Success depends on spouse and workplace

A nonsmoking spouse and smoke-free workplace play key roles in long-term success for young adults who quit smoking, according to research from Indiana University, Bloomington, which found environmental factors to be more influential than individual behaviors and beliefs when it comes to kicking the habit. Smoking has been on the rise for young adults in recent years, adding urgency to research efforts to identify ways to help these 18- to 25-year-olds successfully quit a habit that typically takes more than one attempt to break. "Most smokers cycle through multiple periods of relapse and remission," notes Jon Macy, project director of the IU Smoking Survey, a 27-year longitudinal study of the natural history of cigarette smoking. "In that sense, tobacco dependence is like a chronic disease and should be treated as such."

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Smoking cessation attempts often are thought of as solitary endeavors, Macy points out, but their findings point to possible benefits in cessation programs that involve couples, because marriage to a nonsmoker was such a strong predictor of long-term smoking abstinence. The findings also underscore the benefits of smoke-free workplaces, which Macy says are on the increase.

The researchers looked at factors in four areas: smoking-related beliefs, such as that smoking helps people relax or an understanding of personal health consequences of smoking; smoking-related behaviors, such as the number of quit attempts or age when one began smoking; acquisition of adult roles, such as having children; and smoking in the social environment, such as a spouse's smoking status and extent of access to smoking in the workplace.

"We found that two-thirds of the people who quit between the ages of 18-24 were able to stay quit," Macy says. "Of all the factors we examined, the external environment had the largest independent effect, specifically being married to a nonsmoker, and second, working in a completely smoke-free environment."

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