Patterns of tobacco use, quit attempts, readiness to quit and self-efficacy among smokers with anxiety or depression: Findings among six countries of the EUREST-PLUS ITC Europe Surveys

Ioanna Petroulia; Christina N Kyriakos; Sophia Papadakis; Chara Tzavara; Filippos T Filippidis; Charis Girvalaki; Theodosia Peleki; Paraskevi Katsaounou; Ann McNeill; Ute Mons; Esteve Fernández; Tibor Demjén; Antigona C Trofor; Aleksandra Herbeć; Witold A Zatoński; Yannis Tountas; Geoffrey T Fong; Constantine I Vardavas; EUREST-PLUS consortium

doi:10.18332/tid/98965

Patterns of tobacco use, quit attempts, readiness to quit and self-efficacy among smokers with anxiety or depression: Findings among six countries of the EUREST-PLUS ITC Europe Surveys

Tob Induc Dis. 2019 Feb 5:16:A9. doi: 10.18332/tid/98965. eCollection 2018.

Authors

Ioanna Petroulia¹, Christina N Kyriakos^{2

3}, Sophia Papadakis^{3

4}, Chara Tzavara¹, Filippos T Filippidis^{1

5}, Charis Girvalaki³, Theodosia Peleki¹, Paraskevi Katsaounou¹, Ann McNeill⁶, Ute Mons⁷, Esteve Fernández^{8

9}, Tibor Demjén¹⁰, Antigona C Trofor^{11

12}, Aleksandra Herbeć¹³, Witold A Zatoński^{13

14}, Yannis Tountas¹, Geoffrey T Fong^{15

16}, Constantine I Vardavas^{2

3}; EUREST-PLUS consortium

Affiliations

¹ National and Kapodistrian University of Athens (UoA), Athens, Greece.
² European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium.
³ University of Crete (UoC), Heraklion, Greece.
⁴ Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
⁵ Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
⁶ King's College London (KCL), London, United Kingdom.
⁷ Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁸ Tobacco Control Unit, Catalan Institute of Oncology (ICO), and Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute (IDIBELL), Catalonia, Spain.
⁹ School of Medicine and Health Sciences, Universitat de Barcelona, Catalonia, Spain.
¹⁰ Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary.
¹¹ Universitatea de Medicina si Farmacie 'Grigore T. Popa' Iași, Iași, România.
¹² Aer Pur Romania, Bucharest, Romania.
¹³ Health Promotion Foundation, Warsaw, Poland.
¹⁴ European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland.
¹⁵ Department of Psychology & School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada.
¹⁶ Ontario Institute for Cancer Research, Toronto, Canada.

Abstract

Introduction: We compared smoking behaviors, past quit attempts, readiness to quit and beliefs about quitting among current cigarette smokers with probable anxiety or depression (PAD) to those without PAD, from six European Union (EU) Member States (MS).

Methods: A nationally representative cross-sectional sample of 6011 adult cigarette smokers from six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) was randomly selected through a multistage cluster sampling design in 2016. Respondents were classified as having PAD based on self-reported current diagnosis or treatment for anxiety or depression, or a positive screen for major depression, according to a validated two-item instrument. Sociodemographic characteristics, patterns of tobacco use, past quitting, readiness to quit, self-efficacy and beliefs about quitting were assessed for patients with and without PAD. Logistic regression was used to examine predictors of PAD. All analyses were conducted using the complex samples package of SPSS.

Results: Among smokers sampled, 21.0% (95% CI: 19.3-22.9) were identified as having PAD. Logistic regression analyses controlling for socioeconomic variables and cigarettes smoked per day found smokers with PAD were more likely to have made an attempt to quit smoking in the past (AOR=1.48; 95% CI: 1.25-1.74), made a quit attempt in the last 12 months (AOR=1.75; 95% CI: 1.45-2.11), and report lower self-efficacy with quitting (AOR=1.83; 95% CI: 1.44-2.32) compared to smokers without PAD. Additionally, it was found that individuals with PAD were more likely to report having received advice to quit from a doctor or health professional and having used quitline support as part of their last quit attempt.

Conclusions: Smokers with PAD report a greater interest in quitting in the future and more frequent failed quit attempts than smokers without PAD; however, the high rates of untreated anxiety or depression, nicotine dependence, low confidence in the ability to quit, infrequent use of cessation methods, as well as socioeconomic factors may make quitting difficult.

Keywords: Europe; anxiety; depression; mental health; smoking cessation.