title: To what extent do smokers make spontaneous quit attempts and what are the implications for smoking cessation maintenance? Findings from the International Tobacco Control Four country survey.
abstract: OBJECTIVE
  To assess the extent to which quit attempts are spontaneous and to evaluate if this is a determinant of smoking cessation maintenance, with better control for memory effects.
  
  
  METHODS
  We use data from 3,022 smokers who made quit attempts between Waves 4 and 5 and/or Waves 5 and 6 of the International Tobacco Control Four country survey. Outcomes (quitting for 6 months) were confirmed at the next wave for cases where the attempt began within the previous 6 months. We assessed the length of delay between the decision to quit and implementation and whether the attempt followed a "spur-of-the-moment" decision or some serious prior consideration. Outcomes were modeled using generalized estimating equations.
  
  
  RESULTS
  Prior consideration of quitting was unrelated to the outcome, but there were complex relationships for the delay between choosing a quit day and implementation. Those who reported quitting on the day they decided and those who delayed for 1 week or more had comparable rates of 6-month abstinence. Delaying for 1-6 days was associated with a greater relapse rate than those who quit on the day, although this effect became nonsignificant in multivariate analyses.
  
  
  CONCLUSIONS
  Quitting is on most smokers' minds regularly and most attempts are not preceded by a long lead in period following the decision to try. Neither prior consideration nor delay between the decision to quit and implementation was clearly related to outcomes. Previous findings of greater success for spontaneous quit attempts may be because they conflate setting a date in advance with planning and also perhaps some differential memory effects.
authors.affiliation: VicHealth Centre for Tobacco Control, The Cancer Council Victoria, Victoria, Australia.
authors.forename: Jae
authors.initials: J
authors.lastname: Cooper
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.forename: Hua-Hie
authors.initials: HH
authors.lastname: Yong
authors.forename: Ann
authors.initials: A
authors.lastname: McNeill
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Murray
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
mesh_terms: D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D033182:Intention; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D015203:Reproducibility of Results; D040242:Risk Reduction Behavior; D055502:Secondary Prevention; D020377:Self Efficacy; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult