Smoking is the leading cause of preventable disease and death worldwide. A landmark study analyzed data from more than 5,000 U.S. smokers, revealing important insights into how to help people quit smoking or switch to less harmful alternatives. Led by Dr. Xiaona Liu of the Small Institute, and working with Professor Zhang Xuxi of Peking University School of Public Health and Dr. Ian Fearon of whatIF on the consulting side, the study used sophisticated machine learning techniques to analyze more than 2,000 different factors that may influence changes in smoking behavior. .
The study tracked smokers between 2016 and 2021 and found that while the majority continued to smoke (69.9%), some successfully quit smoking (18.5%) and others became dual users of cigarettes and e-cigarettes (7.2%). There is also a small minority (4.4%) who smoke. “By tracking people over time, we can identify the factors that really contribute to successful change in different groups,” Dr. Liu explains. The research team narrowed 396 potential factors down to 27 key predictors that had a strong impact on smoking behavior change.
Research has identified several key factors for successful quitting smoking. “People who smoke less each day and wait longer after waking up before taking their first cigarette are more likely to quit smoking,” Dr Liu said. “Environmental factors are also important – not living with other smokers and higher Educational level significantly improves quitting success rates. “Studies show that having a specific quitting plan and making a quit attempt also improves success rates.
For those who turn to e-cigarettes, age and social media exposure emerge as surprisingly key factors. “Young people who are active on social media are more likely to switch to e-cigarettes entirely,” Dr. Liu explained. “We also found that people with experience using e-cigarettes and those who believed e-cigarettes were less harmful were more likely to switch.” Interestingly, people who used prescription smoking cessation medications were more likely to switch to e-cigarettes than to continue smoking.
This research has important implications for public health strategies. “Our research shows that we need to take a tailored approach to different groups,” Dr. Liu emphasized. “What works for someone trying to quit smoking completely may be different from what helps someone switch to less harmful alternatives. This understanding could help health care providers and policymakers develop more effective, personalized support programs. Although The study focused on U.S. adults, but its comprehensive analysis and long-term follow-up provide valuable insights for developing more effective smoking cessation and harm reduction strategies globally.
Journal reference
Cao Yue, Zhang Xuxi, Ian M. Fearon, Li Jiaxuan, Chen Xi, Zheng Fangzhen, Zhang Jianqiang, Sun Xinying, Liu Xiaona. “Identifying predictors of smoking switching behavior among adult smokers in the United States: a machine learning approach.” Kururus. DOI: https://doi.org/10.7759/cureus.69183
About the author
Dr. Liu Xiaona Epidemiologist, currently serves as the head of clinical and behavioral sciences at the SMOORE Research Institute in China. Dr. Liu has worked as a senior physician in infection control at the local CDC office in China and as a postdoctoral researcher in health technology assessment and implementation at Erasmus University Medical Center in the Netherlands. She received her PhD in infectious disease control from Erasmus University Medical Center in 2015, her master’s degree in public health from the Netherlands Institute of Health Sciences in 2013, and her master’s degree in social medicine from Peking University Health Science Center in 2011. He is the first and/or corresponding author of 22 scientific journal articles related to disease prevention and control. She has given more than 15 invited lectures at prestigious international conferences.
Dr. Zhang Xuxi Currently, he is an assistant professor in the Department of Social Medicine and Health Education, School of Public Health, Peking University. She received her bachelor’s degree (2014) and master’s degree in public health (2017) from Peking University. She received her Ph.D. Obtained a PhD in Public Health from Erasmus University Rotterdam in 2020. She has published more than 30 scientific papers, with much of her work focused on promoting health in older adults with frailty, chronic disease, disability, cognitive impairment, and mental health.
Dr Ian Phelan is a consultant specializing in the scientific evidence for tobacco harm reduction. He provides scientific advisory support to tobacco and nicotine product manufacturers and pharmaceutical companies, helping them bring new harm reduction products to market and supporting their scientific advocacy. Dr. Fearon has authored nearly 70 peer-reviewed scientific publications, focusing in recent years on the pharmacological and behavioral effects of nicotine-containing products on individuals and populations.
Ms. Cao Yue is a biostatistician currently working at the Small Institute in China, focusing on clinical and behavioral research on the effects of new tobacco products. Previously, she worked as a statistician at the National Kidney Disease Clinical Research Center and contributed to the development of the Chinese Kidney Disease Data System. Ms. Cao received a master’s degree in biostatistics from the Yale School of Public Health in 2019 and a bachelor’s degree in mathematics and statistics from Tongji University in Shanghai in 2017. and experience.
