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Retrospective analysis of changing characteristics of treatment-seeking smokers: implications for further reducing smoking prevalence
  1. Teresa M Leyro1,
  2. Erin E Crew2,
  3. Susan W Bryson3†,
  4. Anna Lembke4,
  5. Steffani R Bailey5,
  6. Judith J Prochaska2,
  7. Lisa Henriksen2,
  8. Stephen P Fortmann2,6,
  9. Joel D Killen2,
  10. Diana T Killen2,
  11. Sharon M Hall7,
  12. Sean P David8
  1. 1Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
  2. 2Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford University, Stanford, California, USA
  3. 3Stanford Prevention Research Center, Stanford University, Palo Alto, California, USA
  4. 4Department of Psychiatry, Stanford University School of Medicine, Stanford, California, USA
  5. 5Department of Family Medicine, Oregon Health & Sciences University, Portland, Oregon, USA
  6. 6Kaiser Permanente Center for Health Research, Northwest, Portland, Oregon, USA
  7. 7Department of Psychiatry, San Francisco Treatment Research Center, University of California, San Francisco, California, USA
  8. 8Department of Medicine, Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, California, USA
  1. Correspondence to Dr Teresa M Leyro; teresa.leyro{at}


Objective The goal of the current study was to empirically compare successive cohorts of treatment-seeking smokers who enrolled in randomised clinical trials in a region of the USA characterised by strong tobacco control policies and low smoking prevalence, over the past three decades.

Design Retrospective treatment cohort comparison.

Setting Data were collected from 9 randomised clinical trials conducted at Stanford University and the University of California, San Francisco, between 1990 and 2013.

Participants Data from a total of 2083 participants were included (Stanford, n=1356; University of California San Francisco, n=727).

Primary and secondary outcomes One-way analysis of variance and covariance, χ2 and logistic regression analyses were used to examine relations between nicotine dependence, cigarettes per day, depressive symptoms and demographic characteristics among study cohorts.

Results Similar trends were observed at both settings. When compared to earlier trials, participants in more recent trials smoked fewer cigarettes, were less nicotine-dependent, reported more depressive symptoms, were more likely to be male and more likely to be from a minority ethnic/racial group, than those enrolled in initial trials (all p's<0.05). Analysis of covariances revealed that cigarettes per day, nicotine dependence and current depressive symptom scores were each significantly related to trial (all p's<0.001).

Conclusions Our findings suggest that more recent smoking cessation treatment-seeking cohorts in a low prevalence region were characterised by less smoking severity, more severe symptoms of depression and were more likely to be male and from a minority racial/ethnic group.


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