Changes in smoking habits in adults: results from a prospective study in Spain

Purpose We assessed changes in smoking behavior and its related factors among healthy adults from five regions in Spain. Methods The smoking status at recruitment and after 3 years was compared in 14,288 men and 23,983 women aged 35 to 64 years. The pattern of smoking and several lifestyle factors were investigated as potential predictors of subsequent changes in smoking habits. Results Among current smokers at baseline the age-adjusted rates of cessation per 1000 person-years were 57.4 for men and 43.2 for women. Among former smokers at baseline the relapse rates were 37.6 and 48.8 per 1000 person-years for men and women, respectively. The initiation rate per 1000 person-years among men who had never smoked was 12.5 and 2.7 for women. Higher amount currently smoked and longer time since quitting were strong predictors of lower rates of cessation and relapse, respectively, while age was associated with lower initiation rates in women. Increased alcohol consumption was related to low cessation and high relapse and initiation rates, mainly among men, while more educated women had higher cessation and initiation rates. Conclusions The current pattern of changes in smoking behavior in Spanish populations aged 35 to 64 years results in rather small prevalence reduction. Additional efforts should be made to promote successful cessation and prevent initiation to reduce the tobacco burden in Spain.