Are there differences in gradual versus abrupt smoking cessation quit attempts and success by social grade? A population study in England

Background and aims:
Smoking rates remain higher among individuals from less advantaged social grades, who tend to be less successful when they try to quit. Abrupt quitting may be more successful than cutting down first, though evidence is mixed. It is not clear whether the quit methods chosen, and their effects, differ by social grade. This study aimed to: (1) compare the prevalence of gradual versus abrupt quit attempts across social grades; (2) examine the association between quit method and quit success; and (3) assess whether social grade moderates this association.

Methods:
We used data from 27,390 adults in England who reported a past-year quit attempt in the Smoking Toolkit Study (2006–2025). Quit method used (gradual vs. abrupt) and quitting success were self-reported. Logistic regression analyses examined the two-way interaction between quit method and social grade (ABC1 =more advantaged vs. C2DE=less advantaged) and success, adjusting for sociodemographic and smoking-related covariates.

Results:
People from less advantaged social grades were less likely to attempt to quit abruptly (53.2 % [95 % CI: 52.3–54.0 %] vs. 57.4 % [56.4–58.4 %]). Abrupt quitting was associated with higher odds of success compared with gradual quitting (OR = 1.70; 95 % CI: 1.58–1.84) providing no clear evidence this was moderated by social grade (interaction OR = 1.13; 95 % CI: 0.97–1.33, p = 0.14).

Conclusion:
People who choose to quit abruptly are more likely to quit successfully than people who choose to quit gradually, irrespective of their social grade. However, people from less advantaged social grades are less likely to choose to quit abruptly.