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Perceptions, Predictors of and Motivation for Quitting among Smokers from Six European Countries from 2016 to 2018: Findings from EUREST-PLUS ITC Europe Surveys

  • Girvalaki, Charis1, 2
  • Filippidis, Filippos T.
  • Kyriakos, Christina N.1, 2
  • Driezen, Pete
  • Herbeć, Aleksandra3, 4
  • Mons, Ute5
  • Papadakis, Sophia1, 6
  • Mechili, Enkeleint A.1, 2, 7
  • Katsaounou, Paraskevi A.8
  • Przewoźniak, Krzysztof3, 9, 10
  • Fernández, Esteve11, 12, 13
  • Trofor, Antigona C.14
  • Demjén, Tibor
  • Fong, Geoffrey T.3, 15
  • Vardavas, Constantine I.1, 2
  • 1 (C.I.V.)
  • 2 European Network for Smoking and Tobacco Prevention, 1050 Brussels, Belgium
  • 3 (G.T.F.)
  • 4 Centre for Behaviour Change, Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
  • 5 Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50923 Cologne, Germany
  • 6 Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, and Faculty of Medicine, University of Ottawa, Ottawa, ON K1Y 4W7, Canada
  • 7 Department of Health Care, Faculty of Public Health, University of Vlora, 9401 Vlora, Albania
  • 8 First ICU Evaggelismos Hospital Athens, National and Kapodistrian University of Athens, 10676 Athens, Greece
  • 9 Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
  • 10 Collegium Civitas, 00-901 Warsaw, Poland
  • 11 Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Catalonia, Spain
  • 12 School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, 08908 L’Hospitalet de Llobregat, Catalonia, Spain
  • 13 Consortium for Biomedical Research in Respiratory Diseases (CIBER of Respiratory Diseases, CIBERES), 28029 Madrid, Spain
  • 14 Aer Pur Romania, 052034 Bucharest, Romania
  • 15 Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
Published Article
International Journal of Environmental Research and Public Health
Publication Date
Aug 28, 2020
DOI: 10.3390/ijerph17176263
PMID: 32872132
PMCID: PMC7504326
PubMed Central


The European Tobacco Products Directive (TPD) was introduced in 2016 in an effort to decrease prevalence of smoking and increase cessation in the European Union (EU). This study aimed to explore quitting behaviours, motivation, reasons and perceptions about quitting, as well as predictors (reported before the TPD implementation) associated with post-TPD quit status. A cohort study was conducted involving adult smokers from six EU countries ( n = 3195). Data collection occurred pre-(Wave 1; 2016) and post-(Wave 2; 2018) TPD implementation. Bivariate and logistic regression analyses of weighted data were conducted. Within this cohort sample, 415 (13.0%) respondents reported quitting at Wave 2. Predictors of quitting were moderate or high education, fewer cigarettes smoked per day at baseline, a past quit attempt, lower level of perceived addiction, plans for quitting and the presence of a smoking-related comorbidity. Health concerns, price of cigarettes and being a good example for children were among the most important reasons that predicted being a quitter at Wave 2. Our findings show that the factors influencing decisions about quitting may be shared among European countries. European policy and the revised version of TPD could emphasise these factors through health warnings and/or campaigns and other policies.

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