The process of stopping smoking has been thought to involve a series of stages, going from thinking about stopping, through planning an attempt, to actually making the attempt. Such planning is widely thought to be important for success.
Over 1,900 smokers and ex-smokers in England were interviewed about their attempts to quit, whether their most recent quit attempt was planned in advance, and whether quit attempts made at least six month's before had been successful.
Almost half of attempts to stop smoking involved no previous planning and, surprisingly, unplanned quit attempts were more likely to succeed, even after adjusting for age, sex, and socioeconomic group.
These findings do not necessarily imply that planning quit attempts is counterproductive, say the authors. Indeed, use of behavioural support and nicotine replacement therapy are known to improve the chances of success even though they generally require planning ahead.
More likely, whether a quit attempt is planned or unplanned reveals something about the state of mind of the smoker at the time, which has importance for whether the attempt will last.
They propose a theory in which smokers have varying levels of motivational "tension" to stop and then "triggers" in the environment lead to a sudden renunciation of smoking. This concept has been incorporated in a general theory of motivation and its application to addictive behaviours.
They suggest that public health campaigns should perhaps focus on what might be called the "3 Ts": creating motivational tension, triggering action in smokers who are on the cusp of a change in their orientation to smoking, and immediate availability of treatment such as nicotine patches and counselling to support those attempts.
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Contact: Emma Dickinson
edickinson@bmj.com
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BMJ-British Medical Journal
26-Jan-2006