Success Factors for Quitting Smoking

Smoking has been linked to a higher risk of breast cancer incidence and recurrence. For many reasons, quitting smoking is one of the healthiest actions that a person can undertake-but it is also one of the most difficult.

Who is more successful at quitting smoking, men or women? According to a new study by a team of Mayo Clinic researchers, the answer is-men.

Writing in the journal Chest, Dr. Lowell Dale of the Mayo Clinic's Nicotine Dependence Center and colleagues also noted that the first two weeks of abstinence are critical in predicting long-term cessation. Furthermore, a non-nicotine pill called bupropion appears to be an effective stop-smoking aid for all types of patients.

The researchers monitored a group of 615 smokers from the Mayo Clinic, the Palo Alto Center for Pulmonary Disease Prevention, and West Virginia University. The smokers were randomly assigned to receive the drug bupropion or a placebo.

"By identifying smokers who are more likely to succeed or fail with bupropion therapy, treatment decisions can be made that might increase the patient's likelihood of stopping," said Dale. "We can use this study's findings to determine who should receive a brief behavioral intervention and who might need more intense therapy."

The researchers found that several characteristics of smokers predicted greater rates of success in their cessation efforts:

• Gender-Males in the study tended to do better than females.
• First Attempts-People who have never quit or who have quit for at least a month are more likely to succeed.
• Cigarettes Smoked per Day-Lighter smokers were more likely to stop.
• Bupropion-People on a higher dose of bupropion were more successful.
• Age-Older people stopped at higher rates.
• Household Smoking-People living in smoke-free households were more successful.

Interestingly, male gender turned out to be a predictor of greater long-term abstinence among the participants in the study. "While some studies have not found a gender difference in ability to stop smoking," Dale said, "other studies have noted that women have more trouble quitting than men. This has been attributed to women's greater concerns about weight gain when they stop."

Dale added that women also tend to have higher rates of depression than men and are more likely to use smoking as a means of managing mood.

Another key finding was that the first two weeks after stopping were absolutely crucial for long-term success. "Patients and physicians must put more effort into those first few weeks of treatment," warned Dale. He recommended counseling, bupropion and nicotine replacement as measures that should be aggressively undertaken to "increase their likelihood of quitting for good."

SOURCES:
The Mayo Clinic (http://www.mayo.edu)
Chest, May 2001

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