Associations between non-daily smoking and motivation to stop smoking: A population study in England 2021-2024.

Abstract

An increasing proportion of adults in England who smoke cigarettes do not smoke every day and may see quitting smoking as less important than those who smoke daily. This study aimed to examine whether motivation to stop smoking differs between those who smoke cigarettes daily vs. non-daily, and to explore differences in this association by relevant sociodemographic, smoking and vaping-related factors. Observational study using data drawn from the Smoking Toolkit Study, a representative cross-sectional survey in England, 2021-2024. 13 277 cigarette smokers (≥16 y). Outcome variables were level of motivation to stop smoking (Motivation to Stop Scale), analysed as a 7-level ordinal variable and dichotomised to assess (1) no desire to stop smoking and (2) high motivation to stop smoking. The exposure variable was daily vs. non-daily smoking. Covariates and potential moderators were age, gender, socioeconomic position, presence of children in the household, strength of urges to smoke, vaping status, harm perceptions of e-cigarettes vs. cigarettes and survey year. Non-daily (vs. daily) smoking was associated with greater motivation to stop smoking [adjusted odds ratio (OR_adj) = 1.22 (95% confidence interval, CI = 1.13-1.32)]. Non-daily smokers were both less likely than daily smokers to report no desire to stop smoking [40.4% vs. 44.0%; OR_adj = 0.85 (95% CI = 0.77-0.95)] and more likely to report high motivation to stop smoking [21.0% vs. 14.8%; OR_adj = 1.78 (95% CI = 1.55-2.03)]. These differences in motivation-especially in the odds of reporting no desire to stop smoking-between non-daily and daily smokers were more pronounced among those who were older and less advantaged. Differences were less pronounced among those who reported no urges to smoke, those who vaped and those who perceived e-cigarettes to be less harmful than cigarettes. In England, adults who smoke cigarettes non-daily appear to tend to be more motivated to quit smoking than those who smoke every day, especially among older and less advantaged people.