Though conventional wisdom says it takes five to seven attempts for most smokers to quit, those estimates may be very low, a recent study suggests.
Based on data for more than 1,200 adult smokers in Canada, the real average number of quit attempts before succeeding may be closer to 30.
"For so long we've been talking about five to seven attempts to quit," said lead author Dr. Michael Chaiton of the school of public health at the University of Toronto in Canada. "For us (the numbers) were a lot higher."
The lower estimate comes from a few past studies that were based on the lifetime recollections of people who successfully quit, but they didn't include attempts by people who had not yet succeeded, Chaiton and colleagues note in the journal BMJ Open.
For their study, the researchers analyzed data from 1,277 people in the Ontario Tobacco Survey who were followed for up to three years. When the study began in 2005, participants reported how many times they recalled ever making a serious attempt to quit smoking, and at each six-month follow-up they reported how many serious quit attempts they had made over the past six months.
A quit attempt was deemed a success when a participant went at least one year without a cigarette.
The researchers used these responses and four different statistical models to estimate how many times the average smoker attempts to quit before succeeding. The most unbiased model suggested an average of 30 quit attempts per smoker.
That's much higher than people tended to report in the previous studies when asked about all their quit attempts since starting smoking, the study team writes.
"People are very bad at remembering over their whole lifetimes," Chaiton told Reuters Health. "The second problem is we were only asking people who have been successful at quitting."
The new study may be a better representation of what most smokers go through over time, but it does only describe their situation rather than predict what will happen to an individual smoker who tries to quit, he cautioned.
"This doesn't mean you hit a magic number and then you can quit," Chaiton said. "There are many people who are able to and do quit on their first attempt or in the first few.
"There are people who are good at many things, some are good at quitting smoking," he added.
Quitting smoking is often a long-term process with many attempts, he said.
"When we talk about trying to reduce the number of smokers, if we try and do that by focusing on one quit attempt at a time we're not going to be very successful," Chaiton said.
A range of smoking cessation medications, policies like smoke-free spaces and plain-pack warnings can all help some smokers quit, he said.
"The main impact of this article is that clinicians should reassure smokers that, just because they have failed 10 times, does not mean they will never quit," said Dr. John Hughes of the University of Vermont School of Medicine in Burlington.
"However, the problem with taking, say, 20 times to quit, is that this may take 10 years and it's not only important to quit but it's important to quit while you are younger," said Hughes, who was not part of the new study.
"So it's important for those who failed several times to seek treatment to increase odds of quitting and we have lots of medication and counseling treatments that work," Hughes told Reuters Health by email.