Willingness-to-try various tobacco cessation methods among US adult cigarette smokers
Chineme Enyioha 1, 2  
Clare Meernik 1, 3
Leah Ranney 1, 3
Adam O. Goldstein 1, 3
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Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, United States
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States
Medical College of Georgia at Augusta University, United States
Chineme Enyioha   

Department of Family Medicine, University of North Carolina, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
Publish date: 2019-05-14
Submission date: 2019-01-15
Final revision date: 2019-04-12
Acceptance date: 2019-04-15
Tob. Prev. Cessation 2019;5(May):18
Long-term smoking cessation success rates without substantive intervention remain low. Some studies suggest an association between sociodemographic factors and tobacco cessation success. We explored US adult tobacco cigarette users’ willingness-to-try diverse tobacco cessation methods by sociodemographics and tobacco use habits.

We electronically surveyed a convenience sample of 562 US adults to explore willingness-to-try various cessation methods among those who reported current tobacco cigarette use. Participants rated their willingness-to-try different cessation methods. Logistic regression models examined associations between willingness-to-try tobacco cessation methods based on sociodemographic and tobacco use characteristics.

Non-Whites were more likely to report willingness-to-try counseling (RR=1.32, 95% CI: 1.14–1.52) and those with high school education or less were less likely to report willingness-to-try counseling (RR=0.78, 95% CI: 0.64– 0.95). Those with lower income were less likely to report willingness-to-try any medication (RR=0.84, 95% CI: 0.73–0.98) and any counseling (RR=0.82, 95% CI: 0.67–0.99). High nicotine dependence was associated with a high likelihood of reporting willingness-to-try any evidence-based method (RR=1.07, 95% CI: 1.04–1.10) and a history of quit attempts was associated with likelihood to report willingness-to-try any evidence-based method (RR=1.31, 95% CI: 1.10–1.56).

Sociodemographics and nicotine dependence may affect preferences for tobacco cessation methods and should be considered when counseling patients on tobacco cessation.

