Natural History of - PowerPoint Presentation

Slide1

Natural History of Attempts to Change Smoking in Self-Quitters

John R Hughes, Laura J Solomon,

James

Fingar, Shelly Naud,

John

E Helzer

University of Vermont Slide2

Purpose of StudyTo describe the patterns of smoking change (i.e. quit attempts, reduction, lapses, and relapses) among self-quitters

To determine if cognitions or environmental cues most determine onset of a quit attempt Slide3

RationaleMany longitudinal studies examine what happens after a quit attempt, none have examined what happens before a quit attempt

Most descriptions of smoking cessation are based on the small percent of smokers willing to attend a research studySlide4

Methods152 smokers who planned to quit in the next 3 months

Recruited from across US

No treatment provided

Conducted by phone, mail and internet Slide5

Methods Called nightly into IVR for 3 month

Reported smoking (cigs/day and quit attempt)

Reported intentions daily (“Do you plan to smoke tomorrow?”)Slide6

Sample Characteristics Mean age = 4567% women

23% minorities

Mean cigs/day = 19

Mean FTND = 5.3

More like self-quitters than treatment seekers Slide7

Examples of changes in cessation, reduction, and intentionSlide8

Major results52% had multiple (>

3) episodes of intention to quit

60% of smokers had multiple episodes of abstinence and reduction

Among the days of intended abstinence, only 85% resulted in a quit attempt

65% of quit attempts began in the morning Slide9

Major Results 72% of quit attempts were not preceded by intention to quit

Unintended quit attempts were less, not more, successful than intended quit attempts (< 1 day

vs

25 days)

Reduction was as common an outcome as abstinence Slide10

Major results Making a failed quit attempt early in the study predicted a greater, not smaller, probability of a later quit attempt

On the longest quit attempt of each smoker, 48% lasted less than a day

18% of quit attempts resulted in abstinence at the end of the study

When a lapse occurred, 60% of the time smokers immediately returned to daily smoking Slide11

Major ResultsWhen asked about quitting at the end of the study, 17% of smokers stated they did not make a quit attempt but during the study reported a quit attempt. Most forgetting of quit attempts was for attempts that did not last for a day Slide12

Limitations Asking daily about quitting may have influenced outcomes

The sample was of those planning to quit in next 3 months (about 30% of US smokers)Slide13

Conclusions Smoking cessation attempts are much more complex than most assume

Smokers had multiple and often rapid attempts to stop or reduce during the 3 months

Most intentions do not result in quit attemptsSlide14

Conclusions Most quit attempts were unplanned

Unplanned quit attempts were less successful

Reduction was as common as cessation

Failed quit attempts do not produce less motivation to quit

Half of quit attempts failed the first day

Smokers often forget about short quit attempts Slide15

Implications A failed quit or reduction attempt is a marker for more attempts to change in the near future

Failure to quit does not result in less interest in quitting in the near future

We need to encourage smokers to return after failure, including proactive contacts after failure Slide16

Studies with the Highest Long-Term (

>

1 Yr) Quit Rates Are Those That Included

Recontacting

Failures

MRFIT, 81 41%

Lung Health, 01 35%

Hall, 04 52% Slide17

Association for the Treatment of Tobacco Use and Dependence

An organization of providers dedicated to the promotion of and increased access to evidence-based tobacco treatment for the tobacco user.

www.attud.org