Social smoker identity and associations with smoking and quitting behaviour: A cross-sectional study in England

Background Social smokers typically smoke predominantly or exclusively in the presence of others who are smoking. Relatively little is known about changes in the prevalence of social smoker identity over time and its association with other smoking-related correlates. Methods Data were from the Smoking Toolkit Study, a nationally-representative cross-sectional survey in England. Participants were 26,774 adults who currently smoked or had quit in the past year (‘past-year smokers’), surveyed between February-2014 and April-2021. We estimated the proportion identifying as social smokers, changes over time, and associations with smoking in social situations, cigarette dependence, motivation to stop, quit attempts and success. Results Of past-year smokers, 34.0% (95% Confidence Interval (CI)=33.5-34.6) identified as social smokers. There was a near linear increase in this proportion from 31.9% (95%CI=29.7-34.2) in February-2014 to 36.5% (95%CI=34.1-38.9) in April-2021. Current smokers identifying as social smokers were less cigarette dependent (adjusted B=0.34, 95%CI=0.31-0.37) and more motivated to stop (aOR=1.20, 95%CI=1.15-1.26) than those who did not. Past-year smokers identifying as social smokers reported more smoking in social situations (aOR=6.45, 95%CI=6.13-6.80) and past-year quit attempts (aOR=1.22, 95%CI=1.14-1.30) than those who did not. Quit success was not associated with social smoker identity among past-year smokers who had attempted to quit (aOR=0.90, 95%CI=0.79-1.02). Conclusions An increasing proportion, over a third, of past-year smokers in England identify as social smokers. Despite being associated with lower dependence, greater motivation to quit and more quit attempts, social smoker identity is not associated with greater quit success, suggesting a complex interplay between identity and smoking-related behaviours.