Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers.
The number of quit attempts it takes a smoker to quit successfully is a commonly reported figure among smoking cessation programmes, but previous estimates have been based on lifetime recall in cross-sectional samples of successful quitters only. The purpose of this study is to improve the estimate of number of quit attempts prior to quitting successfully.



We used data from 1277 participants who had made an attempt to quit smoking in the Ontario Tobacco Survey, a longitudinal survey of smokers followed every 6 months for up to 3 years beginning in 2005. We calculated the number of quit attempts prior to quitting successfully under four different sets of assumptions. Our expected best set of assumptions incorporated a life table approach accounting for the declining success rates for subsequent observed quit attempts in the cohort.



The estimated average number of quit attempts expected before quitting successfully ranged from 6.1 under the assumptions consistent with prior research, 19.6 using a constant rate approach, 29.6 using the method with the expected lowest bias, to 142 using an approach including previous recall history.



Previous estimates of number of quit attempts required to quit may be underestimating the average number of attempts as these estimates excluded smokers who have greater difficulty quitting and relied on lifetime recall of number of attempts. Understanding that for many smokers it may take 30 or more quit attempts before being successful may assist with clinical expectations.
Ontario Tobacco Research Unit, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Michael
0000-0002-9589-2122
M
Chaiton
Ontario Tobacco Research Unit, Toronto, Ontario, Canada.
Lori
L
Diemert
Ontario Tobacco Research Unit, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Joanna E
JE
Cohen
Ontario Tobacco Research Unit, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Susan J
SJ
Bondy
Ontario Tobacco Research Unit, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Peter
P
Selby
Ontario Tobacco Research Unit, Toronto, Ontario, Canada.
Anne
A
Philipneri
Ontario Tobacco Research Unit, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Robert
R
Schwartz
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D033182:Intention; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009864:Ontario / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D000074285:Smokers / Q000523:psychology; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data; D013997:Time Factors
addiction; longitudinal; population; smoking cessation