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      Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase

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          Abstract

          Objectives

          To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase.

          Design

          Cross-sectional study.

          Setting

          A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011).

          Participants

          A total of 2251 male current smokers 20–69 years old.

          Primary and secondary outcome measures

          Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation.

          Results

          The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. ‘The rise in cigarette prices since October 2010’ as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). ‘Feeling unhealthy’ was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant.

          Conclusions

          The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed.

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          Most cited references19

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          Motivation to quit using cigarettes: a review.

          Keven R. Johnson, Jill Hockemeyer, Kathryn Quinlan … (2005)
          This review asks why persons decide to quit using cigarettes. We summarize three literatures from five decades, including over 30 data sets grouped by different methodologies: (a) retrospective reports of ex-smokers (n = 15), (b) cross-sectional surveys of current smokers (n = 14), and (c) prospective studies of smokers in cessation studies (n = 6). Taken together, the data strongly suggest that health concern is the primary motive for quit attempts. These data fit with theoretical reasoning that persons wish to control danger and negative affect. The data also suggest that health professionals should continue emphasizing the negative health consequences of smoking to motivate cessation attempts.
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            Do cigarette prices motivate smokers to quit? New evidence from the ITC survey.

            Andrew Hyland, T. Blecher, Lili Yan … (2011)
            To examine the importance of cigarette prices in influencing smoking cessation and the motivation to quit. We use longitudinal data from three waves of the International Tobacco Control Policy Evaluation Survey (ITC). The study contrasts smoking cessation and motivation to quit among US and Canadian smokers and evaluates how this relationship is modified by cigarette prices, nicotine dependence and health knowledge. Different price measures are used to understand how the ability to purchase cheaper cigarettes may reduce the influence of prices. Our first model examines whether cigarette prices affect motivation to quit smoking using Generalized Estimating Equations to predict cessation stage and a least squares model to predict the change in cessation stage. The second model evaluates quitting behavior over time. The probability of quitting is estimated with Generalized Estimating Equations and a transition model to account for the 'left-truncation' of the data. US and Canada. 4352 smokers at Wave 1, 2000 smokers completing all three waves. Motivation to quit, cigarette prices, nicotine dependence and health knowledge. Smokers living in areas with higher cigarette prices are significantly more motivated to quit. There is limited evidence to suggest that price increases over time may also increase quit motivation. Higher cigarette prices increase the likelihood of actual quitting, with the caveat that results are statistically significant in one out of two models. Access to cheaper cigarette sources does not impede cessation although smokers would respond more aggressively (in terms of cessation) to price increases if cheaper cigarette sources were not available. This research provides a unique opportunity to study smoking cessation among adult smokers and their response to cigarette prices in a market where they are able to avoid tax increases by purchasing cigarettes from cheaper sources. Higher cigarette prices appear to be associated with greater motivation to stop smoking, an effect which does not appear to be mitigated by cheaper cigarette sources. The paper supports the use of higher prices as a means of encouraging smoking cessation and motivation to quit. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.
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              Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1-year follow-up study.

              S Masui, Masakazu Nakamura, Akira Oshima … (2009)
              To examine the percentage of Japanese adult smokers who make quit attempts and succeed in smoking cessation over a 1-year period, and to identify predictors of attempts to stop and successful smoking cessation. This study used Ipsos JSR Company's access panel, whose sampling framework is based on the Basic Resident Register in Japan. We tracked and monitored a selected sample of smokers who were at least 20 years of age through a baseline postal questionnaire survey in 2005 and a follow-up survey 1 year later. The original response rate was 72.1% (1874 of 2600 smokers). There were 1627 current smokers in the baseline survey, and of those, 1358 were followed-up 1 year later. Among the current smokers, 23.0% reported that they had attempted to quit smoking at least once in the past year. Of those who made quit attempts, 25.6% had achieved 1-week abstinence successfully and 13.5% reported having achieved sustained 6-month abstinence successfully at the time of the follow-up survey. The predictors associated with quit attempts were non-daily smoker, higher motivation to quit and previous attempts to stop smoking. Among smokers who made quit attempts, only 13.5% used nicotine replacement therapy. Higher nicotine dependence was associated with lower probability of success in quitting. Japanese smokers attempt to quit at a lower rate than smokers in the United Kingdom and United States, but factors that predict attempts (primarily markers of motivation) and success of attempts (primarily dependence) are similar to those found in western samples.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2015
                Publication date (Electronic): 20 March 2015
                Volume: 5
                Issue: 3
                Electronic Location Identifier: e006658
                Affiliations
                Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University , Fukuoka, Japan
                Author notes
                [Correspondence to ] Dr Shinichi Tanihara; taniyan@ 123456cis.fukuoka-u.ac.jp
                Article
                Publisher ID: bmjopen-2014-006658
                DOI: 10.1136/bmjopen-2014-006658
                PMC ID: 4368926
                PubMed ID: 25795690
                SO-VID: 0ae384c7-aa64-4ed9-8009-ea6f17d7e5fb
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 17 September 2014
                Date revision received : 14 February 2015
                Date accepted : 16 February 2015
                Categories
                Subject: Smoking and Tobacco
                Subject: Research
                Subject: 1506
                Subject: 1734
                Subject: 1724
                Subject: 1734

                ScienceOpen disciplines: Medicine
                Keywords: smoking cessation,nicotine dependence,motivator,tobacco tax increase,fagerström test for cigarette dependence,male workers
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: smoking cessation, nicotine dependence, motivator, tobacco tax increase, fagerström test for cigarette dependence, male workers

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