Brief Original ReportDeterminants of use of smoking cessation aids in 27 European countries
Introduction
Smoking cessation is one of the main strategies suggested by the World Health Organization's (WHO) MPOWER package against the tobacco epidemic (World Health Organization, 2008). The majority of smokers who make a quit attempt, do so without assistance (Cokkinides et al., 2005, Ismailov and Leatherdale, 2010, Rutqvist, 2012), even though several cessation aids, such as medication and provision or referral for counselling, have been proven highly effective (Cahill et al., 2013, Stead et al., 2012, Stead et al., 2013a, Stead et al., 2013b) and are recommended by organisations like the United Kingdom National Health Service (NHS, 2008) and the U.S. Public Health Service Guidelines for tobacco dependence treatment (Tobacco Use and Dependence Guideline Panel, 2008). Other aids are also available, even though evidence of their effectiveness on long-term cessation remains inconclusive (Bullen et al., 2013, White et al., 2014). Smoking cessation and quit attempts have been associated with gender, socioeconomic status, age and employment (Bacigalupe et al., 2013, Davila et al., 2009, Kaleta et al., 2012). However, European-wide research on the determinants of cessation aids' use has been limited (Ismailov and Leatherdale, 2010, Messer et al., 2008, Rutqvist, 2012). Hence, the objective of this study was to assess determinants of smoking cessation aids' use among current and former smokers in the European Union (EU).
Section snippets
Methods
We analysed publicly available data from the Eurobarometer survey, wave 77.1 (February–March 2012) (n = 26,751) (European Commission, 2012a). The survey was conducted in the 27 European Union member countries and included respondents aged ≥ 15 years. Nationally representative samples of persons aged ≥ 15 years were selected through a multi-stage sampling design in each of the 27 EU member countries. Interviews were conducted in people's homes and in the language of each country.
Smoking status was
Results
In total, 9921 respondents were either current smokers who had made a quit attempt (n = 4341) or former smokers (n = 5580). Overall, 32.2% reported using “any smoking cessation aid” (from 16.4% in Greece to 45.9% in Sweden), while 19.9% reported using “any recommended aid with proven efficacy” (from 6.4% in Greece to 41.4% in Ireland) (Table 1, Fig. 1). NRT and other medications were the most popular smoking cessation aids (14.6%), followed by health professional support (6.7%). Wide
Discussion
Our findings demonstrated that the use of smoking cessation aids varied greatly between countries and regions within the EU, whereas age was the only individual-level factor that was a significant determinant of cessation aid use. Extensive coverage/availability of cessation services was also associated with the use of aids of proven efficacy.
Current and former smokers in Southern European countries were less likely to have used smoking cessation aids. This might reflect regional variations in
Conclusions
The likelihood of using smoking cessation aids was higher among Northern European current and former smokers compared to other EU areas, especially Southern Europe. In addition, smokers in countries with comprehensive national cessation programmes had an increased likelihood of using an efficacious smoking cessation aid. These findings underscore the need for enhanced and sustained efforts to improve health systems and to ensure increased access to cessation services and aids as part of a
Conflict of interest statement
The authors declare that there are no conflicts of interest.
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