Unplanned quit attempts—Results from a U.S. sample of smokers and ex-smokers

Introduction: Traditionally, smokers have been encouraged to prepare for cessation in advance of a preset quit date, with the expectation that preparation would improve their chance of success. However, a recent survey of U.K. smokers found that a substantial proportion of attempts involved no preplanning and that these spontaneous attempts were actually more likely to succeed. We set out to explore further the nature of unplanned quit attempts among U.S. smokers. Methods: Nine hundred smokers and 800 ex-smokers were recruited from a market research database for an online survey and asked about the planning involved in their most recent attempt. Results: In all, 39.7% of subjects reported that their most recent quit attempt involved no preplanning (smokers: 29.5%; ex-smokers: 52.4%). Subjects who made an unplanned quit attempt were more likely to be non-white, have no college education, report smoking their first cigarette of the day more than 30 min after waking, and report no use of pharmacotherapy during their quit attempt. Controlling for these variables, the odds of a "spontaneous" quit attempt lasting for 6 months or longer were twice that of preplanned attempts (71.7% vs. 45.6%; adjusted odds ratio = 2.62, 95% CI = 1.99-3.45). Similar results were seen in a survival analysis. Discussion: The results suggest, similar to previous research, that a substantial proportion of quit attempts are unplanned and that such attempts can be a successful route to cessation. Given the frequency of such attempts, methods of making treatment available to assist unplanned quitting should be considered.