Impact of a Medical Diagnosis on Decision to Stop Smoking and Successful Smoking Cessation.

Abstract Smoking cessation counseling is a central part of the Medicare guidelines for lung cancer screening. With increasing age, many heavy smokers eventually stop smoking, however factors influencing the decision to stop smoking are poorly understood. We postulated declining health or physician-diagnosis of a medical condition may be associated with successful smoking cesssation. Methods A total of 4,448 current and former smokers in Phase 2 COPDGene answered a question about reasons for stopping smoking. Subjects were classified as successful quitters (n=3345), and unsuccessful quitters (n=1003). Reasons cited for quitting were grouped as: medical diagnoses, social factors, symptoms. Logistic modeling of factors associated with successful quitting were adjusted for age, gender, race and education. Results The most common factors cited for a quit attempt by all respondants were medical diagnoses (48%), followed by social factors (47%) and respiratory symptoms (36%). Successful quitters were more likely to be older, male and non-Hispanic white. An adjusted model found increased age, white race, education beyond high school and male sex favored successful quitting while ther cited medical diagnoses, social factors and "other" reasons were associated with unsuccessful quitting. Fagerstrom Nicotine Dependence Scores were ³ 5 in 54% of unsuccessful group compared to 45% for successful quitters, p<0.0001 suggesting some increased nicotine dependence in the unsuccessful quitters. Conclusions Medical diagnoses were the most common factor cited for considering a quit attempt by both successful and unsuccessful quitters However, successful quitting was influenced by demographic factors and potentially the severity of nicotine dependence.