Abstract
Aims To accurately document the amount of quitting, length of quit attempts, and prevalence of plans and serious thought about quitting among smokers. Design We used longitudinal data from 7 waves of the International Tobacco Control Policy Evaluation 4-Country Survey (ITC-4). We considered point-prevalence data and cumulative prevalence over the 7 years of the study. We also derived annual estimates of quit activity from reports of quit attempts starting only within more recent timeframes, to control for biased recall. Setting Australia, Canada, the United Kingdom, and the United States of America. Participants 21 613 smokers recruited across 7 waves. Measurements Reported lifetime quit attempts, annual quit attempts, length of attempts, time since last attempt started, frequency of aborted attempts, plans to quit, and serious thought about quitting. Findings Around 40.1% (95% CI: 39.6-40.6) of smokers report attempts to quit in a given year and report an average of 2.1 attempts. Based on free recall, this translates to an average annual quit attempt rate of 0.82 attempts per smoker. Estimates derived only from the preceding month to adjust for recall bias indicate an annual rate of around 1 attempt per smoker. There is a high prevalence of quit-related activity, with over a third of smokers reporting thoughts or actions related to quitting in a given month. Over half the surveyed smokers eventually succeeded in quitting for at least 1 month, and a majority of these for over 6 months. Conclusions Smokers think a lot about stopping and make many unsuccessful quit attempts. Many have been able to last for extended periods and yet they still relapsed. More attention needs to be focussed on translating quit-related activity into long-term abstinence.