RESEARCH PAPER
Smoking cessation attempts: is it useful to treat hard core smokers?
B. Joly 1
,  
P. D’Athis 1
,  
L. Gerbaud 2
,  
J. Hazart 2
,  
J. Perriot 3
,  
C. Quantin 1, 4, 5  
 
 
More details
Hide details
1
Service de Biostatistique et d’Informatique Médicale (DIM), CHRU Dijon, Dijon, France
2
Service de santé Publique, CHU Clermont-Ferrand, EA PEPRADE4681 Université d’Auvergne, Clermont-Ferrand, France
3
Dispensaire Emile Roux, Centre d’Aide à I’Arrêt du Tabagisme (IRAAT), Centre de Lutte Anti-Tuberculeuse (CLAT), Clermont-Ferrand, France
4
INSERM, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, Clinical epidemiology/clinical trials unit, Dijon, France
5
Inserm UMR 1181 « Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases » (B2PHI), Univ. Bourgogne Franche-Comté, Dijon, France
CORRESPONDING AUTHOR
C. Quantin   

Service de Biostatistique et d’Informatique Médicale (DIM), CHRU Dijon, Dijon F-21000, France
Publish date: 2016-11-03
 
Tobacco Induced Diseases 2016;14(November):34
KEYWORDS
ABSTRACT
Background:
Hard core smokers have been studied in many countries but only a few trials have compared the effectiveness of smoking cessation with other smokers. The objective of this study was to compare the frequencies of success in smoking cessation between hard-core smokers and other smokers.

Methods:
Data were collected in Clermont-Ferrand from the Emile Roux dispensary ‘Pneumology and Tobaccology Centre’ between 1999 and 2009. Assistance with smoking cessation was proposed to 1367 patients but only 1296 patients were included: 219 HCS and 1077 other smokers. Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. The profiles of the two types of smokers were compared using Chi square test and Student’s t test. Multivariate logistic regression was used to investigate the association between the smoking cessation result and the type of smokers.

Results:
HCS more frequently consumed other psychoactive substances (41.1 % vs 25.7 % for other smokers; p < 0.001). Current depression was more frequent in HCS (46.6 % vs 34.8 % for other smokers; p = 0.001). Smoking cessation was less frequent in HCS (45.2 % vs 56.5 % for other smokers ; p = 0.002). In multivariate analysis, after controlling for other factors, the frequency of smoking cessation was not significantly associated with the type of smokers (p = 0.47). After limiting to initial factors (present before the beginning of smoking cessation), the frequency of smoking cessation was still not significantly associated with the type of smokers (p = 0.78).

Conclusions:
Smoking cessation is possible for hard core smokers, who should be treated as other types of smokers taking into account other factors:the problem is how to encourage them to try to stop smoking.

 
REFERENCES (40)
1.
System GGTS, editor. The GATS Atlas: Global Adult Tobacco Survey. Myriad edition, 59 lansdowne place, brighton BN3 1FL, UK: CDC Foundation; Center For Disease Control And Prevention (CDC); Global Tobacco Surveillance System; World Health Organization; World Lung Foundation; 2015.
 
2.
Tavolacci MP, Marini H, Bailly L, Ladner J. Prevalence and socio-health characteristic of hard-core smokers in Haute-Normandie. Sante Publique. 2009;21(6):583–93.
 
3.
Etter JF, Perneger TV, Ronchi A. Distributions of smokers by stage: international comparison and association with smoking prevalence. Prev Med. 1997;26(4):580–5.
 
4.
von Soest T, Pedersen W. Hardcore adolescent smokers? An examination of the hardening hypothesis by using survey data from two Norwegian samples collected eight years apart. Nicotine Tob Res. 2014;16(9):1232–9.
 
5.
Clare P, Bradford D, Courtney RJ, Martire K, Mattick RP. The relationship between socioeconomic status and 'hardcore' smoking over time--greater accumulation of hardened smokers in low-SES than high-SES smokers. Tob Control. 2014;23(e2):e133–8.
 
