Time and age trends in smoking cessation in Europe.

BACKGROUND

Smoking is the main risk factor for most of the leading causes of death. Cessation is the single most important step that smokers can take to improve their health. With the aim of informing policy makers about decisions on future tobacco control strategies, we estimated time and age trends in smoking cessation in Europe between 1980 and 2010.

METHODS

Data on the smoking history of 50,228 lifetime smokers from 17 European countries were obtained from six large population-based studies included in the Ageing Lungs in European Cohorts (ALEC) consortium. Smoking cessation rates were assessed retrospectively, and age trends were estimated for three decades (1980-1989, 1990-1999, 2000-2010). The analyses were stratified by sex and region (North, East, South, West Europe).

RESULTS

Overall, 21,735 subjects (43.3%) quit smoking over a total time-at-risk of 803,031 years. Cessation rates increased between 1980 and 2010 in young adults (16-40 years), especially females, from all the regions, and in older adults (41-60 years) from North Europe, while they were stable in older adults from East, South and West Europe. In the 2000s, the cessation rates for men and women combined were highest in North Europe (49.9 per 1,000/year) compared to the other regions (range: 26.5-32.7 per 1,000/year). A sharp peak in rates was observed for women around the age of 30, possibly as a consequence of pregnancy-related smoking cessation. In most regions, subjects who started smoking before the age of 16 were less likely to quit than those who started later.

CONCLUSIONS

Our findings suggest an increasing awareness on the detrimental effects of smoking across Europe. However, East, South and West European countries are lagging behind North Europe, suggesting the need to intensify tobacco control strategies in these regions. Additional efforts should be made to keep young adolescents away from taking up smoking, as early initiation could make quitting more challenging during later life.

Déclaration de conflit d'intérêts

DJ reports research grants from the European Union and Medical Research Council. JLP reports a travel grant from the Thoracic Society of Australia and New Zealand (TSANZ) and Boehringer Ingelheim. MA reports research grants and/or personal fees from Pfizer, Boehringer-Ingelheim, Sanofi. TZ has received industry consulting, research grants and/or honoraria from: AstraZeneca, AbbVie, Almirall, Astellas, Bayer Health Care, Bencard, Berlin Chemie, FAES, HAL, Leti, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes, Takeda, Teva, UCB, Henkel, Kryolan, L´Oréal. TZ reports the following organizational affiliations: Committee member, WHO-Initiative “Allergic Rhinitis and its Impact on Asthma” (ARIA); Member of the Board, German Society for Allergy and Clinical Immunology (DGAKI); Head, European Centre for Allergy Research Foundation (ECARF); Secretary General, Global Allergy and Asthma European Network (GA2LEN); Member, Committee on Allergy Diagnosis and Molecular Allergology, World Allergy Organisation (WAO). VS reports research grants from The Wood Dust Foundation (project no. 444508795). All the other authors report no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, and no other relationships or activities that could appear to have influenced the submitted work. These competing interests do not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. There are no restrictions to the sharing of data from this study.