Adolescent Smoker's Sources of Smoking Cessation Support
Adolescent Smoker's Sources of Smoking Cessation Support
To the best of our knowledge this is the first study to quantify young smokers' use of cessation support. Our findings show that whilst approximately two thirds of current and ex-smokers reported having used one or more means of cessation support, the most frequently utilised mechanisms were quite informal, such as seeking advice from friends and family or choosing not to spend time with friends who smoke. More formal avenues of support, such as seeking advice from a GP, or using the NHS telephone or face-to-face smoking cessation services, were very infrequently used. At present there is little evidence that young people's use of pharmacotherapy can increase quit success; further work is warranted in this area given that a relatively large proportion (15.4 %) of participants in this study, particularly those who smoked more cigarettes per week, reported having used nicotine products to help them quit. Further work would also be of use to understand the effectiveness of approaches to promoting cessation which combine different methods of support; there is some evidence that complex interventions, and those engaging with young smokers over a more extended period of time, may be effective in achieving cessation.
The major strength of this study was the use of a representative sample of young people aged 11–16 living in England, though caution is warranted when generalizing the results of this study to young people living elsewhere. Unfortunately, the cross-sectional design of the Smoking, Drinking and Drug Use in Young People survey, and the nature of the questions asked, means we were not able to investigate whether reported use of particular types of quit support is associated with successful cessation. Cohort studies or randomised controlled trials may help to provide further evidence to support recommendations for the use of particular types of cessation support in this age group. We were also limited in our investigation of factors associated with use of cessation support to variables on which data were available from the Smoking, Drinking and Drug Use in Young People survey. No data were available on the extent of addiction of smoking, though this has previously been shown to be associated with cessation. Similarly, other studies have demonstrated an association between frequency of adolescent drug and alcohol use and making a quit attempt; we found no significant associations between reported substance use and use of cessation support, though our definition of substance use was less detailed compared to other studies as we were not able to identify frequency of cannabis use or binge drinking from the survey dataset.
In adults there is evidence to suggest that unaided quit attempts are the least likely to succeed. If future research suggests the same holds true in the age group studied here, then attention should be paid to understanding which young people are least likely to utilise support when trying to quit, as well as considering how to increase uptake of support in these groups. The results presented here show that current smokers who smoked fewer cigarettes per week were less likely to report use of cessation support than heavier smokers. Further work is warranted to investigate attitudes towards smoking cessation in young people who smoke relatively few cigarettes per week and how to ensure successful cessation in this group. Adolescents who had received lessons on smoking in the last 12 months were more likely to report overall use of cessation support and choosing not to spend time with friends who smoke. If this is shown to be an effective way of enabling and supporting successful cessation then this would justify continued promotion of, and investment in, the delivery of smoking education in schools. In England, however, questions have been raised about the quality of Personal, Social, Health and Economic Education (PSHE), of which teaching about smoking is a part.
In conclusion, this study has shown that the majority of young smokers proactively use several means of support when trying to quit. More evidence is needed to quantify the effectiveness of cessation support mechanisms which are acceptable to young smokers.
Discussion and Conclusions
To the best of our knowledge this is the first study to quantify young smokers' use of cessation support. Our findings show that whilst approximately two thirds of current and ex-smokers reported having used one or more means of cessation support, the most frequently utilised mechanisms were quite informal, such as seeking advice from friends and family or choosing not to spend time with friends who smoke. More formal avenues of support, such as seeking advice from a GP, or using the NHS telephone or face-to-face smoking cessation services, were very infrequently used. At present there is little evidence that young people's use of pharmacotherapy can increase quit success; further work is warranted in this area given that a relatively large proportion (15.4 %) of participants in this study, particularly those who smoked more cigarettes per week, reported having used nicotine products to help them quit. Further work would also be of use to understand the effectiveness of approaches to promoting cessation which combine different methods of support; there is some evidence that complex interventions, and those engaging with young smokers over a more extended period of time, may be effective in achieving cessation.
The major strength of this study was the use of a representative sample of young people aged 11–16 living in England, though caution is warranted when generalizing the results of this study to young people living elsewhere. Unfortunately, the cross-sectional design of the Smoking, Drinking and Drug Use in Young People survey, and the nature of the questions asked, means we were not able to investigate whether reported use of particular types of quit support is associated with successful cessation. Cohort studies or randomised controlled trials may help to provide further evidence to support recommendations for the use of particular types of cessation support in this age group. We were also limited in our investigation of factors associated with use of cessation support to variables on which data were available from the Smoking, Drinking and Drug Use in Young People survey. No data were available on the extent of addiction of smoking, though this has previously been shown to be associated with cessation. Similarly, other studies have demonstrated an association between frequency of adolescent drug and alcohol use and making a quit attempt; we found no significant associations between reported substance use and use of cessation support, though our definition of substance use was less detailed compared to other studies as we were not able to identify frequency of cannabis use or binge drinking from the survey dataset.
In adults there is evidence to suggest that unaided quit attempts are the least likely to succeed. If future research suggests the same holds true in the age group studied here, then attention should be paid to understanding which young people are least likely to utilise support when trying to quit, as well as considering how to increase uptake of support in these groups. The results presented here show that current smokers who smoked fewer cigarettes per week were less likely to report use of cessation support than heavier smokers. Further work is warranted to investigate attitudes towards smoking cessation in young people who smoke relatively few cigarettes per week and how to ensure successful cessation in this group. Adolescents who had received lessons on smoking in the last 12 months were more likely to report overall use of cessation support and choosing not to spend time with friends who smoke. If this is shown to be an effective way of enabling and supporting successful cessation then this would justify continued promotion of, and investment in, the delivery of smoking education in schools. In England, however, questions have been raised about the quality of Personal, Social, Health and Economic Education (PSHE), of which teaching about smoking is a part.
In conclusion, this study has shown that the majority of young smokers proactively use several means of support when trying to quit. More evidence is needed to quantify the effectiveness of cessation support mechanisms which are acceptable to young smokers.