It takes some people as many as 30 attempts to quit smoking for good, a far greater number than previously believed, according to a new study in BMJ Open, an open-access medical journal.
The study, published Friday, demonstrates the difficulty in quitting smoking, said lead researcher Dr. Michael Chaiton, scientist at the Ontario Tobacco Research Unit and assistant professor at the University of Toronto’s Dalla Lana School of Public Health. BMJ Open is associated with the publication formerly known as the British Medical Journal.
Previous estimates for attempts to quit smoking have varied. According to the study, a recent Gallup poll found it took American former smokers an average of six attempts; the Canadian Tobacco Use Monitoring Survey found 3.2 attempts. An often-cited figure is between five and seven attempts, used by the Canadian Cancer Society’s Canadian Smokers’ Helpline.
But most studies have gone back and asked smokers who successfully quit how many attempts they can recall, Chaiton said.
“People are really bad at remembering quit attempts,” he said. Other data that only includes former smokers may be biased, he added.
The BMJ Open study is an analysis of data from 1,277 adult participants in the Ontario Tobacco Survey, who had made an attempt to quit. The longitudinal survey followed up with smokers every six months for three years starting in 2005.
Participants were initially asked, “How many times have you ever made a serious attempt to quit smoking?” And then asked at six-month intervals how many attempts they had made to quit smoking for good. The analysis, which found an average of 29.6 quit attempts, incorporated frequency of the smoker’s habit. Occasional smokers needed fewer attempts.
Using recall, former smokers said they attempted to quit around six times.
Thirty attempts fits previous studies that have shown smokers, on average, attempt to quit once a year, generally in their 40s or 50s, “consistent with clinical observations,” the study said.
Success quitting varies among smokers. A substantial proportion quit on the first few tries. Yet one person in the survey recalled 216 attempts, Chaiton said. Nearly four in 10 will relapse after one year.
Rosa Dragonetti, project director of the Nicotine Dependence Clinic at the Centre for Addiction and Mental Health, said the new study aligns with current practices.
“Those of us who work with clients see this already,” Dragonetti said. Until last year clinic staff told clients 10-12 attempts could be expected. Now 20-30 is the figure used.
It’s important to note not everyone needs 30 tries, a message that could be discouraging to smokers trying to quit, Dragonetti said. For those who struggle, staff recommend added resources like behavioural interventions or medication such as nicotine replacement therapies.