Smoking prevalence, cigarette consumption and advice received from physicians: Change between 1996 and 2006 in Geneva, Switzerland

doi:10.1016/j.addbeh.2009.10.021

Addictive Behaviors

Volume 35, Issue 4, April 2010, Pages 355-358

https://doi.org/10.1016/j.addbeh.2009.10.021 Get rights and content

Abstract

Objective

To assess change between 1996 and 2006 in smoking prevalence, cigarette consumption, quit attempts, motivation to quit and advice received from physicians in Geneva, Switzerland.

Methods

Postal surveys in cross-sectional, representative samples of the general population of Geneva in 1996 and 2006.

Results

There were 742 participants in 1996 (response rate 75%) and 1487 in 2006 (response rate 76%). Smoking prevalence remained stable between 1996 (28.0%, 95% confidence interval: 24.7 to 31.3%) and 2006 (26.5%, 24.3 to 28.7%, p = 0.46). Among smokers, cigarette consumption fell from 15 to 13 cig./day between 1996 and 2006 (p = 0.003). However, tobacco dependence, as measured by the Heaviness of Smoking Index, remained stable (mean = 1.9 vs. 1.7, p = 0.18). The proportion of smokers who made a 24-hour quit attempt in the previous year remained stable (29.2% in 1996, 32.1% in 2006, p = 0.52), but more smokers reported that they intended to quit in the next 6 months in 2006 (39.6%) than in 1996 (29.1%, p = 0.045). The association between smoking prevalence and income was stronger in 2006 (chi² = 53.7, p < 0.001) than in 1996 (chi² = 10.9, p = 0.012). In 2006 (no change since 1996), few smokers reported that, during their last medical visit, their physician told them to quit smoking (27.3%) or offered them help to quit (13.3%).

Conclusions

Over these 10 years, smoking prevalence, nicotine dependence levels and the frequency of quit attempts remained stable, but smokers' motivation to quit increased. We observed a growing social gap in smoking prevalence and cigarette consumption. Smoking cessation advice was seldom received during medical visits.

Introduction

In many western European countries, smoking prevalence started to decrease since the 1960s in men and since the 1980s or 1990s in women (Hill & Laplanche, 2004). In Switzerland, the level of cigarette consumption is very high in international comparison (Guindon & Boisclair, 2003), and started to decrease only after 1985 (ISPA, 2006). In Swiss teenagers, smoking prevalence increased until 2002, and began to decrease only thereafter (Schmid, Delgrande Jordan, Kuntsche, Kuendig, & Annaheim, 2007). To our knowledge there are no published data on change during the past decade in smoking prevalence or cigarette consumption in Geneva specifically.

If screening and brief clinical interventions for smoking cessation were provided to 90% of adults, this would have the same impact, in terms of life years saved, as increasing to 90% the delivery rate of all the following clinical preventive services combined: influenza vaccine in adults, aspirin chemoprophylaxis, screening for colorectal, breast and cervical cancers, and screening for problem drinking (Maciosek et al., 2006). However, screening and brief clinical interventions for smoking are provided to one third of patients only (Humair and Ward, 1998, Maciosek et al., 2006). Whether the frequency of brief clinical advice for smoking cessation increased over the past decade in Switzerland is not documented.

Thus, the aim of this study was to assess change between 1996 and 2006 in smoking prevalence, cigarette consumption, motivation to quit smoking, quit attempts, and smoking cessation advice received from physicians.

Section snippets

Material and methods

We conducted two mail surveys in cross-sectional, representative samples of the general population of Geneva, an urban canton in French-speaking Switzerland. The intended samples included 1000 people in 1996 and 2000 people in 2006, aged 18–70 (Etter, 2009b). The samples were drawn at random from the publicly available part of the population register. This register includes 86% of the population and excludes the personnel of the United Nations, diplomats, elected politicians, and people who

Participation

We collected 742 questionnaires in 1996 (75.2% of 987 valid addresses) and 1487 in 2006 (76.5% of 1945 valid addresses). Participants were 42.3 years old on average in 1996 and 41.0 years in 2006 (p = 0.015), the proportion of men was 48.0% in 1996 and 55.0% in 2006 (p < .001), and the average number of school years was 13.4 in 1996 and 15.3 in 2006 (p < .001).

Smoking prevalence and cigarette consumption

There was no significant change in the proportion of current smokers between 1996 (28.0%, 95% confidence interval: 24.7–31.3%) and 2006 (26.5%;

Smoking prevalence

Smoking prevalence remained stable between 1996 and 2006 in Geneva, despite the substantial rise in tobacco prices (OFSP, 2007), and the increased frequency of smoking bans (Etter, 2009a). However, we observed a decrease in prevalence among men aged 26 to 45 years, and an increase in women over 55 years. In women, this change was explained by an aging effect of the cohort of women born before 1940 who seldom smoked, as there were fewer women in this age group in 2006 than in 1996. The reduction

Role of Funding Sources

Funding for this study was provided by the Geneva Health Department (Département de l'Economie et de la Santé). The Geneva Health Department had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Contributors

JF Etter designed the study, wrote the protocol, collected the data, conducted the statistical analysis and wrote the manuscript.

Conflict of Interest

The author declares that he has no conflicts of interest.

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Short CommunicationSmoking prevalence, cigarette consumption and advice received from physicians: Change between 1996 and 2006 in Geneva, Switzerland

Abstract

Objective

Methods

Results

Conclusions

Introduction

Section snippets

Material and methods

Participation

Smoking prevalence and cigarette consumption

Smoking prevalence

Role of Funding Sources

Contributors

Conflict of Interest

Journal of Clinical Epidemiology

Preventive Medicine

Journal of Clinical Epidemiology

Preventive Medicine

Preventive Medicine

American Journal of Preventive Medicine

American Journal of Preventive Medicine

Nicotine receptor partial agonists for smoking cessation

Cochrane Database of Systematic Reviews

Percentage distribution of adult current cigarette smokers, by number of cigarettes smoked per day—1974–2006

Mortality in relation to smoking: 50 years' observations on male British doctors

British Medical Journal

The psychological determinants of low-rate daily smoking

Addiction

Second hand smoke: Changes between 1996 and 2006 in exposure, opinions and workplace smoking bans in Geneva

International Journal of Occupational and Environmental Health

Perceived priorities for prevention: Change between 1996 and 2006 in a general population survey

Journal of Public Health (Oxford)

Short Communication
Smoking prevalence, cigarette consumption and advice received from physicians: Change between 1996 and 2006 in Geneva, Switzerland