Tobacco cessation program quit rates

Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U. Preventive Services Task Force recommendation statement. Ann Intern Med ;— Centers for Disease Control and Prevention. State Medicaid coverage for tobacco cessation treatments and barriers to accessing treatments—United States, — Medicare and You. Tobacco Prescription Drug Coverage website. Tobacco Cessation Program website. A longitudinal study of Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in hospitalizations for cardiovascular disease.

PLoS Med. The return on investment of a Medicaid tobacco cessation program in Massachusetts. What's this. Related CDC Sites.

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You will be subject to the destination website's privacy policy when you follow the link. CDC is not responsible for Section compliance accessibility on other federal or private website. Cancel Continue. With respect to environmental factors, people who had a smoke-free home were 10 times as likely to be successful quitters as those who lived in a home where smoking took place. For workers, having a no-smoking policy at work doubled the likelihood of successful cessation.

We used a large population-based sample of US adults to examine multiple factors that might be associated with successful smoking cessation. By contrast, most earlier studies have examined quit attempts among population subgroups such as pregnant women, working populations, or specific communities , 18 , 19 , 21 , 53 — 55 the impact of individual interventions, 28 , 36 , 42 or the influence of specific population or environmental characteristics.

We found that having a smoke-free home, having a no-smoking policy at work, being aged 35 or older, having a college education or more, being married or living with a partner, being a non-Hispanic White, having only 1 lifetime attempt to quit, and not switching to low-tar or low-nicotine products for health reasons were significantly associated with cessation.

The significant influence of 2 environmental factors smoke-free home and no-smoking policy at work was found in several earlier studies.

For example, using US population-based survey data, Farkas et al. In a multivariate study that examined predictors of cessation, Hymowitz et al. Finally, Derby et al. Similar to our findings, having higher education, 21 , 53 , 55 being married, 18 and older age 19 have all been identified by others as determinants of successful cessation. Data on the relationship of gender to cessation have been contradictory, with some studies finding men more likely to be successful quitters 19 , 55 , 57 and others 53 , 56 , 58 finding no relationship with gender.

Regarding behavioral characteristics, our finding of a negative correlation between multiple attempts to quit and successful cessation accords well with the findings of Borland et al. On the other hand, Hymowitz et al. Although Hyland et al. Although a few previous studies 19 , 52 , 54 have identified older age of initiation as a significant predictor of successful cessation, we found no relationship between age at which a person started smoking and successful cessation.

Several limitations to the present study need to be noted. Third, we did not have information on the number of cigarettes smoked by former smokers. Past studies 19 , 53 , 55 , 58 , 62 have found that heavy smokers are less likely than light smokers to succeed in quitting. We also could not examine the number and duration of quitting methods used because the information was unavailable in the data set.

The association between the use of quitting methods and cessation outcome may vary depending on the number and duration of methods used. Although our study did not identify a significant impact of nicotine replacement therapy on cessation outcome, clinical trials have found that the use of such therapy and nonnicotine medications such as sustained-release Bupropion double long-term abstinence rates.

This study may have several important implications for policy. The significant impact of a no-smoking policy in the work-place, also shown by several past studies to be related to cessation, indicates that its implementation will help those who intend to quit to succeed. Currently, 7 US states have comprehensive smoke-free policies for most enclosed workplaces and public settings, including bars and restaurants.

The present study suggests that cessation programs need to take a holistic approach. We thank Ralph Caraballo and Anne Malacher for their thoughtful comments on the article. The views expressed in this article are that of the authors and do not necessarily reflect the views of the Centers for Disease Control and Prevention. Contributors C. Lee originated the study, conducted the data analysis, and led the writing. Kahende assisted with the interpretation of the findings and the writing and reviewed drafts of the article.

National Center for Biotechnology Information , U. Am J Public Health. Find articles by Chung-won Lee. Find articles by Jennifer Kahende. Author information Article notes Copyright and License information Disclaimer.

Accepted July 15, This article has been cited by other articles in PMC. Abstract Objectives. Measures Dependent variable. Open in a separate window. Independent variables.

Statistical Analysis Analyses were performed to identify which demographic, behavioral, and environmental characteristics and which quitting methods were associated with successful cessation.

Acknowledgments We thank Ralph Caraballo and Anne Malacher for their thoughtful comments on the article. Notes Peer Reviewed Note. References 1. Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, — Cigarette smoking-attributable morbidity—United States, PHS publication The Health Benefits of Smoking Cessation. Risk indicators for periodontal disease in a racially diverse urban population. Tobacco use: A modifiable risk factor for dental disease among the elderly.

