Do smokers quit after hospital cessation trials? Don’t count on it, or them
Several years ago, researchers recruited sick smokers at a group of hospitals—the Consortium of Hospitals Advancing Research on Tobacco, or “CHART”—and conducted federally supported smoking cessation trials. Taneisha Scheuermann and colleagues, writing in the journal Addiction, examine the post-trial results, focusing on levels of cotinine, a nicotine-breakdown product, in trial participants’ saliva.
Hospitals in six cities provided 5,827 smoking patients with a variety of quit-smoking interventions. Six months later, 4,206 of those subjects completed a survey, with 1,708 reporting that they had not smoked in the past seven days. Nearly 10 percent of them reported using pharmaceutical nicotine, e-cigarettes or other tobacco harm reduction products in the past seven days; those subjects were among the 530 excluded from the Scheuermann analysis. Self-described nonsmokers were offered $50 to $100 in exchange for saliva samples, but only 923 participants responded; of those, 822 supplied usable samples.
Scheuermann used a standard saliva cotinine cutoff of 10 nanograms per-milliliter: participants below this level were considered to be not smoking, while those at or above were still smoking.
Of the 822 participants who reported seven-day abstinence, 347 (42.2 percent) were dissembling, as their saliva cotinine levels indicated they were smoking.
That so many individuals failed to quit evidences a fact that tobacco prohibitionists often ignore: The vast majority of smokers are unable or unwilling to quit. The 475 verified quitters constituted roughly 8 percent of the 5,827 patients who started the trials – a percentage that is consistent with the quit rate among the general population. Also note that these smokers were recruited during a hospitalization, when their focus on health issues might have increased their motivation to quit.
Treating smokers as social outcasts may influence their decision to lie about the results of their quit attempts.
Image by Kaspars Grinvalds