6.
Kishore J, Jena PK, Bandyopadhyay C, Swain M, Das S, Banerjee I. Hardcore smoking in three South-East asian countries: results from the global adult tobacco survey. Asian Pac J Cancer Prev. 2013;14(2):625–30.
 
7.
Jena PK, Bandyopadhyay C, Mathur MR, Das S. Extending application of the 'hardcore' definition to smokeless tobacco use: estimates from a nationally representative population in India and its implications. Asian Pac J Cancer Prev. 2012;13(12):5959–63.
 
8.
Kaleta D, Usidame B, Dziankowska-Zaborszczyk E, Makowiec-Dabrowska T, Leinsalu M. Prevalence and factors associated with hardcore smoking in Poland: findings from the Global Adult Tobacco Survey (2009–2010). BMC Public Health. 2014;14:583.
 
9.
Perriot J, Underner M, Peiffer G, Le Houezec J, Samalin L, Schmitt A, et al. Helping the "hard-core" smokers. Rev Mal Respir. 2012;29(4):448–61.
 
10.
Seidman DF, Covey LS. In: Erlbaum L, editor. Helping the hard-core smoker: a clinician’s guide. New York: Oxford University Press. 1999.
 
11.
Walsh RA, Paul CL, Tzelepis F, Stojanovski E. Quit smoking behaviours and intentions and hard-core smoking in New South Wales. Health Promot J Austr. 2006;17(1):54–60.
 
12.
Perriot J. Provision of smoking cessation therapy. Rev Mal Respir. 2006;23(1 Suppl):3S85–105.
 
13.
Costa ML, Cohen JE, Chaiton MO, Ip D, McDonald P, Ferrence R. "Hardcore" definitions and their application to a population-based sample of smokers. Nicotine Tob Res. 2010;12(8):860–4.
 
14.
Darville A, Hahn EJ. Hardcore smokers: what do we know? Addict Behav. 2014;39(12):1706–12.
 
15.
Perriot J. L’aide à l’arrêt du tabagisme des fumeurs irréductibles. Le Courrier des addictions. 2010;12(1):15–7.
 
16.
Hyland A, Li Q, Bauer JE, Giovino GA, Steger C, Cummings KM. Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res. 2004;6 Suppl 3:S363–9.
 
17.
Joseph AM, Bliss RL, Zhao F, Lando H. Predictors of smoking reduction without formal intervention. Nicotine Tob Res. 2005;7(2):277–82.
 
18.
Schnoll RA, Lerman C. Current and emerging pharmacotherapies for treating tobacco dependence. Expert Opin Emerg Drugs. 2006;11(3):429–44.
 
19.
Shiffman S, Brockwell SE, Pillitteri JL, Gitchell JG. Individual differences in adoption of treatment for smoking cessation: demographic and smoking history characteristics. Drug Alcohol Depend. 2008;93(1–2):121–31.
 
20.
Augustson E, Marcus S. Use of the current population survey to characterize subpopulations of continued smokers: a national perspective on the "hardcore" smoker phenomenon. Nicotine Tob Res. 2004;6(4):621–9.
 
21.
Jarvis MJ, Wardle J, Waller J, Owen L. Prevalence of hardcore smoking in England, and associated attitudes and beliefs: cross sectional study. BMJ. 2003;326(7398):1061.
 
22.
Tabac EC, editor. Comprendre pour agir. 2001.
 
23.
Godtfredsen NS, Prescott E. Benefits of smoking cessation with focus on cardiovascular and respiratory comorbidities. Clin Respir J. 2011;5(4):187–94.
 
24.
Jimenez-Ruiz CA, Andreas S, Lewis KE, Tonnesen P, van Schayck CP, Hajek P, et al. Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit. Eur Respir J. 2015;46(1):61–79.
 
25.
Scholte op Reimer W, de Swart E, De Bacquer D, Pyorala K, Keil U, Heidrich J, et al. Smoking behaviour in European patients with established coronary heart disease. Eur Heart J. 2006;27(1):35–41.
 
26.
Kotseva K, Wood D, De Bacquer D, De Backer G, Ryden L, Jennings C, et al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2015;16.
 
