Abstract 4143925: Cigar smoking and better quality of life positively impact cigarette smoking cessation in adults: Findings from the Population Assessment of Tobacco and Health Study, a national longitudinal cohort study

The likelihood of smoking cessation success, sustained cigarette abstinence, varies by demographics, e.g. age, and other factors which shape quality of life, like stress and comorbidities. The recent emergence of newer tobacco products, like cigars and electronic nicotine delivery systems and in turn newer patterns of tobacco use, like exclusive smoking, dual, or poly use, complicates the picture of cessation process. To fill this gap and inform treatment, this study aimed to assess the role of patterns of tobacco use and perceived change in quality of life in cessation (abstinence ≥ 3 months) and examine the effect of age on those relationships in younger (18-44 years) and middle aged/older (45+) adults in the United States who smoke cigarettes. Methods: This study included (N=5,669) participants, in a longitudinal cohort study, Population Assessment of Tobacco and Health Study, with self-reported patterns of tobacco use (wave 4) and valid information on cessation at follow-up (wave 5). Patterns of use included exclusive smoking, dual cigarette/cigar, dual cigarette/ENDS, and poly use. Perceived change in quality of life—perception of quality of life now compared with 12 months ago—included worse, about the same, and better. Cessation at follow-up, included sustained abstinence of ≥3m and current smoking/short-term abstinence. Weighted descriptive analyses and logistic regressions were conducted with sustained abstinence as outcome and patterns of use and change in quality of life as predictors, adjusting for sex, race, education, income, BMI, and tobacco dependence. Analyses were stratified by age groups. Results: Overall, 25.7% reported sustained abstinence at follow-up. In both age groups, dual cigarette/cigar compared to exclusive smoking (45+ year adults OR 3.33, 95% CI: 1.26-8.79) and better quality of life (compared to about the same) were associated with higher odds of sustained abstinence. In both groups, lower odds were associated with being black and higher tobacco dependence. Of interest, only in 45+ year adults, worse change quality of life had OR 1.95 (95% CI: 1.02-3.74). Conclusion: Findings indicate that patterns of tobacco use, improved quality of life, race, and tobacco dependence influence likelihood of cessation in all ages, but worse change in life may produce cessation only in older adults. Improving quality of life may hold a great potential to achieve successful smoking cessation.