The psychological determinants of low-rate daily smoking

Aims To compare low-rate daily smokers (one to five cigarettes/day) with other daily smokers, using the Transtheoretical Model of Change as a framework. Design Mail survey with a follow-up after 7 months. Setting A randomly selected population sample in French-speaking Switzerland, in 1998. Participants A total of 2338 daily smokers aged 25 + years. including 95 smokers of one to five cigarettes/day, 324 smokers of six to 10 cigarettes/day, 399 smokers of 11-15 cigarettes/day and 1520 smokers of 16 + cigarettes/day. and 17 6 5 people (75% of 2338) at 7-month follow-up. Findings Compared with smokers of 16 + cigarettes/day, low-rate smokers of one to five cigarettes/day included more women (67%, versus 46%, P < 0.001), were 4 years younger (P < 0.001), were less motivated to quit smoking (62% versus 37%) in the 'precontemplation' stage of change, P < 0.001), thought that quitting would be easier (-3.4 points on a 0-10 scale, P < 0.001) and were less bothered by the risk of smoking. Low-rate smokers were taking control more actively over their smoking, e.g. they more often stayed away from places where people smoked, sat in the no-smoking sections in public places and tried to delay as much as they could their first cigarette of the day. Only 45% of low-rate smokers were still in the same category 7 months later. Conclusions For many smokers, low-rate smoking may result from a conscious effort to limit their cigarette consumption. Being a low-rate smoker was a temporary condition for most people. Low-rate smokers should be considered as a specific, although heterogeneous group.