T. Crutchfield is acknowledged for her assistance as the project manager.
A.O. Goldstein reports other from Pfizer Advisory Board, outside the submitted work. The rest of the authors have also completed and submitted an ICMJE form for disclosure of potential conflicts of interest and none was reported.
This work was supported in part by the University of North Carolina at Chapel Hill University Cancer Research Fund at the Lineberger Comprehensive Cancer Center and UNC Primary Care Research Fellowship.
Not commissioned; externally peer reviewed.
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. Samet J, ed. PLoS Medicine. 2006;3(11):e442. doi:10.1371/journal.pmed.0030442
Inoue-Choi M, Liao LM, Reyes-Guzman C, Hartge P, Caporaso N, Freedman ND. Association of long-term, low-Intensity smoking with all-cause and cause-specific mortality in the National Institutes of Health–AARP Diet and Health Study. JAMA Intern Med. 2017;177(1):87-95. doi:10.1001/jamainternmed.2016.7511.
World Health Organization. WHO Global Report: Mortality attributable to tobacco, 2012. Accessed June 15, 2017.
Jamal A, Phillips E, Gentzke AS, et al. Current Cigarette Smoking Among Adults — United States, 2016. Morbidity and Mortality Weekly Report. 2018;67(2):53-59. doi:10.15585/mmwr.mm6702a1
Jacquart J, Papini S, Davis ML, et al. Identifying attendance patterns in a smoking cessation treatment and their relationships with quit success. Drug Alcohol Depend. 2017;174:65-69. doi:10.1016/j.drugalcdep.2017.01.007
Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting smoking among adults — United States, 2000–2015. MMWR Morb Mortal Wkly Rep. 2017;65:1457–1464. doi:10.15585/mmwr.mm6552a1
Joly B, Perriot J, d’Athis P, Chazard E, Brousse G, Quantin C. Success rates in smoking cessation: Psychological preparation plays a critical role and interacts with other factors such as psychoactive substances. Pershouse MA, ed. PLoS ONE. 2017;12(10):e0184800. doi:10.1371/journal.pone.0184800
Caraballo RS, Shafer PR, Patel D, Davis KC, McAfee TA. Quit methods used by US adult cigarette smokers, 2014–2016. Prev Chronic Dis. 2017;14:160600. doi:10.5888/pcd14.160600
Ranney L, Melvin C, Lux L, McClain E, Lohr KN. Systematic review: Smoking cessation intervention strategies for adults and adults in special populations. Ann Intern Med. 2006;145:845–856. doi:10.7326/0003-4819-145-11-200612050-00142
Cokkinides VE, Ward E, Jemal A, Thun MJ. Under-use of smoking-cessation treatments: results from the National Health Interview Survey, 2000. Am J Prev Med. 2005;28:119–22. doi:10.1016/j.amepre.2004.09.007
Zhu S, Melcer T, Sun J, Rosbrook B, Pierce JP. Smoking cessation with and without assistance: a population based analysis. Am J Prev Med. 2000;18(4):305-311. doi:10.1016/s0749-3797(00)00124-0
El-Khoury Lesueur F, Bolze C, Melchior M. Factors associated with successful vs. unsuccessful smoking cessation: Data from a nationally representative study. Addict Behav. 2018;80:110-115. doi:10.1016/j.addbeh.2018.01.016
Centers for Disease Control and Prevention (CDC). Quitting smoking among adults—United States, 2001–2010. MMWR MMWR Morb Mortal Wkly Rep. 2011;60:1513–19.
King G, Polednak A, Bendel RB, Vilsaint MC, Nahata SB. Disparities in smoking cessation between African Americans and Whites: 1990–2000. Am J Public Health. 2004;94(11):1965-1971. doi:10.2105/ajph.94.11.1965
Vangeli E, Stapleton J, Smit ES, Borland R, West R. Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction. 2011;106(12):2110-2121. doi:10.1111/j.1360-0443.2011.03565.x
Brown J, Beard E, Kotz D, Michie S, Wes, R. Real‐world effectiveness of e‐cigarettes when used to aid smoking cessation: a cross‐sectional population study. Addiction. 2014;109(9):1531-1540. doi:10.1111/add.12623
Fagan P, King G, Lawrence D, et al. Eliminating tobacco-related health disparities: Directions for future research. Am J Public Health. 2004;94(2):211-217. doi:10.2105/ajph.94.2.211
Onor IO, Stirling DL, Williams SR, et al. Clinical effects of cigarette smoking: epidemiologic impact and review of pharmacotherapy options. Int J Environ Res Public Health. 2017;14(10):1147. doi:10.3390/ijerph14101147
Heatherton TF, Kozlowski LT, Frecker RC, Rickert W. Robinson J. Measuring the Heaviness of Smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day. Br J Addict. 1989;84(7):791-799. doi:10.1111/j.1360-0443.1989.tb03059.x.
Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:17. doi:10.1186/1751-0473-3-17
Spiegelman D, Hertzmark E. Easy SAS calculations for risk or prevalence ratios and differences, Am J Epidemiol, 2005;162(3):199–200. doi:10.1093/aje/kwi188
Jordan H, Hidajat M, Payne N, Adams J, White M, Ben-Shlomo Y. What are older smokers' attitudes to quitting and how are they managed in primary care? An analysis of the cross-sectional English Smoking Toolkit Study. BMJ Open. 2017;7(11):e018150. doi:10.1136/bmjopen-2017-018150
Ryan MP, Hinojosa JJ. Conceptual obstacles to making use of four smoking-cessation strategies: what reasons do light smokers give for rejecting strategies? Health Psychol Open . 2015;2(2):1–2. doi:10.1177/2055102915624928
