Rational Basis for Smoking Cessation
It has been reported that more than 70% of adult cigarette smokers had made at least one attempt to quit during their lifetime, and approximately 41% of them had tried to quit in the previous 12 months; nevertheless, only about 7% of self-quitters stay quit. Such low quit rates have attracted interest in the area of professional and behavioural counselling and stimulated investment in the development of pharmacological aids for smoking cessation. Evidence shows that brief advice from a medical professional and behavioural support are effective in motivating smokers to quit and that the use of pharmacological aids in smoking cessation has approximately doubled the rate of abstinence in motivated smokers.

Despite the development of these smoking cessation strategies, the overall success rate of long-term smoking abstinence is modest, even when intensive interventions are implemented. This underscores the notion that smoking cessation requires a substantial change in behaviour and for most smokers remains a high-effort task. It usually requires multiple quit attempts as well as persistence in executing cognitive and behavioural coping skills and resisting smoking in the face of aversive withdrawal symptoms, negative affect and powerful urges or cravings.

Predictors of Smoking Cessation
The notion that many smokers are known to respond poorly to smoking cessation efforts has fuelled physicians’ negative attitudes towards the effectiveness of smoking cessation. One way of addressing these negative beliefs and attitudes is by emphasising that valuable predictors of smoking cessation can be easily identified. Several factors are known to indicate whether a smoker is more or less likely to quit and their acquaintance can be translated into an efficient use of physicians’ consultation time.

Gender-specific Predictors
Men usually have a better long-term outcome than women. Although women smoke fewer cigarettes and attempt to quit smoking at the same rate as men, they are less likely to succeed at quitting smoking, whether trying to quit on their own or using some type of cessation assistance. The observation of lower quit rates for women receiving nicotine replacement therapy (NRT) is often cited as evidence for the hypothesis that women may be less likely to obtain therapeutic benefit from NRT. However, a number of analyses have generally found NRT equally effective in men and women. It is possible that an interaction between gender and other factors that are important in dictating the outcome of smoking cessation could explain these discrepancies. For example, it has been shown that gender differences in treatment outcome appear to be related to lower quit rates in more nicotine-dependent women.

That women usually have a worse long-term outcome than men has been generally attributed to women’s greater concerns about weight gain as a precipitant for relapse. As a matter of fact, cigarette smoking for many women is an effective aid used to control weight. Furthermore, women appear to be less motivated to quit smoking. Probably, this occurs because women are more likely to anticipate negative outcomes associated with smoking cessation compared with men. As a final point, women have higher rates of depression than men and are more likely to use smoking as a means of handling negative affects.