Putting a lot of thought and planning into
quitting smoking may not be the best route to success,
a new study finds.
In fact, British researchers found that those smokers
who spontaneously quit were much more likely to not resume
smoking than those who planned a "quit strategy"
long in advance.
The findings run contrary to the conventional wisdom
on quitting.
"A very large proportion, probably about half, of
attempts to stop smoking are made without any pre-planning
at all," said lead researcher Robert West, a professor
of health psychology at University College London. "People
just suddenly decide to quit and do it."
Not only do about 50 percent of quitters decide to quit
suddenly, but they are more successful at quitting, West
added.
"Perhaps more surprisingly, we found that these
spur-of-the-moment quit attempts more likely to be successful,"
he said. "This goes very much against received wisdom
which says that people usually plan their quit attempts
and that planning is important for success."
The report appears in the Jan. 26 online edition of the
British Medical Journal.
In their research, West and colleague Taj Sohal collected
data on 918 smokers who reported having made at least
one attempt to quit, and compared that data to the experiences
of 996 successful ex-smokers.
West and Sohal found that 48.6 percent of smokers said
that their most recent attempt to quit happened immediately
after they made the decision to quit. Moreover, these
unplanned quit attempts were more likely to succeed for
at least six months. In fact, the odds of successfully
quitting were 2.6 times higher in unplanned attempts than
in planned attempts, the researchers found.
"This does not mean, of course, that people should
not plan quit attempts," West said. "We think
it means that there is something different about the state
of mind of someone who says 'That's it -- I've had enough,
and I'm stopping smoking right now' and someone who says
'I've decided to stop smoking and it will be after I finish
the packet tomorrow/next week/or whatever,'" he said.
Stopping smoking suddenly may reflect a more complete
intellectual switch -- the kind of shift that can turn
a smoker into a nonsmoker, West said. "The triggers
that cause this kind of shift can be very small -- having
a cold, something someone says, or even a storm outside
when one's run out of cigarettes."
This kind of switch can also be thought of in what scientists
call "catastrophe theory," West said.
"Hidden tensions build up in the system and then
a trigger, which might be quite small, unpredictably generates
a catastrophic shift -- rather like what happens with
earthquakes," he said.
If their theory is right, the researchers added, then
public health programs to promote smoking cessation might
want to adopt what the researchers are calling "The
Three Ts" model.
"Create motivational tension in smokers --
making them feel dissatisfied with being smokers, rather
than just believing that smoking is bad for them; populate
the world of the smoker with triggers to action
-- get those people who are on the cusp to take action.
And be ready with immediate treatment for smokers
who have just stopped, as well as those that planned their
quit attempt in advance," West said.
One expert thinks differences among smokers are very
personal and may reflect levels of addiction.
"I think the authors' insight is correct,"
said Saul Shiffman, a professor of psychology at the University
of Pittsburgh. "Often people are thinking about quitting
and something, apparently sudden, can push them over the
edge into quitting."
Shiffman believes that when a singular event occurs,
you have an instant motivator, which can have a positive
role in success. "At the same time, it may be that
the people who quit spontaneously are the ones who are
less dependent to begin with and have an easier time quitting,
and that's why they are more successful," he said.
Those who has had multiple attempts to quit are the
ones who have had a lot of difficulty, Shiffman said.
"Those may be the ones, with very good reason, who
are more likely to plan," he said.
Shiffman was careful to say that while quitting spontaneously
might work for some, planning has its place, too.
"Certain kinds of planning are not only good, but
necessary. We know the use of treatment like nicotine
replacement is helpful; we know that getting behavioral
help is useful. So clearly, one should not take this as
'don't bother planning anything, don't bother arranging
help, just quit on a whim.' One really should get that
help," he said.
The study coincides with an article in the Jan. 28 British
Medical Journal that claims tobacco giant British
American Tobacco (BAT) promoted the use of air filtration
devices to restaurants and bars -- even though it knew
they are only 34 percent effective in reducing levels
of secondhand smoke.
In the article, former BAT scientist Nigel Warren said
the company's primary interest in promoting the devices
was "to negate the need for smoking bans around the
world."
