The natural history of quitting smoking: findings from the International Tobacco Control (ITC) Four Country Survey

Authors

  • Natalie Herd,

    1. Department of Psychology, The University of Melbourne, Melbourne, VIC, Australia and
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  • Ron Borland

    Corresponding author
    1. VicHealth Centre for Tobacco Control, The Cancer Council Victoria, VIC, Australia
      Ron Borland, VicHealth Centre for Tobacco Control, The Cancer Council Victoria, 1 Rathdowne Street, Carlton, VIC 3053, Australia. E-mail: ron.borland@cancervic.org.au
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Ron Borland, VicHealth Centre for Tobacco Control, The Cancer Council Victoria, 1 Rathdowne Street, Carlton, VIC 3053, Australia. E-mail: ron.borland@cancervic.org.au

ABSTRACT

Aims  To describe the long-term natural history of a range of potential determinants of relapse from quitting smoking.

Design, setting and participants  A survey of 2502 ex-smokers of varying lengths of time quit recruited as part of the International Tobacco Control (ITC) Four Country Survey (Australia, Canada, United Kingdom, United States) across five annual waves of surveying.

Measurements  Quitters were interviewed by telephone at varying durations of abstinence, ranging from 1 to 1472 days (about 4 years) post-quitting. Smoking-related beliefs and experiences (i.e. urges to smoke; outcome expectancies of smoking and quitting; and abstinence self-efficacy) were included in the survey.

Findings  Most theorized determinants of relapse changed over time in a manner theoretically associated with reduced risk of relapse, except most notably the belief that smoking controls weight, which strengthened. Change in these determinants changed at different rates: from a rapidly asymptoting log function to a less rapidly asymptoting square-root function.

Conclusions  Variation in patterns of change across time suggests that the relative importance of each factor to maintaining abstinence may similarly vary.

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