PT  - JOURNAL ARTICLE
AU  - Michael Chaiton
AU  - Lori Diemert
AU  - Joanna E Cohen
AU  - Susan J Bondy
AU  - Peter Selby
AU  - Anne Philipneri
AU  - Robert Schwartz
TI  - Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers
AID  - 10.1136/bmjopen-2016-011045
DP  - 2016 Jun 01
TA  - BMJ Open
PG  - e011045
VI  - 6
IP  - 6
4099  - http://bmjopen.bmj.com/content/6/6/e011045.short
4100  - http://bmjopen.bmj.com/content/6/6/e011045.full
SO  - BMJ Open2016 Jun 01; 6
AB  - Objectives The number of quit attempts it takes a smoker to quit successfully is a commonly reported figure among smoking cessation programmes, but previous estimates have been based on lifetime recall in cross-sectional samples of successful quitters only. The purpose of this study is to improve the estimate of number of quit attempts prior to quitting successfully.Design We used data from 1277 participants who had made an attempt to quit smoking in the Ontario Tobacco Survey, a longitudinal survey of smokers followed every 6 months for up to 3 years beginning in 2005. We calculated the number of quit attempts prior to quitting successfully under four different sets of assumptions. Our expected best set of assumptions incorporated a life table approach accounting for the declining success rates for subsequent observed quit attempts in the cohort.Results The estimated average number of quit attempts expected before quitting successfully ranged from 6.1 under the assumptions consistent with prior research, 19.6 using a constant rate approach, 29.6 using the method with the expected lowest bias, to 142 using an approach including previous recall history.Conclusions Previous estimates of number of quit attempts required to quit may be underestimating the average number of attempts as these estimates excluded smokers who have greater difficulty quitting and relied on lifetime recall of number of attempts. Understanding that for many smokers it may take 30 or more quit attempts before being successful may assist with clinical expectations.