Natural course of smoking cessation and predictors of quitting in young adulthood

Abstract

Abstract Background Young adulthood is characterized by major life changes that can promote or inhibit cigarette smoking. Gaps in knowledge on the natural course of, and factors associated with quitting impede progress in designing effective cessation interventions targeting this age group. We describe the natural course of cessation among students who smoked cigarettes in their last year of high school and we identify predictors of quit status at age 30. Methods Data were drawn from an ongoing investigation of 1294 grade 7 students age 12-13 recruited in 1999-2000 in 10 high schools in Montreal, Canada. Using data collected at ages 17, 20, 24 and 30, grade 11 cigarette smokers were categorized as quitters or current smokers at age 30. Results Among 245 grade 11 smokers, 48% (55% of females; 33% of males) had quit by age 30. Among 106 quitters with complete data, 27% were consistently abstinent during young adulthood, 33% were intermittently abstinent and 40% were abstinent at age 30 only. Smokers at age 30 had higher impulsivity scores in grade 11 than quitters and were more likely to report nicotine dependence symptoms and have family members who smoked. Quitters rated self-control and social influences as more important reasons to quit than smokers. Although 85% of smokers wanted to quit, only 45% had used a cessation strategy in the past year. Conclusions Adolescents likely to be smokers at age 30 are identifiable in high school. Cessation assistance must be offered early in high school to provide adolescents with opportunities to quit before smoking becomes intractable. Key messages Among grade 11 smokers, 27% were consistently abstinent in young adulthood, 33% were intermittently abstinent, and 40% were abstinent at age 30 only. Cessation programs are needed early in high school to prevent intractable smoking.