Gender differences in medication use and cigarette smoking cessation: results from the International Tobacco Control Four Country Survey

Nicotine Tob Res. 2015 Apr;17(4):463-72. doi: 10.1093/ntr/ntu212.


Introduction: There is conflicting evidence for gender differences in smoking cessation, and there has been little research on gender differences in smoking cessation medication (SCM) use and effectiveness. Using longitudinal data from the International Tobacco Control Four Country Surveys (ITC-4) conducted in the United Kingdom, the United States, Canada, and Australia, we examined gender differences in the incidence of quit attempts, reasons for quitting, use of SCMs, reasons for discontinuing use of SCMs, and rates of smoking cessation.

Methods: Data were analyzed from adult smokers participating in the ITC-4, annual waves 2006-2011 (n = 7,825), as well as a subsample of smokers (n = 1,079) who made quit attempts within 2 months of survey. Adjusted modeling utilized generalized estimating equations.

Results: There were no gender differences in the likelihood of desire to quit, plans to quit, or quit attempts between survey waves. Among quit attempters, women had 31% lower odds of successfully quitting (OR = 0.69; 95% CI = 0.51, 0.94). Stratified by medication use, quit success was lower among women who did not use any SCMs (OR = 0.59; 95% CI = 0.39, 0.90), and it was no different from men when medications were used (OR = 0.73; 95% CI = 0.46, 1.16). In particular, self-selected use of nicotine patch and varenicline contributed to successful quitting among women.

Conclusions: Women may have more difficulty quitting than men, and SCMs use may help attenuate this difference.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Benzazepines / therapeutic use
  • Canada / epidemiology
  • Female
  • Gender Identity*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motivation
  • Nicotine / therapeutic use
  • Nicotinic Agonists / therapeutic use
  • Quinoxalines / therapeutic use
  • Smoking / epidemiology
  • Smoking Cessation / methods*
  • Smoking Prevention*
  • Substance Withdrawal Syndrome / drug therapy*
  • United Kingdom / epidemiology
  • United States / epidemiology
  • Varenicline


  • Benzazepines
  • Nicotinic Agonists
  • Quinoxalines
  • Nicotine
  • Varenicline