Patterns and predictors of smoking cessation

Tobacco use continues to be the leading preventable cause of death worldwide. Despite reduced rates of smoking among countries with effective tobacco control programs, the total number of smokers has actually increased over the past 30 years. International smoking trends have been influenced by global population growth, tobacco industry marketing in poorer and underdeveloped nations, limited awareness of smoking-related health risks and lack of access to frontline smoking interventions. There is also reason to believe that some smokers with certain characteristics or co-occurring conditions may have greater difficulty quitting. Factors that have been associated with poorer cessation outcomes include older age, lower socioeconomic status, exposure to other smokers in the home, greater tobacco dependence and more severe nicotine withdrawal symptoms during smoking abstinence, lower motivation and self-efficacy for quitting, greater negative affect, and the presence of comorbid depression, anxiety and co-occurring substance use disorders. Collectively, these data suggest that cessation rates may be enhanced by increasing the worldwide implementation of tobacco education and control programs, and by targeting recalcitrant smokers who have tried to quit without success.