Recent Quitters Research Articles

Dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers.

To examine indicators of nicotine dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers and their association with sustaining a quit attempt for at least 1 month, and to make comparisons with a national sample of Australian daily smokers. The Talking About The Smokes project used a quota sampling design to recruit 1392 daily smokers from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait from April 2012 to October 2013. These were compared with 1010 daily smokers from the general Australian population surveyed by the International Tobacco Control Policy Evaluation Project from September 2011 to February 2012. Cigarettes per day (CPD), time to first cigarette, Heaviness of Smoking Index (HSI), other indicators of dependence, and whether smokers had ever sustained a quit attempt for at least 1 month. There was little difference in the mean HSI scores for Aboriginal and Torres Strait Islander and other Australian daily smokers. A higher proportion of Aboriginal and Torres Strait Islander daily smokers smoked ≤10 CPD (40% v 33.4%), but more also smoked their first cigarette within 30 minutes of waking (75% v 64.6%). Lower proportions of Aboriginal and Torres Strait Islander smokers reported having strong urges to smoke at least several times a day (51% v 60.7%) or that it would be very hard to quit (39% v 47.9%). Most Aboriginal and Torres Strait Islander smokers reported experiencing difficulties during their most recent quit attempt. All indicators of dependence, except CPD and strong urges, were positively associated with not having made a sustained quit attempt. Reported difficulties during the most recent quit attempt were more strongly associated with being unable to sustain quit attempts than were traditional measures of dependence. Aboriginal and Torres Strait Islander smokers' experiences of past attempts to quit may be more useful than conventional indicators of nicotine dependence in understanding their dependence.

The effect of exposure to media campaign messages on adult cessation

IntroductionNumerous studies have examined the relationship between antitobacco mass-media campaigns and quit attempts. However, less is known about the effect of these campaigns on relapse. This paper evaluates the effect of media exposure on smokers' quit attempts and relapse. MethodsWe used data from the Florida Adult Cohort Survey, a telephone follow-up survey of adult smokers and recent quitters, who completed the Florida Adult Tobacco Survey. For this study, 1823 unique smokers and recent quitters from baseline first observed between July 2008 and October 2012 were surveyed through up to seven follow-up interviews between October 2009 and October 2013. Media exposure during this period primarily represents exposure to Florida's Tobacco Free Florida (TFF) campaign, although it also includes exposure to the Centers for Disease Control and Prevention's Tips From Former Smokers media campaign in 2012–2013. A multiple-spell discrete-time survival model was estimated using logistic regression. Each spell represents a quit attempt or relapse event. ResultsThe odds of the first observed quit attempt are higher at higher levels of target rating points (TRPs) (aOR=1.02, p=0.023). The odds ratio for relapse and second quit and second relapse was not statistically significant. ConclusionsThe results suggest that exposure to media campaign messages in Florida has led to increases in quit attempts. Although the estimates were not statistically significant for relapse or the second spell of quit attempts or relapse, the results suggest that media messages might also influence subsequent quit attempts or relapses after an initial quit attempt.

Quitting activity and tobacco brand switching: findings from the ITC‐4 Country Survey

ObjectiveAmong Australian smokers, to examine associations between cigarette brand switching, quitting activity and possible causal directions by lagging the relationships in different directions. MethodsCurrent smokers from nine waves (2002 to early 2012) of the ITC‐4 Country Survey Australian dataset were surveyed. Measures were brand switching, both brand family and product type (roll‐your‐own versus factory‐made cigarettes) reported in adjacent waves, interest in quitting, recent quit attempts, and one month sustained abstinence. ResultsSwitching at one interval was unrelated to concurrent quit interest. Quit interest predicted switching at the following interval, but the effect disappeared once subsequent quit attempts were controlled for. Recent quit attempts more strongly predicted switching at concurrent (OR 1.34, 95%CI=1.18–1.52, p<0.001) and subsequent intervals (OR 1.31, 95%CI=1.12–1.53, p=0.001) than switching predicted quit attempts, with greater asymmetry when both types of switching were combined. One month sustained abstinence and switching were unrelated in the same interval; however, after controlling for concurrent switching and excluding type switchers, sustained abstinence predicted lower chance of switching at the following interval (OR=0.66, 95%CI=0.47–0.93, p=0.016). ConclusionsThe asymmetry suggests brand switching does not affect subsequent quitting. ImplicationsBrand switching does not appear to interfere with quitting.

