Retrospective self-attributed helpfulness of smoking cessation products used in the most recent quit attempt: a population-based study in Scotland

Abstract Objective To describe retrospective self-attributed helpfulness of seven smoking cessation products used during the most recent quit attempt among ever cigarette smokers in Scotland, including differences by smoking status. Methods We pooled Scottish Health Survey data from 2018, 2019, 2021 and 2022 and included ever cigarette smokers aged 16 years or older ( N = 8487; 2664 current smokers and 5823 former smokers). For each product used during the most recent quit attempt, helpfulness was defined as the respondent attributing at least 1 month of smoking abstinence to that product. Respondents whose abstinence lasted < 1 month were classified as not reporting the product as helpful. Analyses incorporated survey weights, strata and primary sampling units to estimate weighted proportions, absolute former–current differences, product-use patterns and exploratory demographic correlates. Results Helpfulness was highest for varenicline (67.5%, 95% CI 62.0–72.6) and e-cigarettes or vaping devices (63.0%, 59.8–66.0), whose intervals overlapped, and lowest for nicotine gum (32.7%, 28.9–36.8). Former smokers reported higher helpfulness for every product, most markedly for e-cigarettes or vaping devices (difference 52.4 percentage points, 47.0–57.8). Among 2810 respondents with complete outcomes, e-cigarette use alone (25.2%) and patch use alone (21.4%) were the most common patterns. In exploratory models, age was associated with helpfulness for patches and e-cigarettes, and deprivation and survey year with patch helpfulness; sex was not, and no consistent demographic pattern emerged. Conclusions Varenicline and e-cigarettes or vaping devices were most often reported as helpful and nicotine gum least often. These estimates describe retrospective attribution among product users rather than comparative effectiveness, and current–former differences partly reflect whether abstinence was sustained.