Quitting trajectories of Chinese women smokers following telephone smoking cessation counselling: A longitudinal study

Aims and objectives: This study mapped the quitting patterns (trajectories) of Hong Kong Chinese women smokers who had received counselling via a quitline service and examined factors correlated with different trajectories.

Background: Quitting smoking is always a gradual and progressive process. However, most existing studies on smoking cessation have adopted a cross-sectional approach to conduct evaluation. Little is known about the quitting trajectories of smokers, particularly those who are women after receiving smoking cessation counselling.

Methods: We used a retrospective longitudinal design and analysed 474 women smokers who had called the quitline. Quitting trajectories were mapped using latent growth modelling. Multinomial logistic regression was performed to identify factors associated with class membership. A STROBE checklist was completed.

Results: We identified three trajectory groups: 'quitters' who quit smoking at 6 months and abstained from cigarettes up to 6 years; 'reducers' who cut down cigarette consumption ≥50% at 3 years and maintained reduced levels up to 6 years; and 'increasers' who increased smoking ≥20% at 3 years and continued smoking up to 6 years. Participants who perceived more difficulties in quitting were more likely to be increasers. Those with higher daily cigarette consumption at baseline were more likely to be reducers.

Conclusions: We clarified three trajectory groups of women smokers. The results indicate that existing cessation services need to be improved, especially for women smokers who do not quit after receiving telephone counselling.

Relevance to clinical practice: Existing cessation services need to be improved, especially for women smokers who do not quit after receiving telephone counselling. For those who reduce smoking but fail to quit, quit plans should be developed that provide step-by-step guidance in achieving abstinence through smoking reduction. Instant messages may complement telephone counselling to deliver cessation support for those who increase their cigarette consumption.