Department of Behavioural Science and Health, University College London, London, UK.
Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.
Nicotine Tob Res. 2020 Aug 24;22(9):1460-1467. doi: 10.1093/ntr/ntz115.
Almost half of smoking quit attempts are "spontaneous" (initiated as soon as the decision to quit has been made) and are associated with increased success rates. This study aimed to assess to what extent other factors may account for this association.
Data were used from respondents to a survey representative of the adult population in England from 2006 to 2016. We included 2018 respondents who were current smokers at baseline and had attempted to quit between baseline and 6-month follow-up. Logistic regression models assessed the association between quit success and spontaneous quit attempts while adjusting for smoking, sociodemographic, and quit attempt characteristics.
Spontaneous quit attempts were associated with greater odds of quit success (OR = 1.31, 95% CI = 1.07 to 1.60) but the association was not significant in the fully adjusted model (ORadj = 1.19, 95% CI = 0.95 to 1.49). In this adjusted model, those who attempted to quit without cutting down first (ORadj = 3.08, 95% CI = 2.46 to 3.88) and were male (ORadj = 1.44, 95% CI = 1.16 to 1.80) had greater odds of success; although a greater number of attempts in the past 6 months, stronger urges to smoke (strong vs. none), higher daily cigarette consumption, and lower social grade (E vs. AB) were associated with lower odds of success (ORadj range = 0.32-0.98, p < .030). Quit attempts made without cutting down first were correlated with spontaneous quit attempts (r = .150, p < .001) and appeared to account for the diminished association between spontaneous quitting and success (ORadj = 1.18, 95% CI = 0.96 to 1.46).
The increased success rate of spontaneous quit attempts appears to be because spontaneous quit attempts are more likely to be made without cutting down first.
The apparent benefit of spontaneous over planned quit attempts may be attributable to the former being more likely to involve quitting without cutting down first (ie, abrupt cessation) than cutting down first (ie, gradual cessation) and so this may be a more useful target for advice to improve the chances of successful quitting.
近一半的戒烟尝试是“自发的”（一旦做出戒烟决定就立即开始），并且与更高的成功率相关。本研究旨在评估其他因素在多大程度上可以解释这种关联。
本研究使用了 2006 年至 2016 年期间英格兰成年人代表性调查的受访者数据。我们纳入了 2018 年基线时为当前吸烟者且在基线至 6 个月随访期间尝试戒烟的受访者。逻辑回归模型评估了戒烟成功率与自发戒烟尝试之间的关联，同时调整了吸烟、社会人口统计学和戒烟尝试特征。
自发戒烟尝试与更高的戒烟成功率相关（OR=1.31，95%CI=1.07 至 1.60），但在完全调整的模型中无显著关联（ORadj=1.19，95%CI=0.95 至 1.49）。在这个调整后的模型中，那些不先减少吸烟量就尝试戒烟的人（ORadj=3.08，95%CI=2.46 至 3.88）和男性（ORadj=1.44，95%CI=1.16 至 1.80）成功的可能性更高；然而，过去 6 个月内尝试戒烟的次数更多、更强的吸烟冲动（强烈与无）、更高的每日香烟消耗量和较低的社会阶层（E 级与 AB 级）与较低的成功可能性相关（ORadj 范围=0.32 至 0.98，p<.030）。不先减少吸烟量就尝试戒烟与自发戒烟尝试呈正相关（r=0.150，p<.001），并且似乎解释了自发戒烟与成功之间关联减弱的原因（ORadj=1.18，95%CI=0.96 至 1.46）。
自发戒烟尝试的成功率增加似乎是因为自发戒烟尝试更有可能不先减少吸烟量就进行。
自发戒烟尝试比计划戒烟尝试成功率更高的原因可能是前者更有可能直接戒烟（即突然停止），而不是先减少吸烟量（即逐渐停止），因此这可能是提高成功戒烟机会的更有用的建议目标。
