First 24 hours are the hardest for women trying to quit smoking

NEW YORK — Quitting smoking may be good for your health, but that doesn’t make it any easier to do. Like so many other tasks in life, starting is usually the hardest part. With that in mind, researchers from the University of Columbia find women have a tougher time resisting their addiction to cigarettes during the first day of their attempt to break the habit.

These findings come from a study of 12 low and middle-income countries, which is where 60 percent of the global smoking population reside. Study authors stress the importance of their findings, noting that the first day of smoking abstinence is a major predictor of whether someone will succeed or fail at quitting long-term.

The study also reports larger health warning labels on cigarette packs have a link to a reduced risk of relapse among women on “day one.”

“A successful first day of abstinence is one of the most important predictors for prolonged smoking cessation, and little is known about why women may find this period more challenging than men,” says first study author João Mauricio Castaldelli-Maia, a postdoctoral fellow in the Department of Epidemiology at the Columbia Mailman School, in a university release. “It may be that withdrawal syndrome, which typically presents on the first day of abstinence and is cited by smokers as the main reason for relapse, may play an essential role in one-day quit attempt outcomes among women who typically report more withdrawal symptoms than men.”

Women’s smoking motivations often revolve around health

Similarly, women tend to have a tougher time staying away from cigarettes over the long-term. Researchers explain that men and women each have different motivations for why they start and quit smoking cigarettes. For example, women are more likely to smoke as a way to control their weight. However, women are also more likely to quit cigarettes over health-related reasons such as pregnancy.

The 12 countries analyzed for this study include Russia, Mexico, China, Brazil, Bangladesh, Egypt, Thailand, Turkey, Ukraine, Vietnam, India, and Indonesia. Researchers originally collected this data as part of the Global Adult Tobacco Survey (2008-2012). All of the smokers had made one or more attempts to quit over the past 12 months. After accounting for various demographic factors, the final analysis featured 16,576 individuals.

All in all, reports of day one relapses varied anywhere from three to 14 percent. The frequency of women trying to kick the habit varied greatly from country to country. While only one percent of Egyptian women tried to quit, 43 percent of Brazilian women made an attempt.

Cigarette warning labels ‘more credible’ for women

Meanwhile, larger cigarette warning labels had a connection to reduced odds of women relapsing on the first day of their attempt to quit.

“Compared to male smokers, women tend to rate graphic warning labels overall as more credible, evoking more negative emotions, and eliciting higher motivation to quit,” notes senior study author Silvia Martins, MD, PhD, professor of epidemiology at Columbia Mailman School. “Yet, as of 2013, less than half of low-middle income countries included in the Global Adult Tobacco Survey had implemented these warning labels on cigarette boxes.”

Moving forward, study authors believe more research is necessary to determine the best ways to help women quit cigarettes more easily.

“Incorporating national policies, in addition to counseling and pharmacotherapy, could play an essential role in supporting women during the initial abstinence phase of smoking cessation in low- and middle-income countries,” Dr. Castaldelli-Maia concludes. “Medication and/or psychotherapy may be critical in increasing the chance of successfully quitting smoking especially because studies in high-income countries showed that women tend to receive less pharmacological treatment even though they seek treatment more often.”

The study is published in the journal Addictive Behaviors.

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