Giving up smoking

Life events and their effect on people’s motivation to stop smoking

Some people’s pattern of cigarette smoking was very steady, but others said the amount they smoked increased and decreased depending on what else was going on in their lives. Many told us that they were particularly motivated to stop smoking when they thought about having children, getting older, or the impact of smoking on their physical health and appearance.

Others were influenced by the people around them they were closest to, like partners, children or grandchildren. Here we describe events and milestones in people’s lives that made them decide to cut down or stop smoking.

Becoming a parent

A key event that prompted people to cut down or give up smoking was the thought of having children. Many women are highly motivated to give up smoking in pregnancy, though twenty or thirty years ago when less was known about the effects of second-hand smoke and low birth weight of babies born to mothers who smoked it was still fairly common to smoke in pregnancy and around children. Anna gave up the day she found out she was pregnant with her first child. Others, like Caroline and Angela, wanted to give up when they were pregnant but struggled to stop.

Tam kept trying to give up, but gave up for good when she found out she was pregnant. Giving up was still a struggle.

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Age at interview: 37

Sex: Female

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So I kept sort of, you know, I need to give up, but kept smoking, thinking oh well I’ll give up when I get pregnant. So yes, I kept smoking and drinking. We went to Barcelona and we bought a load of duty frees and it was like, “Right, once they’re gone, we’re going to give up.” But yes, it was a couple of weeks after that I found out I was pregnant.

So what happened then?

Shock, yes, big shock. Yes. Kind of that, God I wish I’d had a fag before I peed on the stick. I don’t know, they did that same day that we found out we were pregnant, [name of partner] lost his Mum.

I didn’t give up straightaway. But it was I went from probably 15, 20 a day down to a couple. Because it was. I mean [name of partner] he kept smoking at this point, and just sort of knew I couldn’t, knew I was pregnant, so I had… I couldn’t smoke. But I was, yes, I’d have, like when he went out for a cigarette I’d have a couple of drags. And I had probably about two or three a day at that point. It took me about a week to get my mindset right that I’ve got to stop this now. There’s more people involved now [laughs]. It’s not just me. It was, the thing is I can’t remember exactly when. It might have been that last Bank Holiday. May Bank Holiday that was, you know, that day or the day before was the last day I had a fag. Because I just, because I was sort of challenged. My Mum had said that she’d gone off smoke, she knew she was pregnant because she went off fags. I didn’t go off them I still wanted one, but I knew I couldn’t, because, yes, there’s more people involved. It’s not just me.

So why did you know you couldn’t….?

Because there’s nothing, there’s absolutely nothing that’s any good about smoking and to be pregnant and smoking is just, it’s wrong. It’s not doing… I made that choice to smoke yes. This little alien inside me hadn’t. So I knew I had to give up. I couldn’t make my, I couldn’t make the child be a smoker, you know, I couldn’t smoke whilst pregnant. It’s just, there’s nothing good about it. There’s no… all medical science tells you here is nothing good about it at all. And I couldn’t do it, because when I’ve seen two women smoking pregnant, I only disapprove. So I just knew I had to give up. I had to, you know, I wasn’t going to keep, I wasn’t going to be a pregnant smoker. Well… yes, it took me about a week of the odd couple of puffs before it kind of sunk in. Well not sunk in, that I could get my head round it more and do it. Some days I craved it. Some hours I craved it. But you just know that, I just knew I couldn’t do it. I couldn’t smoke. I was pregnant.

Sue didn’t smoke during her first pregnancy but started again soon afterwards. During her second pregnancy she stopped again and did not start again for several years.

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Age at interview: 48

Sex: Female

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So then I wasn’t very old when I had my first child. So I, luckily I was one of these people who didn’t like smoking when I was pregnant and so I stopped, and then after he was born I was stuck in the hospital in the days when they made you stay in for a week, and they had a room at the end of the ward, where you were allowed to go and smoke. So I was, I think I was all right for two or three days, then I got bored, and the other people were smoking. So I started smoking again, a few days after…. But not a lot, it was never, ever at lot at that point. It was just now and again. But then my husband smoked. So I was surrounded by it.

And then a little while later, I decided, it wasn’t long after I had him, I decided I wanted another baby and I just stopped. I just completely stopped, and then I didn’t smoke again for seven years. And then I started again because my marriage started to break down and because I’d packed up, I resented the fact that my husband was still smoking and it was easier to start smoking than have rows about it. So I started again and that was it.

