Neighbourhood Deprivation and Outcomes of Stop Smoking Support – An Observational Study

BACKGROUND Rates of smoking and smoking cessation vary with socio-economic status. The objectives were to assess the association between neighbourhood deprivation, completion of treatment to support quit attempts and success of quit attempts-while taking into account other predictors of outcome. METHODS 555,744 quit attempts supported by English Stop Smoking Services in 2009-2012 were linked to the Index of Multiple Deprivation (IMD) 2010 ranks for the clients' neighbourhood and split into deciles relative to the national IMD. Logistic regressions tested the association between neighbourhood deprivation and completion (4-week follow-up) of treatment and biochemically validated success (expired-air carbon monoxide <10 ppm) while adjusting for demographics and intervention characteristics. Sensitivity analyses assessed subsamples: first supported attempts (n = 364,397), those with recorded cigarette dependence (n = 98,659) and completed treatment (n = 416,436). RESULTS Higher neighbourhood deprivation was associated with reduced completion (OR(adj) = 0.949, 95% CI: 0.947 to 0.951) and success (OR(adj) = 0.957, 95% CI: 0.955 to 0.959). Results of sensitivity analyses were consistent with those of the main analysis. CONCLUSIONS Neighbourhood deprivation was associated with small but consistent reductions in completion and success of evidence-based interventions. These associations were not explained by intervention characteristics, demographics or dependence and reduced completion did not fully account for reduced success.