Social influences on smoking cessation in mid-life: Prospective cohort of UK women

Introduction: Decisions to quit smoking are thought to be influenced by social factors such as friends, family and social groups, but there have been few attempts to examine comprehensively the influence of a range of social factors on smoking cessation. In the largest study to date, we examined whether smoking cessation was associated with marital status and the smoking habits of a partner, socio-economic status and social participation. Methods: In the prospective Million Women Study, 53,650 current smokers in 2001 (mean age 58.3, SD 4.4) reported their smoking status 4 years later; and reported on social factors on both occasions. Logistic regression yielded odds ratios (ORs) and 99% confidence intervals (CIs) for stopping smoking in the next 4 years by marital status, whether their partner smoked, deprivation, education, and participation in social activities. Results: 31% (16,692) of the current smokers at baseline had stopped after 4 years. Smokers who were partnered at baseline were more likely to quit than those who were not partnered (OR 1.13, 99% CI 1.06–1.19). Compared to having a partner who smoked throughout, those who had a non-smoking partner throughout were more likely to quit (OR 2.01, 99% CI 1.86–2.17), and those who had a partner who smoked at baseline but stopped smoking in the next 4 years were even more likely to quit (OR 6.00, 5.41–6.67). There was no association with cessation for education or deprivation. The association with social participation varied by type of activity but was null overall. Conclusion: Women who were partnered were most likely to stop smoking if their partner also stopped smoking. There was little evidence of a strong influence of either socio-economic status or social participation on smoking cessation. These results emphasise the importance of a spouse’s smoking habits on the likelihood of a smoker successfully quitting smoking.