Rising costs are leading to a boost in smoking cessation in England as health advice falls

Rising costs are leading to a boost in smoking cessation in England as health advice falls

In a recent study published inBMJ public healthResearchers are studying the factors that motivate smokers to quit between 2018 and 2023.

How has COVID-19 affected smoking behavior?

People try to quit smoking for a variety of reasons, including health concerns, social issues, cost, and advice from health professionals. Like many people around the world, residents of England have experienced the global COVID-19 pandemic with nationwide health and financial problems, which may have influenced their motivations to quit smoking.

Understanding temporal and demographic differences in variables that motivate people to quit smoking is critical to developing treatments to support smoking cessation.

About the study

In this study, researchers examine changes in smoking cessation attempts over the past five years, focusing on health concerns, costs, social factors, and advice from medical experts. The influence of age, gender, socioeconomic level, vaping status and number of offspring on these changes was also assessed.

The data comes from the Smoking Toolkit Study, a nationwide cross-sectional survey of adult residents in England between 2018 and 2023. The study included 5,777 previous-year cigarette smokers who had tried to quit smoking at least once in the previous year.

Changes in the percentage of quit attempts triggered by health concerns, social characteristics, costs, and physician advice were identified and used to create prevalence ratios to account for variations in prevalences across the study period.

These data were collected through computer-assisted interviews before the start of the COVID-19 pandemic and by telephone after the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Descriptive data on quit motivations averaged over the study period were provided. In addition, logarithmic-binomial regressions were used to analyze the data, also taking into account possible mediating factors such as age, gender, occupational social status, number of children in the family, and vaping status.

A sensitivity analysis examining current health concerns and future health problems was also conducted to identify differences.

Study results

Of the 101,919 people included in the study, 96% reported attempts to quit smoking in the past year, with 34% reporting making at least one serious attempt. Health-related concerns were the most commonly cited motivation by 52% of the study cohort, particularly future health-related concerns at 36%.

Financial concerns were the second most common motivation, followed by societal considerations and recommendations from medical experts at 23%, 19% and 12%, respectively, while 0.6-3.7% of people supported other motivations.

By 2020, the percentage of efforts to quit cigarette smoking that were based on health concerns, social considerations, and cost increased to 56%, 24%, and 26%, respectively. The proportion of health professionals providing advice fell to 8%; However, health-related and social motivation rates decreased significantly to baseline levels or less, from over 50% to 16% and 22%, respectively.

Health problems were consistently cited as the most common reason for attempting to quit smoking, with these factors reported by 48-56% of individuals across all demographic groups. These factors were more commonly reported by people aged 35 and older and by people who did not have children at home.

Older people, women and those with lower socioeconomic status were more likely to say current health problems were a motivating factor. Those who didn't have children at home were also more likely to be motivated by current and future health problems.

Those from the middle socioeconomic class and those who actively vaped were more likely to cite cost as a motivating factor for quitting smoking. Younger people from middle-class families, those with children, and those who currently smoke were more likely to report social motives. Older women from lower socioeconomic backgrounds were more likely to quit smoking on the advice of a doctor.

Overall, there were minimal changes in quit attempts attributed to health problems throughout the study period. However, the percentage of people who cited health problems as a reason for their recent efforts to quit smoking increased in 2020, peaking at 56% in October 2020, before falling back to baseline levels in December 2021.

This trend was influenced primarily by impending health problems, with small changes in smoking cessation attempts over time triggered by current health problems.

Conclusions

Health concerns remain the most common reason for quitting smoking. However, after 2020, the focus shifted to costs rather than societal considerations and recommendations from healthcare providers.

These changes are likely due to the COVID-19 pandemic, which increased health concerns, particularly among the elderly and those in lower occupational and social categories. The rising cost of smoking is also a key motivator for smoking cessation, highlighting that potential savings could provide incentives for smoking cessation.

Future studies are needed to investigate the reasons for inhibited efforts based on the guidance of healthcare professionals and to develop improved solutions.

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