ATTUD Journal Club Postings

How many attempts does it take to quit?

We have all been asked “how many times does it take to quit smoking, on average?” I, myself, think this is a silly question. When I am asked this, I ask “why do you want to know.” What I hear is that smokers want to know whether they are abnormal in taking many attempts and should give up and clinicians want to know when to stop “nagging” smokers to quit.

A recent study (BMJ Open 2016, 6, e011045) estimated the answer from a longitudinal Canadian survey using several different assumptions. The answer? 6‐142! But they thought 30 was most reasonable answer. Part of the problem is that smokers either fail to recall short quit attempts or rationalize that these were not “serious” quit attempt and don’t count them (Addiction, 107:673). Our studies and others indicate smoker often are reducing their cigarettes smoking and often say to themselves that they are going to quit the next day(NTR 16:1190). So I can believe the 30 number. This notion of 30 attempts before you quit may seem unreal, but remember this is 30 attempts in a lifetime.

We know that half of smokers never quit. So if  one of these 50% of smokers smokes from age 16 to 66 that’s 50 years, and 30 attempts over 50 years is an average of one attempt every 2 years which is consistent with national data that only half of smokers try to quit in a given year.

I think it’s more important for smokers and clinicians to note whether successive quit attempts are lasting longer or not.  All smokers should be encouraged to seek treatment, but those not making progress especially need to do so.  Much of the reluctance to seek treatment is the notion that quitting is all about willpower.  We need to combat this belief using analogies; i.e. how people used to think the same thing in terms of depression and alcoholism.