The Lingering Effects of Tobacco Control Advertising

In commercial market research, “pulsing” advertising is found to be more cost-effective than placing advertisements continuously. However, the benefits of pulsing policy in social marketing have rarely been tested. This study explores the lingering effect of tobacco control advertising. If the effects of tobacco control advertisements linger beyond the time they are on-air, this would provide a theoretical basis for using pulsing policy in tobacco control campaigns. This study analyzed responses from two independent samples of smokers and recent quitters, where respondents reported whether they were exposed to any tobacco control advertising in the last week. Sample 1 was cross-sectional ( n = 3,106), and Sample 2 followed a self-refreshed panel methodology where 846 participants were interviewed for up to 6 times (3,120 interviews). Both studies used the same survey instrument and were in field concurrently. Eighty percent of Sample 1 reported recent exposure to advertising. This was strikingly similar to the response from Sample 2 recorded at their first interview (81%). However, panel members’ self-reported exposure to campaigns decreased at each subsequent interview (approximately a fortnight apart) and eventually reached 56% at the sixth interview. Building on the premises of priming theory, the first response from each Sample 2 respondent represented his or her intuitive thought—a result of the lingering effect of advertising. The drop in recall over time could be due to respondents self-correcting their responses after being primed in the previous surveys. Our findings suggest the effects of tobacco control campaigns linger and support the use of pulsing policy in tobacco control advertising.

Disparities in the Population Distribution of African American and Non-Hispanic White Smokers Along the Quitting Continuum.

To examine disparities and changes over time in the population-level distribution of smokers along a cigarette quitting continuum among African American smokers compared with non-Hispanic Whites. Secondary data analyses of the 1999, 2002, 2005, and 2008 California Tobacco Surveys (CTS). The CTS are large, random-digit-dialed, population-based surveys designed to assess changes in tobacco use in California. The number of survey respondents ranged from n = 6,744 to n = 12,876 across CTS years. Current smoking behavior (daily or nondaily smoking), number of cigarettes smoked per day, intention to quit in the next 6 months, length of most recent quit attempt among current smokers, and total length of time quit among former smokers were assessed and used to recreate the quitting continuum model. While current smoking rates were significantly higher among African Americans compared with non-Hispanic Whites across all years, cigarette consumption rates were lower among African Americans in all years. There were significant increases in the proportion of former smokers who had been quit for at least 12 months from 1999 (African Americans, 26.8% ± 5.5%; non-Hispanic Whites, 36.8% ± 1.6%) to 2008 (African Americans, 43.6% ± 4.1%; non-Hispanic Whites, 57.4% ± 2.9%). The proportion of African American former smokers in each CTS year was significantly lower than that of non-Hispanic Whites. Despite positive progression along the quitting continuum for both African American and non-Hispanic White smokers, the overall distribution was less favorable for African Americans. The lower smoking consumption levels among African Americans, combined with the lower rates of successful smoking cessation, suggest that cigarette addiction and the quitting process may be different for African American smokers.

The Relations Between False Positive and Negative Screens and Smoking Cessation and Relapse in the National Lung Screening Trial: Implications for Public Health.

Lung screening is an opportunity for smoking cessation and relapse prevention, but smoking behaviors may differ across screening results. Changes in smoking were evaluated among 18 840 current and former smokers aged 55-74 scheduled to receive three annual lung screenings. Participants were randomized to low-dose computed tomography or single-view chest radiography in the American College of Radiology/National Lung Screening Trial. Outcome measures included point and sustained (6-month) abstinence and motivation to quit among smokers; and relapse among smokers who quit during follow-up, recent quitters (quit < 6 months), and long-term former smokers (quit ≥ 6 months). During five years of follow-up, annual point prevalence quit rates ranged from 11.6%-13.4%; 48% of current smokers reported a quit attempt and 7% of long-term former smokers relapsed. Any false positive screening result was associated with subsequent increased point (multivariable hazard ratio HR = 1.23, 95% CI = 1.13, 1.35) and sustained (HR = 1.28, 95% CI = 1.15, 1.43) abstinence among smokers. Recent quitters with ≥1 false positive screen were less likely to relapse (HR = 0.72, 95% CI = 0.54, 0.96). Screening result was not associated with relapse among long-term former smokers or among baseline smokers who quit during follow-up. A false positive screen was associated with increased smoking cessation and less relapse among recent quitters. Consistently negative screens were not associated with greater relapse among long-term former smokers. Given the Affordable Care Act requires most health plans to cover smoking cessation and lung screening, the impact and cost-effectiveness of lung screening could be further enhanced with the addition of smoking cessation interventions.

