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Smoking cessation attempts among adolescent smokers: a systematic review of prevalence studies

¹ McGill University Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Canada
² University of Montreal Department of Social and Preventive Medicine, Montreal, Canada
³ Direction de santé publique de Montréal. Agence de santé et de services sociaux, Montreal, Canada

Correspondence to:
Dr Jennifer O’Loughlin, Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montreal, 3875 Saint Urbain, 1st Floor, Montreal, Quebec, H2W 1V1, Canada; jennifer.oloughlin{at}umontreal.ca

ABSTRACT
Objective: To synthesise estimates of the prevalence of cessation attempts among adolescent smokers generally, and according to age and level of cigarette consumption.

Data sources: PubMed, ERIC, and PsychInfo databases and Internet searches of central data collection agencies.

Study selection: National population-based studies published in English between 1990 and 2005 reporting the prevalence, frequency and/or duration of cessation attempts among smokers aged 10 to <20 years.

Data extraction: Five reviewers determined inclusion criteria for full-text reports. One reviewer extracted data on the design, population characteristics and results from the reports.

Data synthesis: In total, 52 studies conformed to the inclusion criteria. The marked heterogeneity that characterised the study populations and survey questions precluded a meta-analysis. Among adolescent current smokers, the median 6-month, 12-month and lifetime cessation attempt prevalence was 58% (range: 22–73%), 68% (range 43–92%) and 71% (range 28–84%), respectively. More than half had made multiple attempts. Among smokers who had attempted cessation, the median prevalence of relapse was 34, 56, 89 and 92% within 1 week, 1 month, 6 months, and 1 year, respectively, following the longest attempt. Younger (age<16 years) and non-daily smokers experienced a similar or higher prevalence of cessation attempts compared with older (age 16 years) or daily smokers. Moreover, the prevalence of relapse by 6 months following the longest cessation attempt was similar across age and smoking frequency.

Conclusions: The high prevalence of cessation attempts and relapse among adolescent smokers extends to young adolescents and non-daily smokers. Cessation surveillance, research and program development should be more inclusive of these subgroups.