Positive smoker identity as a barrier to quitting smoking: findings from a national survey of smokers in England

Drug Alcohol Depend. 2013 Dec 1;133(2):740-5. doi: 10.1016/j.drugalcdep.2013.09.001. Epub 2013 Sep 10.

Abstract

Background: It has been proposed that positive smoker identity may be an important factor undermining smoking cessation but very little research exists on this. This study tested the hypothesis that a simple measure of positive smoker identity would predict quit attempts over and above other known predictors in a population sample. More tentatively it explored whether this measure would also predict quit success.

Methods: A representative sample of adult smokers in England (n=9456) was included at baseline and 2099 were followed-up at six months. Demographic and smoking characteristics, a single item measure of positive smoker identity (endorsing the statement: 'I like being a smoker'), measures of smoking-related attitudes, quit attempts and quit success were included.

Results: A total of 18.3% (95% CI=17.5-19.2) of smokers reported a positive smoker identity. Adjusting for all other predictors, those with a positive smoker identity were more likely to be older (p<0.001), male (p=0.013), more nicotine dependent (p<0.001), have lower motivation to stop (p<0.001), have not made a quit attempt in the past year (p=0.025), enjoy smoking (p<0.001), and consider themselves to be addicted (p<0.001). Having a positive smoker identity independently predicted failure to make a quit attempt at six months (p=0.007). The independent association with quit success was similar in magnitude but did not reach statistical significance (p=0.053).

Conclusions: Only a minority of smokers in England have a positive smoker identity. However, where it is present it may be an important barrier to quitting smoking and merits further study.

Keywords: Barriers; Positive smoker identity; Quit attempt; Quit success; Smoking Toolkit Study; Smoking cessation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Attitude
  • England / epidemiology
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Motivation
  • Prevalence
  • Reinforcement, Psychology
  • Sex Factors
  • Smoking / epidemiology
  • Smoking / psychology*
  • Smoking Cessation / psychology*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult