How to quit smoking cigarettes

Cigarette smoking and economic activity status

Those who were economically active were more likely to smoke than those who were not, but this is largely explained by the lower prevalence of smoking among those aged 60 and over who form the majority of economically inactive people. Indeed, among both men and women, prevalence was highest (33%) among economically inactive people aged 16 to 59 compared with 28% of economically active people and only 15% of economically inactive people aged 60 and over. Prevalence was particularly high among economically inactive people aged 16 to 59 whose last job was a routine or manual one, 46% of whom were cigarette smokers.

Cigarette consumption

Although the prevalence of cigarette smoking changed little during the 1990s, the GHS has shown a continuing fall in the reported number of cigarettes smoked. The fall in consumption has occurred mainly among younger smokers, while the number of cigarettes smoked by those aged 50 and over has changed very little since the mid-1970s. Most of the decline in consumption in the 1990s is due to a reduction in the proportion of heavy smokers. The proportion of respondents smoking on average 20 or more cigarettes a day fell from 14% of men in 1990 to 11% in 1998, and from 9% to 7% of women over the same period. It has since remained virtually unchanged among both men and women. The proportion of respondents who were light smokers also changed little throughout the 1990s. In all age groups, respondents are much more likely to be light than heavy smokers, the difference being most pronounced among younger age groups up to the age of 35. For example, 19% of young men and 25% of young women aged 16 to 19 were light smokers in 2002, but only 3% and 4% respectively were heavy smokers. As in previous years, male smokers smoked more cigarettes a day on average in 2002 than female smokers (15 compared with 13). Cigarette consumption also varied by age. Among both men and women smokers, those aged 35 to 59 smoked the most – men smokers smoked on average 17 or 18 cigarettes a day and women smoked 15 a day. Earlier GHS reports have shown cigarette consumption levels to be higher among male and female smokers in manual socio-economic groups than among those in non-manual groups. A similar pattern was evident in 2002 in relation to NS-SEC. Smokers in households where the household reference person was in a routine or manual occupation smoked an average of 15 cigarettes a day, compared with 13 a day for those in managerial or professional households.

 Cigarette type

Filter cigarettes continue to be the most widely smoked type of cigarette, especially among women. During the 1990s, however, there was a marked increase in the proportion of smokers who said that they smoked mainly hand-rolled tobacco. In 1990, 18% of men smokers and 2% of women smokers said they smoked mainly hand-rolled cigarettes, but by 2002 this had risen to 33% and 13% respectively. There are likely to be two main reasons for this sharp increase in the use of hand-rolled cigarettes:

• the rise in the real price of packaged cigarettes - hand-rolled ones are cheaper;

• the reduced tar yield of packaged cigarettes (see below) - depending on how they are rolled and smoked, hand-rolled ones may give a higher tar yield. It is possible that the lessening of the restrictions on the amount of tobacco that can legally be brought into the country and an increase in smuggling have also contributed to the increase in the consumption of handrolled tobacco. The use of hand-rolled tobacco was more common among men aged 35 to 59 than among men of other ages. Among women smokers there was less variation with age, except that only 7% of women smokers aged 60 or over used hand-rolled tobacco.

Tar yield

Table 8.18 shows the very marked reduction in the tar yield of cigarettes over the period during which the GHS has been collecting information about brand smoked. In 1986, 40% of those who smoked manufactured cigarettes smoked brands yielding 15mg or more of tar per cigarette. In the following decade, the proportion smoking this type of cigarette fell to zero. Initially, this was partly due to smokers switching to lower tar brands, but the main factor has been the requirement for manufacturers to reduce substantially the tar yields of existing brands. Following legislation in 1992, they were required to reduce the tar yield to no more than 12mg per cigarette by the beginning of 1998. An EU Directive which came into force at the end of 2002 has further reduced the maximum tar yield to 10 mg per cigarette from January 20046. Although there has been a shift towards the cigarettes with the lowest tar yield, the biggest increase has been in what used to be the middle category – cigarettes with a tar yield of 10 but less than 15mg. In 2002 71% of those who smoked manufactured cigarettes smoked brands in this category. Among smokers aged under 35, differences between men and women in the tar yield of their usual brand were small. Among those aged 35 and over, however, men were much less likely to smoke low tar brands. There was also a difference in tar yield of cigarettes smoked according to the socio-economic classification of the smoker’s household reference person. Cigarettes with the highest tar yield (12 mg or more) were more likely to be smoked by those in routine and manual households than by other smokers: 44% of smokers in routine and manual groups smoked these cigarettes, compared with only 31% of smokers in managerial and professional households.

