Are health conditions and concerns about health effects of smoking predictive of quitting? Findings from the ITC 4CV Survey (2016–2018)

Lin Li, Ron Borland, K. Michael Cummings, Ann McNeill, Bryan W. Heckman, Geoffrey T. Fong, Richard J. O’Connor, Pete Driezen

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)


INTRODUCTION Limited research has investigated the relationship between multiple health conditions and subsequent quitting activities at the population level. This study examines whether nine health conditions and concerns related to smoking are predictive of quit attempts and success among those who tried. METHODS Data came from the International Tobacco Control Four Country Smoking and Vaping Survey conducted in Australia, Canada, England and the US. A total of 3998 daily smokers were surveyed in 2016 and recontacted in 2018. Respondents were asked in 2016 whether they had a medical diagnosis for depression, anxiety, alcohol problems, obesity, chronic pain, diabetes, heart disease, cancer, and chronic lung disease, and whether they had concerns about past/future health effects of smoking. Outcomes were quit attempts and success (having been abstinent for at least one month between surveys). RESULTS Across all four countries, 44.4% of smokers tried to quit between the two survey years, and of these 36.8% were successful. Concerns about past (adjusted odds ratio, AOR=1.66, 95% CI: 1.32–2.08, p<0.001) and future effects of smoking (AOR=2.17, 95% CI: 1.62–2.91, p<0.001) and most health conditions predicted quit attempts, but were mostly unrelated to quit success, with concerns about future effects (AOR=0.59, 95% CI: 0.35–0.99, p<0.05), chronic lung conditions (AOR=0.56, 95% CI: 0.37–0.86, p<0.01) and chronic pain (with a trend) being associated with lower success. CONCLUSIONS Having a major chronic health condition does, generally, motivate making quit attempts, but in some cases it is associated with failure among those who try. More effective cessation support is required for these high priority groups.

Original languageEnglish
Article number60
Number of pages10
JournalTobacco Prevention and Cessation
Publication statusPublished - Oct 2020
Externally publishedYes


  • health conditions
  • longitudinal study
  • risk of tobacco use
  • smoking cessation

Cite this