Professor Aveyard describes why it is so important for women to stop smoking when they are pregnant and the risks for their babies of smoking.

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Can you talk about sort of the health risk connected to, to do with pregnancy?

Okay. Well let’s start with the health risk then. It’s really important for pregnant women to stop smoking. We know that smoking in pregnancy can do a variety of things. Primarily it reduces the blood flow, down the placenta to the baby and that restricts growth and that may have a number of long terms effects but in the short time can increase the risks of certain complications in pregnancy. And is quite likely to cause a growth restriction of the baby.

Now there may also be subtle neurological effects that exposure to the drugs in cigarettes, the nicotine and the other substances that cross through the barrier to the baby may have a neuro development and there’s increasing evidence that subtle things, relatively subtle things, not major developmental abnormalities, but relatively subtle things like ADHD hyperactivity problems for example, or conduct problems in childhood are more common in the offspring of smokers.

So there may also be a minor degree of blunting of IQ.

So, it’s important that people stop and as soon as there’s a pregnancy the sooner they stop, the less they are likely to do to their baby that’s developing. In fact ideally they should stop before hand.

There are special services the NHS Stop Smoking Service will have somebody whose dedicated to helping pregnant women stop smoking. They do all the usual sorts of things that we’ve talked about already, although if they are actually pregnant then some of the medications may need to be slightly adjusted or only used for example the nicotine replacement treatment. So there are small differences, but in essence the support is the same. And it’s really important that women stop as soon as they can and the NHS is there to help them do that.

Men who became fathers also talked about the effect that fatherhood had on their smoking.

The birth of his Jules’s daughter was the ”ultimate reason” he gave up smoking.

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The birth of his Jules’s daughter was the ”ultimate reason” he gave up smoking.

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Age at interview: 41

Sex: Male

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And I think the next time, [name of partner] gave up when she was pregnant. She said that virtually immediately, the first week she had a couple of puffs when I was outside having a cigarette. She came out and had a puff. But within a week thank God, after she told me that she was pregnant and I knew I had to give up smoking. I knew I had to give up smoking. I kept on and I finally gave up when [name of daughter] was nine weeks old. I used patches. Again there was that want to give up smoking and I think that’s, for me that’s the key thing. But if I didn’t want to give up smoking I wouldn’t be able to give up. But I really wanted to. And yes, [name of daughter] my little girl is the ultimate reason it was quite weird. Before she came along I think there was never any reason to actually give up smoking, if I kill myself it’s my life, but with [name of daughter] I’ve got to be there. Excuse me, I get a bit emotional [laughs].

I’m not surprised. And so was it more a responsibility of being there, rather than you know, sort of her seeing you smoke or how did you feel it?

Well for all sorts of reasons. That the being there, I want her to have a father, I want her to have a Mother and Dad. I want to be able to support her. Be there when she comes home crying or whatever. I want to physically be able to be there with her to play with her, to teach her to ride a bike, run after her without [huh huh] you know. I don’t know, I was very aware of a friend of mine who’s boy saw me smoke and he then picked up a twig and pretended to smoke and that was quite profound. I felt ashamed. Like I couldn’t even do… you know, I didn’t think about it at the time. But it could have that sort of kid could want to copy you. But when I saw her I thought this is wrong you can’t do that in front of kids. So yes, in the back of my mind when there’s going to be a time when [name of daughter] going to look to me if she sees me doing it, she’s going to think it acceptable to do. So yes that’s another reason. There’s loads of reasons not to actually smoke.

Having a daughter made Haseen think seriously about giving up smoking, but he gave up only later.

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Age at interview: 46

Sex: Male

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Actually it was serious, I not until actually I had [name of daughter]. I mean I was serious, and but to be very honest, I was, I was, you know, I wouldn’t say like, you know, I was serious at the same time, not dead serious, not really till I had a child. Okay, you know. Now things are very different. Now, you know, you really have something in your life. You see even when you marry somebody, it is not like having a child. So, you know, you of course care for the person, very much, and so on and so forth, but when you have a child the dynamic completely changes. And then it is not just about yourself. Till then it was more a little bit o selfish kind of lifestyle, but the moment you have a child, then you know you’ve got to live long enough for the kid. You know. So that really.