Cigar and pipe smoking

A decline in the prevalence of pipe and cigar smoking among men has been evident since the survey began, with most of the reduction occurring in the 1970s and 1980s. In 2002, only 5% of men smoked at least one cigar a month, compared with 34% in 1974. Only a small number of women smoked cigars in 1974, and since 1978 the percentages have been scarcely measurable on the GHS. Only 1% of men in 2002 said they smoked a pipe. At 3%, the proportion doing so was higher among men aged 60 and over than among any other age group. Cigar smoking, on the other hand, was not so concentrated among older men, with 2% of men aged 16 to 19 saying they smoked at least one cigar a month.

Age started smoking

The White Paper Smoking Kills3 noted that people who start smoking at an early age are more likely than other smokers to smoke for a long period of time and more likely to die prematurely from a smoking-related disease. Two thirds of respondents who were either current smokers or who had smoked regularly at some time in their lives had started smoking before they were 18, and almost two fifths started before the age of 16. Men were more likely than women to have started smoking before they were 16 (42% of men who had ever smoked regularly, compared with 33% of women). One fifth of women who had ever smoked did not start until they were in their twenties or older, compared with 15% of men. As the GHS has shown in previous years, there was an association between age started smoking regularly and socio-economic  classification based on the current or last job of the household reference person. Of those in managerial and professional households, 30% had started smoking before they were 16, compared with 43% of those in routine and manual households. Current heavy smokers were much more likely than other current or ex-smokers to have started smoking at an early age. Of those smoking 20 or more cigarettes a day, 50% started smoking regularly before they were 16, compared with only 32% of those currently smoking fewer than 10 cigarettes a day.

Dependence on cigarette smoking

For the prevalence of cigarette smoking to reduce, young people have to be discouraged from starting to smoke and existing smokers have to be encouraged to stop. Since 1992, the GHS has asked three questions relevant to the likelihood of a smoker giving up. First, whether they would like to stop smoking, and then two indicators of dependence: whether they think they would find it easy or difficult not to smoke for a whole day; and how soon after waking they smoke their first cigarette. There has been very little change since 1992 in any of the three dependence measures used. This is perhaps not unexpected, given that there has been little change in the prevalence of cigarette smoking over that period. For an attempt to stop smoking to be successful, the smoker must want to stop. In 2002, 68% of smokers (68% of men and 69% of women) said they would like to stop smoking altogether. The relationship between wanting to stop smoking and the number of cigarettes smoked is not straightforward. In every survey since the questions were first included in 1992, the proportion wanting to give up has been highest among those smoking on average 10-19 cigarettes a day. It is interesting that it is not the heaviest smokers who are most likely to want to stop. This may be because they feel it would be too difficult or because they have been discouraged from wanting to stop by previous unsuccessful attempts. Furthermore, some previously heavy smokers who would like to give up may have cut down their consumption prior to an attempt to do so. In 2002, 57% of smokers felt that it would be either very or fairly difficult to go without smoking for a whole day. Not surprisingly, heavier smokers were more likely to say they would find it difficult – 81% of those smoking 20 or more cigarettes a day did so, compared with only 22% of those smoking fewer than 10 cigarettes a day. Since women are less likely to be heavy smokers than men, it might be expected that women would be less likely to say they would find it hard to stop smoking for a day. As in previous years, however, this was not the case. Overall, 59% of women, compared with 56% of men, said they would find it difficult not to smoke for a day. The difference was particularly marked among those smoking 20 or more cigarettes a day: 86% of women, compared with 77% of men, said they would find it difficult. In 2002, 15% of smokers had their first cigarette within five minutes of waking up. Heavy smokers were more likely than light smokers to smoke immediately on waking up, with 31% of those smoking 20 or more cigarettes a day doing so, compared with only 3% of those smoking fewer than 10 a day. The proportions of men and women smokers who said they had their first cigarette within five minutes of waking were similar. Women smokers are therefore more likely to perceive themselves as dependent despite the fact that on average they smoke fewer cigarettes a day than men. There is no statistically significant difference between men and women smokers in the proportions wanting to give up, nor in the more objective of the two indicators of dependence (how soon they smoke after waking up). Smokers in managerial and professional households were more likely than smokers in routine and manual households to say they would like to give up smoking altogether (72% compared with 66%). In general, this association was evident at each consumption level. Overall, smokers in routine and manual households were more likely than others to say they would find it difficult to go without smoking for a whole day (62% compared with 50% of those in managerial and professional households). However, once amount smoked was taken into account (smokers in that group smoke more on average than smokers in other social classes) the pattern of association was less clear. Similarly, smokers in routine and manual households were more likely than others to have their first cigarette of the day within five minutes of waking up. The difference was particularly marked among those smoking 20 or more cigarettes a day. Of heavy smokers in routine and manual households, 32% smoked within five minutes of waking, compared with only 25% of those in managerial and professional households.

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