The Journey to the End of Smoking

Smoking rates nationally have declined over the past 40 years from 42 percent in 1965 to 20 percent in 2007, yet this long-term success exists amidst disappointing short-term rates of cessation. This descriptive study takes a broad perspective on the overall process of addictive behavior change, using data from population surveys of ever-smokers in Maryland in 2000, 2002 and 2006 to examine the journey of smokers through the cessation process.

By the end of 2006, the population of current smokers was smaller but was also less willing to quit. The 2006 cohort of smokers had tried to quit more times than had previous cohorts. Greater percentages of smokers were in the precontemplation and contemplation stages, which indicates ambivalence about quitting. Still, the vast majority of smokers expects to quit and believes they will succeed eventually.

While there are encouraging indicators that current smokers will move toward cessation in greater numbers, their interest and desire to quit has not yet turned into proximal motivation to quit. Since many of these current smokers have already tried cessation products and services, they offer a unique perspective to tobacco-control advocates. Smokers’ unsuccessful attempts to stop need to be examined to gain insight into what goes wrong with quitting.

This article is part of a special issue on tobacco cessation in the March 2010 edition of the American Journal of Preventive Medicine.