Gender differences in unassisted cessation attempts by South Australian smokers: 1998-2014

Background Unassisted cessation is the most common method of quitting successfully among both men and women, yet women have lower quit rates overall. It is important to examine characteristics of unassisted cessation attempts with regard to gender. Methods Household surveys of approximately 3000 South Australians (aged 15+) were conducted each year from 1998 to 2014, yielding an overall sample size of 50100, including 4662 female smokers and 5866 male smokers. The survey assessed attitudes and behaviours regarding smoking and quitting. Results The proportion of cessation attempts that were unassisted decreased significantly over time, from 63.5% to 39.3% among males and 58.7% to 30.9% among females (logistic regressions, both p< .001). Females had lower average nicotine dependence than their male counterparts among assisted and unassisted attempts (t tests, p< .001). For unassisted cessation attempts resulting in abstinence of up to one year, females had a longer average period of abstinence (49.8 days) compared to males (37.6 days) and females that used assistance (37.2 days) (t-tests, both p< .001). There were no gender differences in the length of abstinence from unassisted attempts when only accounting for attempts lasting less than 3 months (89% of all attempts). Conclusions The high rate of using assistance used by female smokers despite having lower average nicotine dependence may be reflective of lower self-efficacy to quit, especially given that females do not have superior quitting outcomes resulting from their higher use of support. Females should not be discouraged from attempting to quit unassisted if they wish to do so as this can lead to lengthy periods of abstinence in excess of that achieved from assisted attempts. Trends in the use (and non-use) of cessation supports by female smokers should continue to be monitored given the potential for overuse of cessation support on non-successful attempts to ultimately damage self-efficacy to quit