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Int J Oral Maxillofac Implants. Tobacco control activities in U. Diagnostic and Statistical Manual of Mental Disorders. Mallin R. Smoking cessation: Integration of behavioral and drug therapies. Am Fam Physician. Prochazka AV. New developments in smoking cessation. Treating tobacco use and dependence. Washington DC: U. These last 2 models also included as a covariate use of a pharmaceutical aid, because this information was available for those seriously trying to quit.

To avoid recall bias in the length of quit attempts, we assessed the odds of abstinence from smoking at the time of the survey in the latter 2 models, as was done in previous work.

We computed all estimates using the published TUS-CPS survey weights, which account for selection probabilities from the sampling design and adjust for survey nonresponse. With the expected exception that fewer to year-olds had completed high school or attended college, there were no differences in education across age groups. Among the 3 oldest age groups, there was no difference in the proportion of smokers who had started smoking before age 15 years; however, this proportion was higher in the youngest age group, as would be expected assuming some in this group were beginning to smoke.

The proportion of smokers working in a smoke-free workplace did not vary across the 3 younger age groups, but it was lower in the oldest age group, as expected, because fewer people in this group were in the workforce. The proportion of recent dependent smokers who had quit for at least 6 months in the past year was 8. Past-year prevalence of seriously attempting to quit smoking, quitting for at least 1 day, and quitting for at least 6 months, by age: Tobacco Use Supplement to the US Current Population Survey, Odds are from multivariate logistic regression, with adjustment for all listed variables.

Model A presents the odds of having seriously tried to quit in the past year, among recent dependent smokers. Model B presents the odds of abstinence for 1 day or more at time of survey, among recent dependent smokers who reported having seriously tried to quit. Model C presents the odds of abstinence for 6 months or more at time of survey, among recent dependent smokers who reported seriously trying to quit. After adjustment for these covariates, differences between age groups in the estimated odds of quitting were not statistically significant.

The use of any pharmaceutical aid during the most recent quit attempt was Use of any pharmaceutical aid during the most recent quit attempt increased significantly with each higher age group, from 9.

In the oldest age group, only Among to year-olds, the proportion who quit for 6 months or more was significantly higher among those who used an aid. Data from the TUS-CPS shows that among smokers with at least a 6-month history of daily smoking, those aged 18 to 24 years successfully quit smoking i. This new finding was expected from cessation trends during the s. In this study, young adults had a much higher prevalence of smoke-free homes, as has previously been reported, 16 , 17 , 24 , 35 , 36 as well as lower levels of addiction, and both factors are associated with attempted cessation in the literature and in our statistical models.

However, the proportion of young adults who reported an interest in quitting was much greater than could be accounted for by these and other factors in our multivariate analysis. Indeed, the adjusted odds ratio of trying to quit was nearly twice as high for to year-olds as for to year-olds. It is possible that social norms against smoking are much stronger among these youngest adult smokers, and this may be reflected by a high level of interest in quitting.

Among those who reported seriously trying to quit, a higher proportion of the youngest adults quit for at least 6 months during the past year than did older smokers. However, this difference by age was no longer significant in our multivariate models after we adjusted for covariates. In this statistical analysis, as in previous work, the strongest independent predictor of longer-term abstinence was presence of a smoke-free home.

This suggests that among those who tried to quit, the higher success rates experienced by the youngest adults were explained by a greater prevalence of smoke-free homes, lower levels of dependence, and other favorable tobacco-related factors. This study replicates previous work on the difficulty of quitting successfully. This proportion was independent of age despite large differences between age groups in dependence levels.

In our multivariate models, use of a pharmaceutical aid increased the probability of abstinence from smoking for at least 1 day, and use of such assistance was over twice as common among older smokers than among to year-olds. Thus, greater use of pharmaceutical aids appears to have allowed older smokers to achieve rates of 1-day abstinence comparable to those of to year-old smokers. Raising this low success rate has been a goal of tobacco control for many years, and there was early promise that pharmaceutical aids would lead to such an increase.

Some expected associations with cessation were not apparent in this study. Educational level was not a prognostic factor in our models, which may reflect sampling bias in educational attainment in the youngest age group, because it is likely that some year-olds who would later go on to college had not completed high school at the time of the survey. Many studies have reported that African American smokers have more difficulty quitting than do non-Hispanic White smokers.

In this study, African Americans were less likely to successfully quit; however, they were more likely to report trying to quit. This interest in quitting could result from stronger antismoking norms in the African American community.

That such norms exist has been postulated as one reason for the much lower rate of smoking initiation among African Americans in recent years. Smokers may forget short quit attempts. Quit attempts in which a pharmaceutical aid was used may be more memorable than other quit attempts, which would lead to an overestimate of the importance of pharmaceutical aids in achieving short-term abstinence in our statistical models.

Further, use of pharmaceutical aids may be much more prevalent among smokers who have low self-efficacy for quitting, and this would lead to an underestimate of the importance of pharmaceutical products as an aid to successful quitting.