Smokers’ reasons for quitting in an anti-smoking social context

SummaryObjectiveTo examine the impact of the social denormalization of smoking on smokers' motives for quitting and on subsequent abstinence in a context of intensified anti-smoking measures.Study designThis study is based on data from 13,746 French smokers who were registered in cessation services nationwide between September 2006 and September 2007.MethodsMotives freely reported by smokers on their first visit to a cessation service were explored through open coding. Bivariate methods and multivariate logistic regression analyses were used to assess the association with biochemically validated abstinence at 1 month follow-up.ResultsMotives most frequently expressed by smokers were health concerns (55.0%) and cost of smoking (24.2%), but no significant association was found with abstinence. The highest abstinence rates were achieved by smokers motivated by their social network: ‘motivated or pressured by others’ (20.9%), ‘setting a good example’ (20.7%) and ‘having a smoke-free social network’ (20.3%). Smokers could no longer bear the social constraints of smoking: ‘[my] friends and family have all quit, [I] smoke outside all alone and feel left out’ and ‘I no longer want people to say with disgust that I smell of tobacco. I would like to be freed from this addiction because I'm ashamed of smoking, not at home but on the street’.ConclusionFrench smokers' motives for quitting reflect a social unacceptability of smoking which has been buttressed by measures intended to reduce tobacco use. Through smoke-free social networks, the denormalization of smoking appears to improve short-term abstinence.