Cigarette smoking comes in many forms. Not everyone who smokes does so heavily or on a daily basis. Social smokers, for instance, predominantly smoke in social situations and around peers who are also smoking. They tend to perceive their smoking as less harmful and may be less likely to try to quit. This week, ASHES reviews a study by Dimitra Kale and colleagues that investigated the association between social smoking identity and smoking and quitting behaviors among adult past-year smokers in England.
What were the research questions?
What proportion of past-year smokers in England self-identify as social smokers? Is social smoker identity associated with smoking and quitting behaviors, including motivation to quit, quit attempts, and quit success?
What did the researchers do?
The researchers analyzed data from the Smoking Toolkit Study–a nationally-representative, cross-sectional survey. Participants were 26,774 adults in England who currently smoked or had quit smoking in the past year. Data were collected between 2014 and 2021. Participants were asked whether they self-identified as a social smoker. They also reported on smoking-related behaviors, including (1) motivation to stop smoking, (2) quit attempts, and (3) success in quitting. The researchers conducted linear and logistic regressions to assess the association between social smoker identity and each smoking-related behavior.
What did they find?
Approximately one-third of the study participants self-identified as being social smokers. These individuals were more likely to report having attempted to stop smoking in the past year compared to non-social smokers (see Figure). Current smokers who identified as social smokers were more motivated to quit smoking compared to those who did not identify as social smokers. Among the participants who had attempted to stop smoking, self-identified social smokers were not more likely to have successfully quit compared to non-social smokers.
Figure. Odds ratios of the association between social smoking identity and smoking-related behaviors among adult past-year smokers in England. Self-identified social smokers were compared to non-social smokers, controlling for covariates (e.g., age, sex, occupational social grade, survey year). All associations are statistically significant except success in quitting. Click image to enlarge.
Why do these findings matter?
Even occasional smoking can have health consequences, but many social smokers may not recognize these risks. This study found that a substantial minority of past-year smokers identify as social smokers. Despite being more motivated and more likely to attempt to stop smoking, social smokers are not more likely to successfully quit. These individuals may benefit from targeted education into the risks of occasional smoking. Cessation support that addresses the unique experiences of being a social smoker might be beneficial for these individuals as they attempt to quit (e.g., strategies for maintaining abstinence around peers who are smoking).
Every study has limitations. What are the limitations of this study?
This study relied on self-reported data, which may be subject to social desirability bias and recall bias. Findings from this study may not be generalizable to populations outside of England or to users of non-tobacco nicotine products (e.g., e-cigarettes). Part of the data was collected during the COVID-19 pandemic and social distancing may have affected some participants’ social smoking behaviors.
For more information:
SmokeFree offers tools and tips for quitting and maintaining abstinence from tobacco use. The Centers for Disease Control and Prevention also provides research and tips about cigarettes and how to quit. For additional self-help tools, please visit the BASIS Addiction Resources page.
— Kira Landauer, MPH