title: Gradual versus abrupt quitting among French treatment-seeking smokers.
abstract: OBJECTIVE
  This study examined the prevalence and predictors of gradual quitting among treatment-seeking smokers.
  
  
  METHODS
  This study examined quit attempts among 28,156 adult smokers who attended French smoking cessation services nationwide between 2007 and 2010. Predictors of gradual quitting were determined using multivariate regression models.
  
  
  RESULTS
  Only 4.4% quit gradually whereas 48.7% quit abruptly and 46.9% continued smoking. 34.1% of abrupt quitters and 31.9% of gradual quitters were abstinent at 1month post-quit (p=0.108). Gradual quitting was associated with: older age, heavy smoking at baseline, no previous quit attempts, low self-efficacy, baseline intake of anxiolytics, symptoms of depression and history of depressive episodes. Gradual quitters had a similar anxio-depressive profile than continued smokers but were more educated and more likely to have reported previous quit attempts. Prescription of oral nicotine replacement therapy (NRT) only as opposed to combination NRT doubled the odds of gradual quitting. Likelihood of gradual quitting compared with continued smoking improved with the number of follow-up visits.
  
  
  CONCLUSIONS
  Our findings suggest that hard-to-treat smokers may be more likely to quit gradually than abruptly. However, intense follow-up with adapted treatment appears to be crucial to achieve cessation gradually in French smoking cessation services.
authors.affiliation: Univ Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, F-75006 Paris, France. Electronic address: moniquebaha@yahoo.fr.
authors.forename: Monique
authors.initials: M
authors.lastname: Baha
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, EA 4069, Hôtel-Dieu 1, place du Parvis Notre-Dame, F-75004 Paris, France; AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, F-75015 Paris, France.
authors.forename: Anne-Laurence
authors.initials: AL
authors.lastname: Le Faou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D015995:Prevalence; D020377:Self Efficacy; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D018722:Nicotinic Agonists
keywords: Abrupt quitting; Gradual quitting; Nicotine replacement therapy; Quit attempt; Smoking cessation; Varenicline