Smoking cessation among daily smokers, aged 45-69 years: a longitudinal study in Malmö, Sweden.

OBJECTIVE To investigate differences in snuff consumption, socio-demographic and psychosocial characteristics between baseline daily smokers who had remained daily smokers, become intermittent smokers or stopped smoking at the 1-year follow-up. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS A population of 12 507 individuals aged 45-69 years, interviewed at baseline in 1992-94 and at a 1-year follow-up, was investigated in this longitudinal study. The three groups of baseline daily smokers were compared to the total population according to socio-demographic, psychosocial and snuff consumption characteristics. A multivariate logistic regression model was used to assess differences in psychosocial conditions, adjusting for age, sex, country of origin, marital status, education and snuff consumption. FINDINGS Eighty-six per cent of all baseline daily smokers remained daily smokers, 6.5% had become intermittent smokers and 7.3% had stopped smoking at the 1-year follow-up. The daily smokers who remained daily smokers were more likely to be born in other countries than Sweden, not married, have a lower educational level and poorer psychosocial conditions than the total population, while the socio-demographic characteristics and psychosocial resources of those daily smokers who had become intermittent smokers or had stopped smoking were much more similar to the general population, with the exception of a higher snuff consumption, especially for intermittent smokers. CONCLUSIONS Daily smokers who remained daily smokers at the 1-year follow-up had poorer psychosocial assets, especially social participation, than baseline daily smokers who had become intermittent smokers or had stopped smoking, and the general population. The results suggest that low levels of social participation are a potent barrier against smoking cessation. Snuff consumption may explain a part of the increase in smoking cessation among men as opposed to women in Sweden.