Promoting cessation & reduction in smokers who are not interested in quitting

While most smokers are interested in quitting at some stage in the future, most do not successfully quit in any given year, and many do not even try. A core goal of tobacco control policy has been to motivate smokers to attempt to quit. Traditional “stages of change”-based approaches focus on gradually increasing motivation, but a number of recent studies have found that many quit attempts occur seemingly without pre-planning and without a gradual escalation of stage of change. One way to promote quit attempts might be by offering all smokers immediate access to treatment. In this single group pilot study, we recruited 100 smokers who reported that they were not interested in quitting within the next three months (84% reported no interest in quitting within the next year) to take part in an online survey of smoking. Within a week of completing the initial survey, all participants were mailed a package containing a quit booklet and a 7-day supply of nicotine patches; an accompanying letter explained that while they were not currently interested in quitting, they should seriously consider doing so. Four weeks after the initial survey participants were re-contacted (via email) and asked to complete a brief follow-up survey. Follow-up data was collected on 58% of the initial sample. Despite reporting no initial interest in quitting, 22.4% (13/58) of respondents reported using the patches provided. Of those who completed the follow-up survey, 57% had reduced their smoking rate since the initial survey: the average change in smoking rate was -20.3% (-4.5 cigarettes per day). Lower nicotine dependence (as measured by time to first cigarette) was associated with greater reduction (p=.005); patch use was also associated with greater smoking reduction (-41.2% vs -15.9%; p=.020). One respondent reported abstinence at follow-up. While modest, these pilot results suggest that, given the right conditions, even smokers with no stated interest in quitting smoking can be prompted to change their behaviour.