TY - JOUR T1 - The hardening hypothesis: does it matter? JF - Tobacco Control JO - Tob Control SP - 267 LP - 268 DO - 10.1136/tobaccocontrol-2011-050382 VL - 21 IS - 2 AU - Graeme Docherty AU - Ann McNeill Y1 - 2012/03/01 UR - http://tobaccocontrol.bmj.com/content/21/2/267.abstract N2 - Tobacco control has made great progress in reducing smoking prevalence in countries where cigarette smoking rates were once high, as in the UK.1 When prevalence began to fall at a slower rate from the late 1980s, a number of commentators suggested this may be due to the remaining smokers becoming more ‘hardened’ to cessation, that is, less likely to be influenced by cessation measures.2 To assess this hypothesis was therefore seen as important because if true, it could be argued that more investment should be made to target the ‘hardened’ groups as existing interventions were clearly not affecting these smokers; but if false, then it could be assumed that existing interventions were largely adequate.An assessment of hardening is incomplete without defining what constitutes a hardcore (or ‘hardened’) smoker. Definitions include having no intention to quit, usually lack of previous quit attempts and a measure of dependence.3 In general, most authors agree that hardcore smokers are those who do not want to quit or those who find it very difficult to quit; in each case, smokers who are very likely to continue smoking.One study found support for hardening.4 This research used the Fagerstrom Test of Nicotine Dependence (FTND) as an indicator of hardening, analysing FTND scores in countries with varying smoking … ER -