Smoking, smoking cessation and smoking relapse patterns: a web-based survey of current and former smokers in the US


  • Disclosures
    Jenö P. Marton, MD, Kelly H. Zou, PhD and Richard J. Willke, PhD are employees of Pfizer Inc. Karen Yeomans, BSc, Krista A. Payne, MEd, Elizabeth P. Merikle, PhD, Irina Proskorovsky, MSc and Qian Li, PhD are employees of United BioSource Corporation, which received payment from Pfizer for research and consulting services associated with this manuscript.

  • Access to study data
    The study data that support the publication were circulated to all authors in the form of table shells, charts and figures.

  • Research ethics
    The study was approved by a central IRB prior to initiation. All participants were preregistered members of the YouGov panel and provided confirmation of consent prior to completing the survey. Residents of California were shown the California Experimental Subjects’ Bill of Rights as part of the online consent process.

  • Prior Publication
    The submitted work is not published, in press or currently being considered for publication elsewhere.

Karen Yeomans, United BioSource Corporation, 185 Dorval Avenue, Suite 500, Dorval, QC, H9S 5J9, Canada
Tel.: +1 514 422 8271
Fax: +1 514 422 8272


Aim:  The aim of this study was to characterise the natural course of smoking cessation behaviour in a web-based survey of current and former cigarette smokers (CS and FS) in the United States.

Methods:  A web-based survey of CS and FS was conducted in April 2009; demographic and socioeconomic characteristics and smoking history (including the number of lifetime and length of latest quit attempts, aids used and time to relapse) were collated. The surveyed cohort was selected from prescreened CS and FS panellists and matched for age, race and education, to be representative of the US population. Descriptive statistics and time-to-event analyses using Kaplan–Meier curves were applied in the analysis of this report.

Results:  The final cohort comprised 512 CS and 566 FS (n = 1078). A larger proportion of FS than CS reported a longest smoke-free period of > 1 year (78.8% vs. 22.4%, respectively). As a greater variety of smoking cessation products became available over time, the proportion of unassisted quit attempts decreased from 76.1% prior to 1983 to 43.9% after 2006 for CS and from 79.3% to 50.3% for FS. The cumulative proportion of subjects relapsing was 31.3% by 1 week and 79.3% by 6 months. The estimated median time to next quit attempt was approximately 360 days.

Conclusions:  These data confirm that relapse is common and that as the variety of cessation modalities increase, the proportion of unassisted quit attempts decreases. Self-help or cold-turkey methods still provide significant alternatives even when pharmacotherapy is available. This study provides data related to the smoking history and smoking cessation patterns of a large, nationally representative sample of CS and FS.