Gradual Versus Abrupt Quitting Among French Treatment-seeking Smokers.
1Association Robert Debré pour la Recherche Médicale, Paris, France
2Univ. Paris Diderot, Sorbonne Paris Cité, Paris, France
3AP-HP, Hôpital Européen Georges Pompidou, Paris, France
Background: Until recently, smoking cessation guidelines only recommended abrupt quitting. Yet, almost half of smokers interested in quitting plan to quit gradually. This study examined predictors of gradual quitting among treatment-seeking smokers. Methods: We examined quit attempts of 28156 adult smokers who attended French cessation services nationwide in 2007-2010. Predictors of gradual quitting were determined with multivariate regression models. Findings: Only 4.4% quit gradually while 48.7% quit abruptly. Gradual quitting was associated with: older age, heavy smoking at baseline, no previous quit attempts, low self-efficacy, baseline intake of anxiolytics, symptoms of depression and history of depressive episodes. Gradual quitters had a similar anxio-depressive profile than continued smokers. Gradual quitters were twice more likely to be prescribed oral nicotine replacement therapy than abrupt quitters. Odds of gradual quitting vs. continued smoking improved with the number of follow-up visits. Discussion. Hard-to-treat smokers may be more likely to quit gradually than abruptly. However, intense follow-up with adapted treatment seems crucial to achieve cessation gradually.