Watkins LS, Thrul J, Max W, Ling PM. Cold Turkey and Hot Vapes? A National Study of Young Adult Cigarette Cessation Strategies, Nicotine & Tobacco Research. 2018. doi:10.1093/ntr/nty270
Rabius V, Wiatrek D, McAlister AL. African American participation and success in telephone counseling for smoking cessation. Nicotine Tob Res. 2012;14(2):240-242. doi:10.1093/ntr/ntr129
Zhu SH, Gardiner P, Cummins S, et al. Quitline utilization rates of African-American and white smokers: The California experience. Am J Health Promot. 2011;25(5 suppl):S51–S58. doi:10.4278/ajhp.100611-quan-185
Cokkinides VE, Halpern MT, Barbeau EM, Ward E, Thun MJ. Racial and ethnic disparities in smoking-cessation intervention: Analysis of the 2005 National Health Interview Survey. Am J of Prev Med. 2008;34(5):404-412. doi:10.1016/j.amepre.2008.02.003
Houston TK, Scarinci IC, Person SD, Greene PG. Patient smoking cessation advice by health care providers: The role of ethnicity, socioeconomic status, and health. Am J Public Health. 2005;95(6):1056-1061. doi:10.2105/AJPH.2004.039909
Fu SS, Burgess D, van Ryn M, Hatsukami DK, Solomon J. Joseph AM. Views on smoking cessation methods in ethnic minority communities: a qualitative investigation. Prev Med. 2007;44(3):235–240. doi:10.1016/j.ypmed.2006.11.002
Karadoğan D, Önal Ö, Kanbay Y. How does reimbursement status affect smoking cessation interventions? A real-life experience from the Eastern Black Sea region of Turkey. Tob. Induc. Dis. 2019;17(January). doi:10.18332/tid/100412
Gollust SE, Schroeder SA, Warner KE. Helping smokers quit: Understanding the barriers to utilization of smoking cessation services. Milbank Q. 2008;86(4):601-627. doi:10.1111/j.1468-0009.2008.00536.x.
Ngo-Metzger Q, Sorkin DH, Billimek J, Greenfield S, Kaplan SH. The effects of financial pressures on adherence and glucose control among racial/ethnically diverse patients with diabetes. J Gen Intern Med. 2012;27(4):432-437. doi:10.1007/s11606-011-1910-7
Wagner TH, Heisler M, Piette JD. Prescription drug co-payments and cost-related medication underuse. Health Econ, Policy Law. 2008;3(1):51-67. doi:10.1017/s1744133107004380
Cupertino AP, Richter KP, Sanderson Cox L, et al. Smoking cessation pharmacotherapy preferences in rural primary care. Nicotine Tob Research :official journal of the Society for Research on Nicotine and Tobacco. 2008;10(2):301. doi:10.1080/14622200701825817
Siahpush M, Wakefield M, Spittal M, Durkin S. Antismoking television advertising and socioeconomic variations in calls to Quitline. J Epidemiol Community Health. 2007;61(4):298–301. doi:10.1136/jech.2005.043380
Sheffer CE, Brackman SL, Cottoms N, Olsen M. Understanding the barriers to use of free, proactive telephone counseling for tobacco dependence. Qual Health Res. 2011;21(8):1075–1085. doi:10.1177/1049732311404248
Sheffer C, Brackman S, Lercara C, et al. When Free Is Not for Me: Confronting the Barriers to Use of Free Quitline Telephone Counseling for Tobacco Dependence. Int J Environ Res Public Health. 2015;13(1):15. doi:10.3390/ijerph13010015.
Bock BC, Papandonatos GD, de Dios MA, et al. Tobacco cessation among low-income smokers: motivational enhancement and nicotine patch treatment. Nicotine Tob Res. 2013;16(4):413–422. doi:10.1093/ntr/ntt166
Wen KY, Miller SM, Lazev A, Fang Z, Hernandez E. Predictors of smoking cessation counseling adherence in a socioeconomically disadvantaged sample of pregnant women. J health care poor underserved. 2012;23(3):1222-1238. doi:10.1353/hpu.2012.0096
Choo EK, Sullivan AF, LoVecchio F, Perret JN, Camargo CA, Boudreaux ED. Patient preferences for emergency department-initiated tobacco interventions: a multicenter cross-sectional study of current smokers. Addict Sci Clin Pract. 2012;7(1):4. doi:10.1186/1940-0640-7-4
Maher JE, Rohde K, Dent CW, Stark MJ, Pizacani B, Boysun MJ. et al. Is a statewide tobacco quitline an appropriate service for specific populations? Tob Control. 2007;16(Suppl 1):i65-i70. doi:10.1136/tc.2006.019786
Lee DJ, Fleming LE, McCollister KE, et al. Healthcare provider smoking cessation advice among US worker groups. Tob Control. 2007;16(5):325-328. doi:10.1136/tc.2006.019117
Thomas D, Abramson MJ, Bonevski B, et al. Quitting experiences and preferences for a future quit attempt: a study among inpatient smokers. BMJ Open. 2015;5(4):e006959. doi:10.1136/bmjopen-2014-006959
Ferguson SG, Brown J, Frandsen M, West R. Association between use of pharmacological aids in a smoking cessation attempt and subsequent quitting activity: a population study. Addiction. 2015;110(3):513-518. doi:10.1111/add.12795
Berry KM, Reynolds LM, Collins JM, et al. E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013–2015. Tob Control. 2018. doi:10.1136/tobaccocontrol-2017-054108
Zhu SH, Zhuang YL, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. The BMJ. 2017;358:j3262. doi:10.1136/bmj.j3262
Vickerman KA, Schauer GL, Malarcher AM, Zhang L, Mowery P, Nash CM. Reasons for electronic nicotine delivery system use and smoking abstinence at 6 months: A descriptive study of callers to employer and health plan-sponsored quitlines. Tob Control. 2017;26(2):126. doi:10.1136/tobaccocontrol-2015-052734