Characteristics of smoking cessation among hard-core smokers (HCS)

Introduction: “Hard-Core Smokers » (HCS) are an heterogeneous population which received increasing interest in research literature.According to English terminology, those smokers are unmotivated to quit withoutprevious attempts to stop and Heavy chronic and dependent smokers failed in their repeated attempts to stop smoking. Aims: We aimed to describe the general characteristics,the history of smoking, the tobacco dependence and the specifics of those “irreducible” or “difficult” smokers and consider predictors of smoking cessation in this particular population. Methods: We retrospectively studied the files of smokers followed between 1999 and 2015. Factors influencing smoking cessation are identified by univariate and multivariate analysis. Results: A total of 2056 smokers were enrolled, 640 were HCS (31%). The mean age was 44,43±13,7 years.Ninety-two percent of these smokers were male. The age of onset of smoking was on average 17.6 ± 4.6 years and 334 smokers (52.2%) had started smoking before the age of 18. The most common behavioral dependence was the smoking habit among 335 smokers (45.5%). The majority of smokers had a strong physical dependence assessed by Fagerstrom score ≥7 (66%). Only 21% of smokers have successfully quit smoking. In a multivariate analysis, predictors of smoking cessation were the age of the smoker, the age of onset of smoking, the number of cigarettes smoked per day, the Fagerstrom score, Co expired rate and the Hospital Anxiety Depression (HAD) score. Conclusion: Hard-Core Smokers(HCS) represent a priority target in the smoking cessation consultations. Praticians must optimize their therapeutic proposals and expand their collaboration on the management of these smokers.