The vast majority of smokers who successfully quit do so entirely on their own without the help of a smoking cessation program. Since most studies of what factors lead to successful quitting are conducted among people enrolled in smoking cessation programs, little has been known about what factors are operating in the natural environment. 

Researchers from Arizona State University and Indiana University surveyed 8500 6th-12th graders in a midwestern community from 1980 to 1983 and then followed up with 700 who met their criteria as regular smokers in 1987 and 1994 (by which time they were between 24 and 32 years old). They were looking for common factors among those who had attempted to quit smoking and among those who had successfully quit. What they found was that the factors common to those who had attempted to quit were not the same factors common to those who had successfully quit.

For example, perceiving smoking as dangerous to health both generally and personally was associated with a higher likelihood of attempting to quit smoking, but health beliefs about smoking did not predict successful cessation. Furthermore, to the researchers' surprise, the amount of smoking by participants and smoking among peers and parents were unrelated to quit attempts. In other words, being in a social environment that is conducive to smoking (or to not smoking) had no effect on whether participants tried to quit (or didn't try). But having fewer smoking friends was associated with successful cessation as was feeling lower social pressure reasons for quitting.

While both attempters and successful quitters were more likely to have some college education and to value health, the factors associated with attempting to quit smoking (but not with successful cessation) were:

• being female
  
• perceiving smoking as dangerous to health generally (among heavy smokers) and personally smoking to control affect smoking for sensorimotor reasons -- enjoying the handling of a cigarette -- (women who smoked for this reason were more likely to attempt to quit, but men who smoked for this reason were less likely to attempt to quit)
  
• being married
  
• occupying more social roles.
  

The factors associated with successful cessation were:

• smoking less than pack a day
  
• perceiving oneself as being less likely to be smoking in a year
  
• having fewer smoking friends
  
• having sensorimotor reasons for smoking (among heavier smokers only)
  
• having lower levels of stimulation motives -- less need for cigarettes to "perk up" (for men only)
  
• having more sensory reasons for quitting -- messiness, lack of pleasure -- (for men only)
  
• feeling lower social pressure reasons for quitting
  
• being employed
  
• not living with children.
  

The researchers conclude that, based on these data, interventions aimed at smoking cessation that increase personally relevant health beliefs about smoking will likely produce more attempts to quit, but in the longer term, promoting a strong value on achieving a healthy lifestyle generally will contribute to more successful quitting.

Reference:

• Jennifer S. Rose, Ph.D., Laurie Chassin, Ph.D., and Clark C. Presson, Ph.D., Steven J. Sherman, Ph.D. (1999). Prospective Predictors of Quit Attempts and Smoking Cessation in Young Adults. Health Psychology, Vol. 15, No. 4, pp 261-268.

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