Characteristics of smokers who enroll and quit in self-help programs

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Abstract
Smokers who volunteer for self-help smoking cessation programs may be poor candidates for such minimal treatments. Through general publicity, we recruited 2021 Health Maintenance Organization enrollees for a self-help quit smoking intervention trial. Volunteers were mostly heavy smokers (mean 26 cigarettes/day) with a long-established habit (mean 27 years), strong nicotine dependency (77% smoked their first cigarette of the day within 30 min of awakening) and extensive quitting histories [median of three serious quit attempts and many who had already tried group or individual quitting programs (35%), nicotine gum (25%) or quitting guides (43%)]. Self-reported, cotinine-validated, 7-day abstinence rates at 16 months follow-up were significantly higher for smokers with lower nicotine dependency, lower cigarette brand nicotine content, no previous use of nicotine gum, no smoking-related chronic medical conditions, longer duration of previous quit, a more health promotive lifestyle with respect to alcohol and diet, and a supportive partner, and in subjects randomized to a minimal contact telephone counseling intervention. The telephone counseling advantage was significantly greater for smokers who at baseline were less nicotine dependent, had not used an intensive cessation treatment, smoked higher nicotine cigarettes and had less social support. Diffusion strategies to reach smokers with lower readiness to volunteer and triage mechanisms to screen out smokers who are poor candidates for self-help treatments are needed if these treatments are to achieve their potential.

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