Barriers to quitting smoking – a survey among 1000 adult cigarette smokers in Germany

BACKGROUND: It is well known that smoking has serious health effects. Despite public health initiatives to discourage smoking initiation and encourage smoking cessation, overall smoking rates have been constant for years and 17 million people currently smoke in Germany. PURPOSE: This study aims to characterize barriers preventing adult smokers in Germany from quitting cigarette smoking and assessing the general motivation to quit smoking cigarettes. This approach allowed to probe for correlations between quit motivation, barriers, smoking behaviors and smokers’ characteristics. MATERIALS AND METHODS: Computer-assisted web interviews were conducted with 1,000 smokers aged 19 years and older in Germany between May and June 2021. Quotas on age, gender and federal state were used to ensure the respondent profile was representative for the smokers in Germany. Data on demographics, smoking behavior, quit attempts perceptions and usage of alternatives to cigarettes were collected.  KEY FINDINGS: The majority of smokers in Germany (54 %) report that they are not motivated to stop smoking cigarettes. Barriers and motivations to quit smoking cigarettes differed and allowed a distinction in subgroups of smokers. The most prominent subgroups constitute smokers over 50 years of age and smokers of disadvantaged socioeconomic status (education and income). Only 29 % of smokers in Germany intend to stop smoking and only 3 % of them plan to stop smoking in the following month. CONCLUSION: Smokers cannot be considered as a homogeneous group of people, their motivation to stop smoking differs, which requires a differentiated approach towards them in order to be able to successfully move adult smokers away from cigarettes, the most harmful way of tobacco and nicotine consumption. Inclusive interventions based on the Tobacco Harm Reduction principle could prove useful, especially for smokers that do not quit smoking cigarettes.