Milestones in the process of cessation among novice adolescent smokers

Objectives. We sought to document the sequence and timing of milestones in the process of smoking cessation by prospectively studied cessation milestones among novice adolescent smokers. Methods. Participants, aged 12 to 13 years in 1999 (n=1293), completed selfreport questionnaires every 3 months during the school year over 5 years. We ascertained time after first puff to attain 5 cessation milestones among 319 participants who initiated cigarette smoking during follow-up. Results. The cumulative probability of first reports of a serious desire to quit and perceived permanent cessation was 25% at 1.5 months (95% confidence interval [CI]=1.5, 2.5) after the first puff. The first serious quit attempt occurred at 2.5 months (95% CI=2.5, 5.4), lack of confidence about quitting followed at 18.4 months (95% CI=18.4, 26.8), and awareness of the difficulty of quitting occurred at 32.2 months (95% CI=19.2, 38.4). Conclusions. Desire and attempts to quit began soon after smoking onset. Novice smokers progressed through several stages in their perception of the difficulty of quitting. Increased understanding of the cessation process may help in developing effective tobacco control interventions for novice smokers.