27.
Gregor K, Borrelli B. Barriers to quitting smoking among medically ill smokers. J Behav Med. 2012;35(5):484–91.
 
28.
Fiore Jr JF, Chiavegato LD, Denehy L, Paisani DM, Faresin SM. Do directed cough maneuvers improve cough effectiveness in the early period after open heart surgery? Effect of thoracic support and maximal inspiration on cough peak expiratory flow, cough expiratory volume, and thoracic pain. Respir Care. 2008;53(8):1027–34.
 
29.
Goodwin RD, Wall MM, Choo T, Galea S, Horowitz J, Nomura Y, et al. Changes in the prevalence of mood and anxiety disorders among male and female current smokers in the United States: 1990–2001. Ann Epidemiol. 2014;24(7):493–7.
 
30.
Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: A population-based prevalence study. Jama. 2000;284(20):2606–10.
 
31.
Baiardini I, Sorino C, Di Marco F, Facchini F. Smoking cessation, anxiety, mood and quality of life: reassuring evidences. Minerva Med. 2014;14.
 
32.
Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ. 2014;348:g1151.
 
33.
Brown RA, Kahler CW, Zvolensky MJ, Lejuez CW, Ramsey SE. Anxiety sensitivity: relationship to negative affect smoking and smoking cessation in smokers with past major depressive disorder. Addict Behav. 2001;26(6):887–99.
 
34.
McClave AK, Dube SR, Strine TW, Kroenke K, Caraballo RS, Mokdad AH. Associations between smoking cessation and anxiety and depression among U.S. adults. Addict Behav. 2009;34(6–7):491–7.
 
35.
Zvolensky MJ, Stewart SH, Vujanovic AA, Gavric D, Steeves D. Anxiety sensitivity and anxiety and depressive symptoms in the prediction of early smoking lapse and relapse during smoking cessation treatment. Nicotine Tob Res. 2009;11(3):323–31.
 
36.
Zvolensky MJ, Bakhshaie J, Sheffer C, Perez A, Goodwin RD. Major depressive disorder and smoking relapse among adults in the United States: a 10-year, prospective investigation. Psychiatry Res. 2015;226(1):73–7.
 
37.
Lund M, Lund KE, Kvaavik E. Hardcore smokers in Norway 1996–2009. Nicotine Tob Res. 2011;13(11):1132–9.
 
38.
Bommele J, Kleinjan M, Schoenmakers TM, Burk WJ, van den Eijnden R, van de Mheen D. Identifying subgroups among hardcore smokers: a latent profile approach. PLoS One. 2015;10(7), e0133570.
 
39.
Lam TH, Cheung YT, Leung DY, Abdullah AS, Chan SS. Effectiveness of smoking reduction intervention for hardcore smokers. Tob Induc Dis. 2015;13(1):9.
 
40.
Emery S, Gilpin EA, Ake C, Farkas AJ, Pierce JP. Characterizing and identifying "hard-core" smokers: implications for further reducing smoking prevalence. Am J Public Health. 2000;90(3):387–94.
 
 
CITATIONS (4):
1.
Tobacco Treatment Guideline for High Risk Groups: A pilot study in patients with Chronic Obstructive Pulmonary Disease
Antigona Trofor, Sophia Papadakis, Lucia Lotrean, Ioana Buculei- Porosnicu, Vergina Vyzikidou, Vaso Evangelopoulou, Constantine Vardavas, Panagiotis Behrakis
Tobacco Induced Diseases
 
2.
Is ‘hardcore smoker’ a useful term in tobacco control?
Robert West, Martin J. Jarvis
Addiction
 
3.
The Longitudinal Relationships between Depression and Smoking in Hardcore Smokers Using Autoregressive Cross-Lagged Modeling
Jeong Han, Hanna Lee
Journal of Korean Academy of Nursing
 
4.
Impact of a standardized referral to a community pharmacist-led smoking cessation program before elective joint replacement surgery
Lauren Beaupre, Fadi Hammal, Chrisopher DeSutter, Robert Stiegelmar, Edward Masson, Barry Finegan
Tobacco Induced Diseases
 
eISSN:1617-9625