Photo by: John Krumm

Age and pre quit-day attrition during smoking cessation treatment

Cigarette smoking remains the leading cause of preventable death worldwide. Despite the well documented health risks and costly efforts to implement effective smoking cessation interventions, approximately 13.7% of all adults and 20% of adults between the ages of 25-44 remain cigarette smokers in the United States. Importantly, daily smokers aged 25-44 express the most interest in quitting smoking. Nevertheless, younger adults are less inclined to seek help from mental health professionals and less likely to complete gold-standard smoking cessation interventions (e.g., cognitive behavioral therapy combined with nicotine replacement therapy) than older adults. Younger adults are also more likely than older adults to discontinue treatment prior to a scheduled quit-day. Age-related risk factors that may be implicated in the inverse relationship existing between age and pre quit-day treatment discontinuation have yet to be examined. A study was therefore conducted to, 1) replicate the common finding that younger age predicts pre quit-day attrition, and 2) explain the relationship between younger age and pre quit-day attrition by examining age-related risk factors for low smoking cessation treatment engagement, including smoking-related health motivations (i.e.,  heart disease, lung cancer), social expectancies (i.e., smoking facilitates relaxed conversation and social engagement), and expected severity of cravings.

Study participants were prescribed a standard smoking cessation treatment consisting of cognitive behavioral therapy combined with nicotine replacement therapy. Additionally, participants were randomly assigned to either an exercise intervention or a wellness education intervention, each involving three weekly sessions over the course of 15 weeks. Participants were asked to make a quit attempt on week 6 of the intervention. All study participants completed questionnaires assessing smoking-related health motivations, social expectancies, and expected severity of cravings.

The results of this study support the finding that younger smokers had a significantly greater likelihood of continuing with treatment past quit-day than younger smokers. Health motivations, social expectancies, and/or perceived severity of cravings did not account for the effect of age on pre quit-day attrition.

There remains an unmet need to understand the pre quit-day attrition problem existing amongst younger smokers. Currently, there is no plausible explanation for the root of this problem and clinical researchers are uninformed on how to develop interventions to effectively address it. Considering the current and impending negative public health implications, it is critical that future work identifies empirically and theoretically sound variables related to pre quit-day attrition during smoking treatment amongst young adults.

Read the full paper: Conroy, H. E., Jacquart, J., Baird, S. O., Rosenfield, D., Davis, M. L., Powers, M. B., Frierson, G. M., Marcus, B. H., Otto, M. W., Zvolensky, M. J., & Smits, J. A. J. (2020). Age and Pre Quit-Day Attrition During Smoking Cessation Treatment. Cognitive Behaviour Therapy. doi: 10.1080/16506073.2020.1751262

Pictured: Haley E. Conroy

Photo by: John Krumm


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