An annual pre-announced step-increase in tobacco excise in New Zealand

New Zealand is implementing a policy of pre-announced 10 per cent annual increases in tobacco excise for 7 years (from 2010 to 2016). Internationally, little is known about smokers' receptiveness to persistent step-increases in tobacco excise. This article reports on data collected in 2013 (600 interviews in total). The New Zealand Smoking Monitor is a fortnightly survey of smokers and recent quitters; respondents are maintained on a panel and interviewed up to six times. We found that, one-quarter of respondents supported continuing with a 10 per cent annual increase. Eight in ten were aware that a pack of cigarettes will cost US$16.50 in 3 years, and six in ten believed knowing the future cost of cigarettes gave them a strong reason to stop smoking now. While most respondents did not want the annual excise increase to continue, how they perceived the impact of persistent excise increases suggests this policy has the potential to increase quit attempts.

Explaining the effects of electronic cigarettes on craving for tobacco in recent quitters

ObjectiveTo explore how e-cigarettes attenuate craving for tobacco, in e-cigarette users who recently quit smoking. DesignCross-sectional survey of recent quitters, Internet (French and English), 2012–2014. Participants were 374 daily users of e-cigarettes who had quit smoking in the previous two months, enrolled on websites dedicated to e-cigarettes and to smoking cessation. We measured perception that e-cigarettes attenuate craving for tobacco cigarettes, characteristics of e-cigarettes, modifications of the devices, patterns of e-cigarette use, reasons for use, satisfaction with e-cigarettes, dependence on e-cigarettes, and personal characteristics. ResultsThe strongest attenuation of craving for tobacco was obtained by using higher nicotine concentrations in refill liquids, modular systems (rather than unmodified devices), and high voltage batteries. The strength of the effect of e-cigarettes on craving was also associated with more intensive use (more puffs per day, more refill liquid). Stronger effects on craving were associated with satisfaction with e-cigarettes, and with reporting that e-cigarettes helped to quit smoking. Participants who reported the strongest effects on craving for tobacco were the most dependent on the e-cigarette and had the strongest urges to vape. ConclusionsFrom a public health perspective, there is a trade-off between e-cigarettes that provide high levels of nicotine, high satisfaction and more effects on craving for tobacco, but may also be addictive, and e-cigarettes that contain less nicotine and are less addictive, but are also less satisfactory and less efficient at relieving craving and at helping dependent smokers quit smoking. This trade-off must be kept in mind when regulating e-cigarettes.

Differences between recent quitters and current smokers during pregnancy

Differences between recent quitters and current smokers during pregnancy

Associations between use of pharmacological aids in a smoking cessation attempt and subsequent quitting activity: a population study.

Modelling the population impact and cost-effectiveness of smoking cessation aids is limited by lack of knowledge about how the use of aids changes across quit attempts. Here we test whether the quit method used in a previous attempt influences (i) future decisions to quit and/or (ii) treatment/s used during subsequent attempts. Data came from the Smoking Toolkit Study, a United Kingdom national household survey. Smokers (n = 5489) who completed a baseline and 6-month follow-up questionnaire. Respondents were asked what treatment/s, grouped as: prescription medication/s [bupropion, varenicline or nicotine replacement therapy (NRT)], over-the-counter NRT or unaided that they had used in their most recent quit attempt (at baseline), and any use of treatment/s for a quit attempt in the last 3 months at follow-up. Smokers who had tried to quit at baseline were more likely to report having tried to quit again prior to follow-up [all odds ratios ≥ 2.19 relative to no attempt at baseline, P < 0.001]. Smokers who tried to quit using pharmacological aids were more likely to try to quit again at follow-up (all ORs ≥ 2.19 relative to no attempt at baseline, P < 0.001). Smokers tended to re-try aids used in baseline attempts in future attempts (all ORs ≥ 1.48 relative to no attempt at baseline, P < 0.01). Smokers who have tried to quit in the past year are more likely to try to quit again within 6 months regardless of whether they used a pharmacological aid, and they are more likely to re-try aids they had used previously.

