Defining and understanding success at smoking reduction: a mixed-methods study

Abstract

Much is known about the outcomes of different smoking reduction and cessation programs. However there is a lack of information about the degree to which such programs can achieve successes after initial failures. This study evaluated the patterns of success and failure during a smoking reduction intervention with a sample of 164 adult smokers (mean age 62; mean baseline smoking rate 21.2 cigarettes per day) who wanted to reduce their smoking but were not ready to attempt cessation. Success was defined by both self-reported number of cigarettes smoked assessed during counseling calls and carbon monoxide levels at 3 and 12 month follow-ups. There was a strong relationship between initial success/failure and eventual outcome using both assessment methods, and a moderate relationship between success categorization using the different methods (r=.43). Qualitative contextual data identified that types of travel, work and family environmental barriers experienced differed across success categories. This research confirms the importance of initial success in changing addictive behaviors and suggests directions for future research; including ways to enhance initial success, and the suggestion that more study is needed regarding the generalizability of these findings across settings and behaviors.

Figure 1

Possible participant paths based on self-reported goal attainment or failure.

Figure 2

Possible participant paths based on object CO outcomes at 3 and 12 months post initiation of the intervention.

Figure 3

Overall study flow diagram.

Figure 4

Smoking Less, Living More intervention structure.