E-poster Presentation 2014 World Cancer Congress

Making sense of quitting unassisted – exploring the reasons why smokers choose to quit on their own (#846)

Andrea L. Smith 1 , Stacy M. Carter 1 , Sally M. Dunlop 2 , Simon Chapman 3 , Becky Freeman 3
  1. Centre for Values, Ethics and Law in Medicine, University of Sydney, Sydney, NSW, Australia
  2. Cancer Prevention Division, Cancer Institute NSW, Sydney, NSW, Australia
  3. School of Public Health, University of Sydney, Sydney, NSW, Australia

Background and Context: Unassisted cessation is an enduring phenomenon and one that persists even in nations advanced in tobacco control where cessation assistance such as nicotine replacement therapy and smoking cessation medications are readily available. 

Aim: To understand why a significant proportion of smokers still choose to quit unassisted rather than consult their GP, use over-the-counter or prescribed smoking cessation pharmacotherapy, or seek support from a quitline.

Strategy/Tactics: In-depth, one-on-one interviews with Australian adult ex-smokers who quit unassisted within the past 6–24 months. 

Programme/Policy Process: Asking ex-smokers who choose to quit unassisted why they did so is an ideal way of gathering rich and informative data that can be used to inform smoking cessation policies and practices that reflect the needs of the smoker.

Outcomes/What was learned: The reasons smokers quit on their own are complex and go beyond previously reported issues such as misperceptions of effectiveness and safety of pharmacotherapy, structural barriers such as affordability and accessibility, and overconfidence in one's ability to quit unassisted. Factors impacting on a smoker's decision to quit unassisted include: (1) feeling personally responsible for quitting; (2) sizing-up the costs and benefits of assisted vs unassisted quitting; (3) giving preference to experiential quitting knowledge gained directly or indirectly over professional or theoretical knowledge; (4) believing quitting on one's own can be a positive experience. 

Deep-rooted personal and societal values such as independence, strength, autonomy, self-control and self-reliance appear to be influencing beliefs and decisions about quitting. We conclude that existing policy-related measures aimed at making assistance more readily available and affordable, or at changing smokers' attitudes and beliefs about assistance may be of limited benefit to many smokers. Alternative strategies may be necessary to support those smokers who choose to quit on their own or to persuade them of the benefits of assistance.