Reasons of failure to quit smoking: A cross sectional survey in major cities of Pakistan

Tobacco dependence is a chronic relapsing disease which is potentially treatable. It kills a third to half of its users and most die on average 10-15 years prematurely. Majority of smokers would like to quit but are unable to because variety of reasons. Aims To assess factors associated with failure to quit smoking among current smokers / tobacco users in major cities of Pakistan. Methods Free health camps supervised by a physician and manned by trained staff were held across major cities of Pakistan. All consenting participants were administered a self-reporting questionnaire and had there exhaled carbon monoxide level measured. Results 12969 participants were interviewed. 99.3% (12872) were men. Mean age (SD) was 31.4± 10 years (Range 13-85). 66.1 % smoked tobacco where as 12.6% used smokeless tobacco and 20.5% both. Average duration of smoking was 8.8 ± 6.5 years (Range 0.25 - 40). Measured exhaled carbon monoxide (ppm) was 12 ± 8 (Range 0 - 215). 12633 (97.4%) participants wanted to quit. 12708 (98%) had received some form of advice to quit. 81.6% had tried smoking cessation pharmacotherapy. Reasons cited for failing to quit were dependence 1965(15.2%), unknown reason 1622 (12.5%), friends / peer pressures 1554 (12%), family related anxiety 771 (5.9%), work related anxiety 681 (5.3%), changes in mood 390 (3%) and weight gain 82 (0.6%) Conclusion A vast majority of participants wanted to quit tobacco use regardless of age, gender or years of usage. Nearly everyone had received advice about quitting, and more than three quarter had tried smoking cessation pharmacotherapy. Three commonest reasons cited for failing to quit were dependence, unknown reason and friend/peer pressure.