The use of, and attitudes towards, electronic cigarettes and self‐reported exposure to advertising and the product in general

ObjectiveVery few studies have investigated New Zealanders’ use of, and attitudes towards, e‐cigarettes, their exposure to e‐cigarette advertising and their general exposure to this product. The current study aims to fill this information gap. MethodsResponses were gathered from a sample of adult smokers and recent quitters who took part in a fortnightly computer‐assisted telephone interviewing survey. This paper reports on data collected in 2013 on the use of, and attitudes towards, e‐cigarettes and exposure to advertising and the product in general. Responses were compared by socio‐demographic status and recent quit attempts. ResultsBetween 23% and 39% of respondents reported having used e‐cigarettes (with the highest level among those who had quit or tried to quit recently), and 8–16% had used e‐cigarettes in the past two weeks. About one half reported seeing advertising of e‐cigarettes in the past two weeks, 22–41% had seen people they knew using e‐cigarettes and 10–15% had seen a stranger using them in the past two weeks. Attitudinal responses are reported in the main text. ConclusionsThe rate of ever‐use suggested that smokers and recent quitters are receptive to e‐cigarettes and that they were available to many of them to try. Exposure to e‐cigarette advertising or the product in general was not uncommon. Future studies should continue monitor the use of e‐cigarettes and investigate the impact of the exposure to people's attitudes towards the product and their subsequent use of e‐cigarettes.

Prospective cohort study of the effectiveness of varenicline versus nicotine replacement therapy for smoking cessation in the "real world".

BackgroundIt is important to know the comparative effectiveness of varenicline and nicotine replacement therapy (NRT) for smoking cessation when prescribed under routine circumstances and in the general population. Previous estimates relied on cross-sectional data. The objective of the current study was to use longitudinal data to compare the abstinence rates of smokers trying to stop having used varenicline versus NRT on prescription (Rx) when provided with minimal professional support in the general population while adjusting for key potential confounders.MethodsProspective cohort study in 270 adults who participated in a household survey, smoked at baseline, responded to the 6-month follow-up survey, and made at least one quit attempt between the two measurements with either varenicline or NRT Rx in their most recent quit attempt. The main outcome measure was self-reported abstinence up to the time of the survey, adjusted for key potential confounders including cigarette dependence (measured at baseline).ResultsUsers of varenicline were younger, reported more time spent with urges to smoke at baseline, and were less likely to stop abruptly during their last quit attempt (all p < 0.01). The adjusted odds of abstinence in users of varenicline were 3.83 (95% CI = 1.88-7.77) times higher compared with users of NRT Rx.ConclusionsVarenicline use with minimal professional support in the general population of smokers appears more effective than NRT Rx in achieving abstinence.

Short-Term Fluctuations in Motivation to Quit Smoking in a Sample of Smokers in Hawaii

Background: Despite its potential for usefulness in informing the development of smoking cessation interventions, short-term fluctuations in motivation to quit is a relatively understudied topic. Objectives: To assess the prevalence of smokers’ day-to-day fluctuations in motivation to quit, and to assess associations of day-to-day fluctuations in motivation to quit with several established cessation-related variables. Methods: A cross-sectional survey was administered to smokers in Hawaii (N = 1,567). To assess short-term fluctuations in motivation to quit smoking, participants were asked to respond “True” or “False” to the statement: “My motivation to quit smoking changes from one day to the next.” Other items measured desire to quit smoking, intention to quit, confidence in quitting, cigarette dependence, and other cessation-related variables. Results: “My motivation to quit smoking changes from one day to the next” was endorsed as true by 64.7% of smokers, and false by 35.3%. Analyses revealed that smokers who indicated fluctuating motivation were significantly more interested in quitting as compared to smokers without fluctuations. Fluctuations in motivation to quit also were associated with greater confidence in quitting, lesser cigarette dependence, and more recent quitting activity (all p < .01). Conclusions: Day-to-day fluctuations in motivation to quit are common. Day-to-day fluctuations in motivation to quit are strongly associated with higher motivation to quit, greater confidence in future quitting, and other positive cessation-relevant trends.