But even then, so you can imagine, when we went to Africa despite having that knowledge that I should not smoke, I did smoke when I was there literally for the first year. I was there, I used to smoke. Five or six cigarettes a day. Hm. Probably more. Seven, eight cigarettes I used to smoke. But when in Birmingham I used to smoke like on a weekend I would smoke a cigar. Like a small cigar and [names of friends] I used to roll with them and smoke a cigarette with them.

But not yet. But I mean that’s how. I mean. How much the smoking had actually got a grip of me, you see like I said, you know, I have really saw how it is important it is for me to stop smoking, especially having a family. Because I had a child and so on. Despite all that, you still get back into it, you know. It is so hard, it is so hard. I have never. I can probably stop everything, but cigarettes was such a strong, strong addiction for me.

Life stage: growing older

Others wanted to give up because they were getting older and didn’t want to smoke into their ‘middle age’ or beyond. Some spoke about changing many things in their life, and smoking was just one of those things.

Giving up smoking was part of a bigger project in Peter’s life: he wanted to get out of ”self-destructive” habits.

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Age at interview: 39

Sex: Male

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Because when I stopped smoking I changed lots of other things too at the same time. So, so it’s like the smoking really was just one part of, of just sort of shifting my perspective overall on what I’m doing and what I want to be doing and how I go about doing it. So it was, it was part of a bigger project to, to sort of turn things around. And actually in that sort of bigger life context smoking was just a sort of small thing. Or that’s how I see it now. It was part of the bigger project.

And what’s the big project?

Well the bigger project is to, to enjoy work more and to enjoy life more and to just live well. Not do self-destructive and get out of self-destructive patterns. So, so in my situation I ended up being very highly qualified in my area and yet stuck perpetually in part time employment, which is to do with the whole way the market has changed.

So connected to sort of giving up smoking, you were saying, you mentioned thinking about turning 40?

Hm.

What role would you has age played in thinking about giving up smoking?

Well it’s part of the same thing, because by the time my parents were 40 I was 10 I’m still childless and still not in full time work and I’m approaching 40, and if I compare myself to my parents although of course I have a university education that they had never had, and all this sort of thing, in terms of welfare and well being and life experiences, you know, I’m way behind.

The significance of that, well yes yes, it is significant, because I’m also 40 you’re probably you’re past half, the half way mark of your life you know, life is precious and you have to do something more with it…

So you’re saying that smoking, if I’m right in connecting the two things was a self-destructive habit?

Yes.

And in what way do you mean self-destructive because there are lots of different way …?

Well obviously health wise. So this is what you know, but what you don’t do anything about when you’re a smoker because smoking is your security blanket. And so even if someone diagnosed you with cancer you’re probably, the first response would be to have a fag. Because that’s your security blanket.

So it’s destructive... it’s obviously destructive and it’s benefit, you know, the benefits of it has long, it’s a long time since the benefits of social pleasure and all the rest of it, you know, outweighs the you know, if you just look at its pros and cons [laughs]. So, so sort of, it’s a no brainer, but then but then you just have to you have to do it, that’s the tough bit.

Both Andy and Tom wanted to give up as they approached their 30th birthday; it seemed time to quit. In her thirties, Rukmini got into yoga and pilates and didn’t want to smoke.

Various people talked of changes in their lives that helped them smoke less: Sue no longer hung around with her smoker friends, and Tom moved in with his girlfriend who smoked less than he did.

Becoming aware of smoking as an unhealthy way of coping

Many people said they smoked more when they were particularly stressed. They felt at the time that smoking helped, but with hindsight many saw it as part of more self-destructive behaviour. For example, Lisa felt that smoking actually made her feel more stressed. Judith recognised that smoking was tied into her mental health problems, and though at times it helped her cope, she realised that smoking caused more anxiety than it relieved. Abdul smoked a lot of skunk to help him cope with his dad’s death, but he felt it messed up his “outlook on the world” and this eventually made him want to quit. Mariam’s smoking indicated to her that she no longer cared about herself after getting divorced, but now takes better care of herself and not smoking was part of that.

Sue thinks that it was ‘crazy’ to smoke more when her Dad was dying.

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Age at interview: 48

Sex: Female

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And I remember you saying that you actually smoked more for a while after your Dad had died?

Yes.

Was that right?

Yes.

Can you tell me about that?

