G, Cafolla M, Saulle R, Bulzomi V, Antici D, Cuccurullo P, et al. Demographic characteristics, nicotine dependence, and motivation to quit as possible determinants of smoking behaviors and acceptability of shocking warnings in Italy. Biomed Res Int 2014;2014:723035.
Fagan P, Augustson E, Backinger CL, O’Connell ME, Vollinger Jr RE, Kaufman A, Gibson JT. Quit attempts and intention to quit cigarette smoking among young adults in the United States. Am J Public Health 2007;97(8):1412–20.
La Torre G, Saulle R, Nicolotti N, de Waure C, Gualano MR, Boccia S. From nicotine dependence to genetic determinants of smoking. Smoking prevention and cessation. Springer; 2013. p. 1–29.
Biener L, Abrams DB. The contemplation ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991;10(5):360–5.
Velicer WF, DiClemente CC, Prochaska JO, Brandenburg N. Decisional balance measure for assessing and predicting smoking status. J Pers Soc Psychol 1985;48(5):1279–89.
Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989;129(1):125–37.
Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med 2008;3(1):17.
Maldonado G, Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol 1993;138(11):923–36.
World Health Organization (WHO). Who report on the global tobacco epidemic, 2008. The mpower package. Geneva, Switzerland: World health organization, 2008. Available at http://www.Who.Int/tobacco/mpower/mpower_report_full_2008.Pdf. [accessed].
Who. 2009. Global adult tobacco survey (gats): Bangladesh. World health organization. Available from: http://www.Searo.Who.Int/linkfiles/regional_tobacco_surveillance_system_gatsban_fullreport2009.Pdf.
Hyland A, Borland R, Li Q, Yong HH, McNeill A, Fong GT, et al. Individual-level predictors of cessation behaviours among participants in the international tobacco control (itc) four country survey. Tob Control 2006;15(Suppl 3). iii83–94.
Ma Y, Goins KV, Pbert L, Ockene JK. Predictors of smoking cessation in pregnancy and maintenance postpartum in low-income women. Matern Child Health J 2005;9(4):393–402.
Segan CJ, Borland R, Greenwood KM. Can transtheoretical model measures predict relapse from the action stage of change among ex-smokers who quit after calling a quitline? Addict Behav 2006;31(3):414–28.
Bousquet PJ, Cropet C, Klossek JM, Allaf B, Neukirch F, Bousquet J. Effect of smoking on symptoms of allergic rhinitis. Ann Allergy Asthma Immunol 2009;103(3):195–200.
Successful smoking cessation: Learning to swim without drowning. 2010. Paper presented at: WAO International Scientific Conference.
Brewer NT, Hall MG, Noar SM, Parada H, Stein-Seroussi A, Bach LE, Hanley S, Ribisl KM. Effect of pictorial cigarette pack warnings on changes in smoking behavior: a randomized clinical trial. JAMA Intern Med 2016;176(7):905–12.
Bittencourt L, Person SD, Cruz RC, Scarinci IC. Pictorial health warnings on cigarette packs and the impact on women. Rev Saude Publica 2013;47(6):1123–9.
Leatherdale ST, Shields M. Smoking cessation: intentions, attempts and techniques. Health Rep 2009;20(3):31–9.
Tsoh JY, Tong EK, Gildengorin G, Nguyen TT, Modayil MV, Wong C, McPhee SJ. Individual and family factors associated with intention to quit among male Vietnamese American smokers: implications for intervention development. Addict Behav 2011;36(4):294–301.
Yang T, Abdullah AS, Mustafa J, Chen B, Yang X, Feng X. Factors associated with smoking cessation among chinese adults in rural China. Am J Health Behav 2009;33(2):125–34.
Fong GT, Cummings KM, Borland R, Hastings G, Hyland A, Giovino GA, et al. The conceptual framework of the international tobacco control (itc) policy evaluation project. Tob Control 2006;15(Suppl 3). Iii3–11.
Abdullah AS, Ho LM, Kwan YH, Cheung WL, McGhee SM, Chan WH. Promoting smoking cessation among the elderly: what are the predictors of intention to quit and successful quitting? J Aging Health 2006;18(4):552–64.
Kozlowski LT, Porter CQ, Orleans CT, Pope MA, Heatherton T. Predicting smoking cessation with self-reported measures of nicotine dependence: Ftq, ftnd, and hsi. Drug Alcohol Depend 1994;34(3):211–6.
Farkas AJ, Pierce JP, Zhu SH, Rosbrook B, Gilpin EA, Berry C, et al. Addiction versus stages of change models in predicting smoking cessation. Addiction 1996;91(9):1271–80. discussion 1281–1292.
Pierce JP, Farkas AJ, Gilpin EA. Beyond stages of change: the quitting continuum measures progress towards successful smoking cessation. Addiction 1998;93(2):277–86.
Gilpin EA, White MM, Farkas AJ, Pierce JP. Home smoking restrictions: which smokers have them and how they are associated with smoking behavior. Nicotine Tob Res 1999;1(2):153–62.
Borland R, Yong HH, Cummings KM, Hyland A, Anderson S, Fong GT. Determinants and consequences of smoke-free homes: Findings from the international tobacco control (itc) four country survey. Tob Control 2006;15 (Suppl 3). iii42–50.
Balmford J, Borland R. What does it mean to want to quit? Drug Alcohol Rev 2008;27(1):21–7.
Siahpush M, Borland R, Scollo M. Factors associated with smoking cessation in a national sample of Australians. Nicotine Tob Res 2003;5(4):597–602.
Borland R, Yong HH, Balmford J, Cooper J, Cummings KM, O’Connor RJ, McNeill A, Zanna MP, Fong GT. Motivational factors predict quit attempts but not maintenance of smoking cessation: findings from the international tobacco control four country project. Nicotine Tob Res 2010;12(Suppl):S4–11.
Author information
Authors and Affiliations
Corresponding author
Additional information
Peer review under responsibility of Ministry of Health, Saudi Arabia.
Rights and permissions
This is an open access article under the CC BY-NC-ND license (https://doi.org/creativecommons.org/licenses/by-nc-nd/4.0/).
About this article
Cite this article
Layoun, N., Hallit, S., Waked, M. et al. Predictors of past quit attempts and duration of abstinence among cigarette smokers. J Epidemiol Glob Health 7, 199–206 (2017). https://doi.org/10.1016/jjegh.2017.06.003
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/jjegh.2017.06.003