Profile of e-cigarette use and its relationship with cigarette quit attempts and abstinence in Kansas adults

ObjectiveThe aim of this study is to describe electronic cigarette use in Kansas adults and its relationship with cigarette cessation. MethodsThe Kansas Adult Tobacco Survey (ATS) is a 2012–2013 phone survey of non-institutionalized Kansas adults (N=9656). The ATS was analyzed to create a profile of cigarette and e-cigarette users, and demonstrate associations between e-cigarette use and cigarette cessation attempts and cigarette abstinence. ResultsIn 2013, 45% of adult cigarette smokers had tried e-cigarettes and 14% had used e-cigarettes in the past month. The prevalence of current cigarette smoking was 76.5% among past-month e-cigarette users. Adults who only use e-cigarettes are younger and more affluent than adults who only smoke cigarettes. The prevalence of past-month e-cigarette use among smokers who made a quit attempt in the past year is more than double that of smokers who did not. E-cigarette use was negatively associated with past-month (aPOR=0.21, 95% CI: 0.11–0.38) and past-year cigarette abstinence (aPOR=0.14, 95% CI: 0.10–0.22). ConclusionsE-cigarette use is common among cigarette smokers. E-cigarette use is more common among smokers who made a recent quit attempt and many smokers report using smokeless tobacco or e-cigarettes to help quit. Recent cigarette abstinence, however, is negatively associated with e-cigarette use.

Exercise interventions for smoking cessation.

Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014, and searched MEDLINE, EMBASE, PsycINFO, and CINAHL Plus in May 2014. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme (which we considered the control in this review). Studies were required to recruit smokers or recent quitters and have a follow-up of six months or more. Studies that did not meet the full inclusion criteria because they only assessed the acute effects of exercise on smoking behaviour, or because the outcome was smoking reduction, are summarised but not formally included. We extracted data on study characteristics and smoking outcomes. Because of differences between studies in the characteristics of the interventions used we summarized the results narratively, making no attempt at meta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration. We identified 20 trials with a total of 5,870 participants. The largest study was an internet trial with 2,318 participants, and eight trials had fewer than 30 people in each treatment arm. Studies varied in the timing and intensity of the smoking cessation and exercise programmes offered. Only one included study was judged to be at low risk of bias across all domains assessed. Four studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow-up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow-up. Another study reported significantly higher abstinence rates at six month follow-up for a combined exercise and smoking cessation programme compared with brief smoking cessation advice. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow-up but not at the end of treatment or 12-month follow-up. The other studies showed no significant effect for exercise on abstinence. Only two of the 20 trials offered evidence for exercise aiding smoking cessation in the long term. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which may not have been sufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions in terms of both exercise intensity and intensity of support being provided, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.

Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study.

Background and AimsElectronic cigarettes (e-cigarettes) are rapidly increasing in popularity. Two randomized controlled trials have suggested that e-cigarettes can aid smoking cessation, but there are many factors that could influence their real-world effectiveness. This study aimed to assess, using an established methodology, the effectiveness of e-cigarettes when used to aid smoking cessation compared with nicotine replacement therapy (NRT) bought over-the-counter and with unaided quitting in the general population.Design and SettingA large cross-sectional survey of a representative sample of the English population.ParticipantsThe study included 5863 adults who had smoked within the previous 12 months and made at least one quit attempt during that period with either an e-cigarette only (n = 464), NRT bought over-the-counter only (n = 1922) or no aid in their most recent quit attempt (n = 3477).MeasurementsThe primary outcome was self-reported abstinence up to the time of the survey, adjusted for key potential confounders including nicotine dependence.FindingsE-cigarette users were more likely to report abstinence than either those who used NRT bought over-the-counter [odds ratio (OR) = 2.23, 95% confidence interval (CI) = 1.70–2.93, 20.0 versus 10.1%] or no aid (OR = 1.38, 95% CI = 1.08–1.76, 20.0 versus 15.4%). The adjusted odds of non-smoking in users of e-cigarettes were 1.63 (95% CI = 1.17–2.27) times higher compared with users of NRT bought over-the-counter and 1.61 (95% CI = 1.19–2.18) times higher compared with those using no aid.ConclusionsAmong smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.