It does sound crazy doesn’t it? it does really sound crazy. But I, almost, it’s really fading now, but it was obviously the worst time of my life, your first parent dying is such a shock, you don’t realise, you don’t ever realise it’s going to happen until it happens. You know it will but… Actually it was almost, it was actually it was before he died that it got worse. So he hadn’t actually died, but the fact that my Mum and him were both ill at the time, made me, I can remember thinking, oh what the hell, you know, this is going to happen to me anyway. I’m just giving up trying to give up, or thinking about it or anything. Still I wasn’t smoking in front of the people at work, still I didn’t, yes, so I still had the thing in the back of my mind that I really shouldn’t be doing it.

And then, when my Dad actually did die, I mean, I think, I drove from… I was living up the road at the time, and I got a phone call to say you’ve got to get down here quick. I got going down there, of course by the time I got there it was too late, you know, he died, really before I got there. But the first thing that I did, yes, to go out, it was May, it was a warm night and I went and sat outside, my goodness knows what time, most of them outside and I was smoking. And it just seems bizarre now. Sorry, I’m getting a bit … [coughs] It seems crazy to have done that, but that’s it, then I was probably in a daze of just smoking then, because I was just with my Mum. And I think at that point, she just, well I don’t know how much she was smoking. She was, she was on, she was having chemotherapy for the breast cancer, but I mean, and so she wasn’t smoking much, because she’d kind of lost the plot a bit, the chemotherapy was making her go a bit odd. And yes, so it wasn’t a good time. But you know, I’m sure it did make me worse.

Rosanna used cigarette smoking as a stress reliever. She had a cancer scare (not lung cancer) that gave her an understanding of what it’s like to experience a serious illness.

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Age at interview: 56

Sex: Female

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I suppose I’ve smoked on and off really since I was a teenager, when I first started smoking, and I smoked probably from about the age of sixteen or seventeen, until I had my children and then I gave up for quite a long period. I didn’t smoke for, for many years actually, and then more recently, I suppose over the last six or seven years maybe I took up smoking with a vengeance. I was going through quite a lot of stressful stuff in my life and I think a lot, like a lot of people it just seemed like a, I enjoyed it and it seemed like a stress reliever. And I smoked quite a lot, I suppose, over the last few years, on and off. But always with a feeling in the back of my mind that it was a silly thing to do. And, I work in a health-related environment, so I’m quite well aware of the dangers, and so on. And not to mention that quite a few years back I had a scare, a cancer scare which wasn’t lung cancer, but even so it gave me a feeling of an understanding of what it’s like having a serious illness. And you know, rationally, why would you, why would you do that to yourself, and smoking obviously is something that can initiate a serious illness. So I’ve always had it in the back of my mind that I want it to stop. But like everybody else I suppose, it is an addiction and it is quite difficult to do that. And so, I think on and off, I’ve cut back a lot on cigarettes at different times, but then things have happened in my life and it’s sort of increased again. So I’ve been on this kind of yo-yo thing of cutting down to very few cigarettes a day. Some days not smoking, and then something happening and going bonkers with it again.

So I was thinking about how I could do something different, I think. Rather than just keep going on this pattern of, you know, up and down and more and less.

Jules said that when there was a “tragedy in the family” he had started smoking again. However now he has his daughter, he feels strongly that he won’t smoke again.

The last time Anna smoked was when her Dad was dying; she stopped soon afterwards when she found out she was pregnant.

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Age at interview: 47

Sex: Female

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So, and then I think the very last time I smoked which is about pretty much exactly five years ago, I think. No, no, it must be six now. Was when my Dad died and both my, well my sister, my step brother and my Dad’s second wife were really heavy smokers. So we were just sitting around the whole time crying, smoking and occasionally drinking. And I think it was, just sort of, I just thought, I’ll just join in with them. But they kind of knew that I was joining in with them for a short period of time. I kind of knew that this was just like okay, this is, I’m going to smoke throughout the mourning period. And then I’ll have to, you know, find a way of stopping this quite quickly.

And then what happened was that it sounds quite weird. But basically in between my Dad dying and his funeral I conceived my daughter, and then I think I found out that I was pregnant, sort of while I was still mourning. And I remembered I had, you know, getting the pregnancy test and sort of thinking, okay this is it, and going out and sitting on the balcony, lighting a fag, and thinking okay this is definitely the last cigarette [laughs] but, you know, I’m going to have it.

(Also see ‘Appearance and physical health’ and ‘The role of others in the decision to quit’).

Last reviewed August 2018.