Nondaily smokers should be asked and advised to quit.
BACKGROUND
Nondaily smokers are a growing subpopulation of smokers. Current cessation guidelines were developed for daily smokers, and how clinicians might help nondaily smokers is not clear.


METHODS
Analyzing the 2000 National Health Interview Survey in 2004, we compared characteristics of nondaily smokers with never smokers and daily smokers. We used multivariate logistic regression to compare predictors of wanting to quit in 6 months between nondaily and daily smokers.


RESULTS
About one in five current smokers was a nondaily smoker. Nondaily smokers reported better health than daily smokers, but had some health status indicators suggesting worse health than never smokers. Nondaily smokers were more likely to want to quit (odds ratio [OR]=1.31, 95% confidence interval [CI]=1.10-1.56) than daily smokers, but were less likely to report a physician having asked about tobacco use (41% vs 50%, p<0.0001) or advised quitting (31% vs 41%, p<0.0001). In both nondaily and daily smokers, physician advice (nondaily OR=1.50, 95% CI=1.03-2.2; daily OR=1.58, 95% CI=1.32-1.89), and the belief that secondhand smoke harms others (nondaily OR=1.48, 95% CI=1.04-2.1; daily OR=1.80, 95% CI=1.56-2.1), predicted wanting to quit. Higher-educated nondaily smokers were less likely to want to quit (OR=0.54, 95% CI=0.32-0.91), unlike in daily smokers (OR=1.48, 95% CI=1.15-1.89). Latino nondaily smokers were less likely (OR=0.43, 95% CI=0.30-0.64) than whites, and African-American daily smokers were more likely (OR=1.27, 95% CI=1.04-1.55) than whites, to want to quit.


CONCLUSIONS
While daily smokers may seem a higher cessation priority, nondaily smokers may be more likely to quit with brief interventions. Cessation messages should address health risks of any smoking, ethnic differences, smoke-free messages, and situational triggers.
Tong
Elisa K
EK
Division of General Internal Medicine, Department of Medicine, University of California-San Francisco, San Francisco, California 94143-0329, USA.
Ong
Michael K
MK
Vittinghoff
Eric
E
Pérez-Stable
Eliseo J
EJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D003376:Counseling; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008875:Middle Aged; D010349:Patient Compliance; D010507:Periodicity; D010817:Physician-Patient Relations; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000208:ethnology; D016540:Smoking Cessation / Q000208:ethnology / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology