Predictors for successful quitting among more than 4000 smokers using SMS or internet-based programs

Abstract

Background: The prevalence of daily smoking in Norway has decreased over the years among both men and women like in other developed countries. However, smoking remains one of the world’s leading causes of preventable deaths. A web-based smoking cessation service is one of the aids for quitting smoking. The Directorate of Health opened the website, www.slutta.no to the Norwegian public as part of the national smoking cessation strategy. The purpose of the present study was to determine if selected characteristics could predict successful smoking cessation among smokers using a web-based cessation program for quitting smoking in Norway. Methods: We followed 4,335 Norwegian men and women who signed up to a multi-component Norwegian internet-based smoking cessation program, www.slutta.no. The outcome was a self-reported, no smoking past 7 days at 1 month, 3, 6 and 12 months. We used Logistic regression model to test for predictors of successful quitting at 1 month, 3, 6 and 12 months, while adjusting for relevant confounders with emphasis on predictors at 6 months. Results: At 6 months, those who reported to have more than 9 years of education were twice as likely to successfully quit smoking [10-12 (OR=2.19; 95% CI=1.15-4.17), 13-16 (OR=2.65; 95% CI=1.40-5.01) and ≥17 (OR=2.65; 95% CI=1.37-5.11)] compared with those who reported to have 9 years or less education. Those who reported having a very strong motivation at enrollment had twice (OR=2.04; 95% CI=1.36-3.06) the success of quitting smoking compared with those who reported having a weak motivation.. Compared with non-snus users, the success of quitting smoking was significantly decreased with 51% for both occasional snus users (OR=0.49; 95% CI=0.33-0.74) and daily snus users (OR=0.49; 95% CI=0.27-0.90). Other significant predictors of decreased successful cessation included having many friends who smoked, experiencing social pressure to quit, hating most to give up the first cigarette in the morning, and not working. In addition, those who reported they had tried to quit before had a 39% decreased (OR=0.61; 95% CI=0.43-0.89) success of quitting smoking compared with those who had not. Conclusions: Health workers and officials can use the knowledge about the predictors of successful smoking cessation for those using a web-based cessation service to encourage smokers in these categories and in campaigns for smoking cessation. The results may be used to revise and improve the web-based cessation service so smokers with lower education, who are unemployed and who use snus daily or occasionally can succeed in their cessation attempt.