How Do Smokers Use a Smoking Cessation Text Messaging Intervention?

Mobile-phone-based text (SMS) messaging is an effective method for delivering smoking cessation assistance; however, little is known about optimal program use. This paper reports on the use of 2 forms of interaction (reporting changes in quit status and emergency help) among users of QuitTxt, an interactive, automated text messaging advice program. We examined preferences for messaging intensity, duration of use, and their associations with short-term cessation outcome or perceived helpfulness. QuitTxt was offered during participation in a previously reported randomized controlled trial and was activated by 924 smokers or recent quitters, of whom 862 used it to a criterion level. Outcome data (quit attempts, 7-day point prevalence abstinence, and perceived helpfulness) were collected 1 month after first use. Most (68.9%) accepted the default of 4-8 messages per day, and median use duration was 27 days. Half (49.1%) appeared to miss reporting at least 1 status change, with relapses less likely to be reported than quit progression. Emergency help was used by 27.0% of those eligible for it; emergency help was used more frequently among those with recent quit experience and lower nicotine dependence. Use of emergency help was unrelated to short-term cessation outcome. The most notable finding is the variability in use. Some users complied fully with the requirement to report status changes, while even among those who did not, many found QuitTxt to be very helpful, suggesting that perfect congruence between message content and quit status is not essential. The use of emergency help functionality was relatively rare but was appreciated.

The immediate and long-term changes in support of tobacco display ban after its implementation in New Zealand

Four recent studies, two with particularly strong methodology, have assessed post-implementation support for tobacco display bans.1–4 The first found generally high support but no difference between Canadian smokers who lived...

Smoking Prevalence and Cessation Characteristics among U.S. Adults With and Without COPD: Findings from the 2011 Behavioral Risk Factor Surveillance System

Introduction: Cigarette smoking is a major cause of chronic obstructive pulmonary disease, (COPD) but many persons with COPD continue to smoke. Quitting can help prevent the development of and complications from COPD. This study examined whether smoking and cessation behaviors differed among adults with a) COPD, b) asthma, c) other chronic conditions only, or d) no chronic conditions. Methods: Smoking and chronic disease status was obtained from 488,909 adults aged > 18 years using the Behavioral Risk Factor Surveillance System; 9,476 current smokers and recent quitters in 5 states responded to additional questions about cessation. We computed age-adjusted prevalence of smoking and past-year quit attempts, and used bivariate and multivariable logistic regression to identify correlates of past-year quit attempts. Results: Similar to the overall sample, in the 5-state sample, 47.3% of adults with COPD were current smokers versus 23.1% of those with asthma, 28.8% of adults with other chronic conditions, and 20.0% of those with no chronic conditions. Those with COPD did not differ significantly from those with asthma, other chronic diseases, or no chronic disease in having made a past-year quit attempt (59.7% versus 64.0%, 61.5%, and 53.9%, respectively). Smokers with COPD were significantly more likely than those with no chronic disease to have used cessation treatment resources, including a quitline, counseling, or medication (p < 0.001). Conclusions: Adults with COPD were just as likely as those without COPD to make a past-year quit attempt; however, approximately 40% of smokers with COPD did not try to quit.

Using content and network analysis to understand the social support exchange patterns and user behaviors of an online smoking cessation intervention program

Informational support and nurturant support are two basic types of social support offered in online health communities. This study identifies types of social support in the QuitStop forum and brings insights to exchange patterns of social support and user behaviors with content analysis and social network analysis. Motivated by user information behavior, this study defines two patterns to describe social support exchange: initiated support exchange and invited support exchange. It is found that users with a longer quitting time tend to actively give initiated support, and recent quitters with a shorter abstinent time are likely to seek and receive invited support. This study also finds that support givers of informational support quit longer ago than support givers of nurturant support, and support receivers of informational support quit more recently than support receivers of nurturant support. Usually, informational support is offered by users at late quit stages to users at early quit stages. Nurturant support is also exchanged among users within the same quit stage. These findings help us understand how health consumers are supporting each other and reveal new capabilities of online intervention programs that can be designed to offer social support in a timely and effective manner.