Tobacco use continues to be the leading preventable cause of death worldwide. Despite reduced rates of smoking among countries with effective tobacco control programs, the total number of smokers has actually increased over the past 30 years. International smoking trends have been influenced by global population growth, tobacco industry marketing in poorer and underdeveloped nations, limited awareness of smoking-related health risks and lack of access to frontline smoking interventions. There is also reason to believe that some smokers with certain characteristics or co-occurring conditions may have greater difficulty quitting. Factors that have been associated with poorer cessation outcomes include older age, lower socioeconomic status, exposure to other smokers in the home, greater tobacco dependence and more severe nicotine withdrawal symptoms during smoking abstinence, lower motivation and selfefficacy for quitting, greater negative affect, and the presence of comorbid depression, anxiety and co-occurring substance use disorders. Collectively, these data suggest that cessation rates may be enhanced by increasing the worldwide implementation of tobacco education and control programs, and by targeting recalcitrant smokers who have tried to quit without success.
© 2015 S. Karger AG, BaselTobacco use continues to be the leading global cause of preventable death, with greater than 5 million annual deaths attributable to tobacco-related illnesses [1]. The World Health Organization has further estimated that if current trends continue, by 2030 tobacco will be responsible for 8 million deaths each year, with the vast majority occurring among persons living in low-to middle-income countries. Thus, it is imperative to examine patterns and predictors of smoking cessation, as these data may inform emerging tobacco control policies and the development of novel treatments. To this end, we first discuss international trends in smoking cessation, with a focus on how observed reductions in the prevalence of smoking among countries with effective tobacco control programs have been offset by an escalating tobacco epidemic in the developing world. We then examine factors that have consistently been shown to predict abstinence and relapse to smoking, including sociodemographic characteristics, household smoking behaviors, motivation and self-efficacy for quitting, nicotine/ tobacco dependence and withdrawal severity, and co-occurring/individual difference factors that may make quitting more difficult for some subpopulations of tobacco smokers.
International Trends in Tobacco Smoking and CessationTobacco smoking statistics are often reported in terms of the percentage of persons in a given population who are classified as smokers (see also chapter 2). However, given that factors such as population growth can influence the interpretability and comparability of percentages over time, inferences regarding overall public health impact should also take into account the total number of smokers within and across populations. For example,...