Population-based survey of cessation aids used by Swedish smokers

Background: Most smokers who quit typically do so unassisted although pharmaceutical products are increasingly used by those who want a quitting aid. Previous Scandinavian surveys indicated that many smokers stopped smoking by switching from cigarettes to smokeless tobacco in the form of snus. However, usage of various cessation aids may have changed in Sweden during recent years due to factors such as the wider availability of pharmaceutical nicotine, the public debate about the health effects of different tobacco products, excise tax increases on snus relative to cigarettes, and the widespread public misconception that nicotine is the main cause of the adverse health effects associated with tobacco use. Methods: A population-based, cross-sectional survey was done during November 2008 and September 2009 including 2,599 males and 3,409 females aged between 18 and 89 years. The sampling technique was random digit dialing. Data on tobacco habits and quit attempts were collected through structured telephone interviews. Results: The proportion of ever smokers was similar among males (47%) compared to females (44%). About two thirds of them reported having stopped smoking at the time of the survey. Among the former smokers, the proportion who reported unassisted quitting was slightly lower among males (68%) compared to females (78%). Among ever smokers who reported having made assisted quit attempts, snus was the most frequently reported cessation aid among males (22%), whereas females more frequently reported counseling (8%), or pharmaceutical nicotine (gum 8%, patch 4%). Of those who reported using snus at their latest quit attempt, 81% of males and 72% of females were successful quitters compared to about 50-60% for pharmaceutical nicotine and counseling. Conclusions: This survey confirms and extends previous reports in showing that, although most smokers who have quit did so unassisted, snus continues to be the most frequently reported cessation aid among male smokers, whereas usage of pharmaceutical nicotine was more prevalent among females. Use of snus at the latest quit attempt appeared to be associated with a higher success rate among both males and females than other reported methods, although statistically significant differences were mainly observed among males.