More Smokers Successfully Quit On a Whim

Spontaneous decision might beat planning, study finds

FRIDAY, Jan. 27, 2006 (HealthDay News) -- Putting a lot of thought and planning into quitting smoking may not be the best route to success, a new study finds.

In fact, British researchers found that those smokers who spontaneously quit were much more likely to not resume smoking than those who planned a "quit strategy" long in advance.

The findings run contrary to the conventional wisdom on quitting.

"A very large proportion, probably about half, of attempts to stop smoking are made without any pre-planning at all," said lead researcher Robert West, a professor of health psychology at University College London. "People just suddenly decide to quit and do it."

Not only do about 50 percent of quitters decide to quit suddenly, but they are more successful at quitting, West added.

"Perhaps more surprisingly, we found that these spur-of-the-moment quit attempts more likely to be successful," he said. "This goes very much against received wisdom which says that people usually plan their quit attempts and that planning is important for success."

The report appears in the Jan. 26 online edition of the British Medical Journal.

In their research, West and colleague Taj Sohal collected data on 918 smokers who reported having made at least one attempt to quit, and compared that data to the experiences of 996 successful ex-smokers.

West and Sohal found that 48.6 percent of smokers said that their most recent attempt to quit happened immediately after they made the decision to quit. Moreover, these unplanned quit attempts were more likely to succeed for at least six months. In fact, the odds of successfully quitting were 2.6 times higher in unplanned attempts than in planned attempts, the researchers found.

"This does not mean, of course, that people should not plan quit attempts," West said. "We think it means that there is something different about the state of mind of someone who says 'That's it -- I've had enough, and I'm stopping smoking right now' and someone who says 'I've decided to stop smoking and it will be after I finish the packet tomorrow/next week/or whatever,'" he said.

Stopping smoking suddenly may reflect a more complete intellectual switch -- the kind of shift that can turn a smoker into a nonsmoker, West said. "The triggers that cause this kind of shift can be very small -- having a cold, something someone says, or even a storm outside when one's run out of cigarettes."

This kind of switch can also be thought of in what scientists call "catastrophe theory," West said.

"Hidden tensions build up in the system and then a trigger, which might be quite small, unpredictably generates a catastrophic shift -- rather like what happens with earthquakes," he said.

If their theory is right, the researchers added, then public health programs to promote smoking cessation might want to adopt what the researchers are calling "The Three Ts" model.

"Create motivational tension in smokers -- making them feel dissatisfied with being smokers, rather than just believing that smoking is bad for them; populate the world of the smoker with triggers to action -- get those people who are on the cusp to take action. And be ready with immediate treatment for smokers who have just stopped, as well as those that planned their quit attempt in advance," West said.

One expert thinks differences among smokers are very personal and may reflect levels of addiction.

"I think the authors' insight is correct," said Saul Shiffman, a professor of psychology at the University of Pittsburgh. "Often people are thinking about quitting and something, apparently sudden, can push them over the edge into quitting."

Shiffman believes that when a singular event occurs, you have an instant motivator, which can have a positive role in success. "At the same time, it may be that the people who quit spontaneously are the ones who are less dependent to begin with and have an easier time quitting, and that's why they are more successful," he said.

Those who has had multiple attempts to quit are the ones who have had a lot of difficulty, Shiffman said. "Those may be the ones, with very good reason, who are more likely to plan," he said.

Shiffman was careful to say that while quitting spontaneously might work for some, planning has its place, too.

"Certain kinds of planning are not only good, but necessary. We know the use of treatment like nicotine replacement is helpful; we know that getting behavioral help is useful. So clearly, one should not take this as 'don't bother planning anything, don't bother arranging help, just quit on a whim.' One really should get that help," he said.

The study coincides with an article in the Jan. 28 British Medical Journal that claims tobacco giant British American Tobacco (BAT) promoted the use of air filtration devices to restaurants and bars -- even though it knew they are only 34 percent effective in reducing levels of secondhand smoke.

In the article, former BAT scientist Nigel Warren said the company's primary interest in promoting the devices was "to negate the need for smoking bans around the world."

More information

Get more tips on quitting smoking at the American Cancer Society.

SOURCES: Robert West, Ph.D., professor of health psychology, University College London; Saul Shiffman, Ph.D., professor of psychology, University of Pittsburgh; Jan. 26, 2006, online edition British Medical Journal; Jan. 28, 2006, British Medical Journal
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