Predictors and reasons for starting and sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers

Introduction and Aims: The national prevalence of daily smoking among the Aboriginal and Torres Strait Islander population is 39% but falling. We explore factors associated with starting and sustaining quit attempts, and reasons given for quitting.

Design and Methods: We analysed data from the nationally representative quota sample of 759 Aboriginal and Torres Strait Islander adults who reported smoking at least weekly in the Talking About The Smokes baseline survey (April 2012–October 2013) who completed a follow-up survey a year later (August 2013–August 2014).

Results: Having made more quit attempts, more recent quit attempts in the past, motivational attitudes, having been encouraged to quit by a health professional and having noticed tobacco advertising were associated with making a quit attempt between surveys. Having made longer quit attempts in the past, non-daily smoking and quit self-efficacy were associated with sustaining abstinence. But neither having made more quit attempts in the past nor dependence was associated with sustaining abstinence. Health concerns, price and setting an example to children were the most common reasons given by smokers and ex-smokers for quitting.

Discussion and Conclusions: Different factors predict making and sustaining quit attempts among Aboriginal and Torres Strait Islander smokers. We need to rethink current messages that just encourage Aboriginal and Torres Strait Islander smokers to keep making quit attempts by increasing motivation to quit, as motivation and making more quit attempts does not predict eventual success. We could focus more on increasing smokers’ confidence that they can successfully quit.