Research

Aiming at Tobacco Harm Reduction: A survey comparing smokers differing in readiness to quit

Maria Loumakou¹ , Vasiliki Brouskeli² and Jasmin-Olga Sarafidou³

¹  University of Thessaly, Department of Primary Education, Argonafton – Filellinon st., 38221 Volos, Greece

²  Labor Institute of the General Confederation of Greek workers, Sot. Petroula 5, 59100, Veria, Greece

³  Institute of Child Health, Statistical Department, "Agia Sofia" Children's Hospital, Goudi, 11527, Athens, Greece

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Harm Reduction Journal 2006, 3:13doi:10.1186/1477-7517-3-13

Published:	29 March 2006

Abstract

Background

Greece has the highest smoking rates (in the 15-nation bloc) in Europe. The purpose of this study was to investigate Greek smokers' intention and appraisal of capability to quit employing the theoretical frameworks of Decisional Balance (DB) and Cognitive Dissonance (CD).

Methods

A cross-sectional study including 401 Greek habitual smokers (205 men and 195 women), falling into four groups according to their intention and self-appraised capability to quit smoking was carried out. Participants completed a questionnaire recording their attitude towards smoking, intention and self appraised capability to quit smoking, socio-demographic information, as well as a DB and a CD scale.

Results

The most numerous group of smokers (38%) consisted of those who neither intended nor felt capable to quit and these smokers perceived more benefits of smoking than negatives. DB changed gradually according to smokers' "readiness" to quit: the more ready they felt to quit the less the pros of smoking outnumbered the cons. Regarding relief of CD, smokers who intended but did not feel capable to quit employed more "excuses" compared to those who felt capable. Additionally smokers with a past history of unsuccessful quit attempts employed fewer "excuses" even though they were more frequently found among those who intended but did not feel capable to quit.

Conclusion

Findings provide support for the DB theory. On the other hand, "excuses" do not appear to be extensively employed to reduce the conflict between smoking and concern for health. There is much heterogeneity regarding smokers' intention and appraised capability to quit, reflecting theoretical and methodological problems with the distinction among stages of change. Harm reduction programs and interventions designed to increase the implementation of smoking cessation should take into account the detrimental effect of past unsuccessful quit attempts.