The Socio-Demographic and Psychosocial Drivers of Smoking Initiation and Cessation: A Systematic Literature Review
Keywords:
Smoking initiation Smoking cessation Socio-demographic factors Psychosocial determinants Tobacco controlAbstract
Tobacco use remains one of the leading causes of preventable morbidity and mortality globally. Understanding the multifaceted drivers of smoking initiation and cessation is critical for developing effective public health interventions, particularly in light of persistent health disparities. This systematic literature review explores the socio-demographic and psychosocial factors that influence smoking behaviors across diverse populations. Following the PRISMA guidelines, a systematic search was conducted across major academic databases. Forty-seven peer-reviewed studies published between 2010 and 2025 were included based on relevance, methodological rigor, and thematic alignment. Studies were screened and analyzed using thematic synthesis to identify key variables influencing smoking initiation and cessation. The review identified several recurring socio-demographic predictors including age, gender, educational attainment, and socioeconomic status. Adolescents, individuals with lower education and income, and males in low- and middle-income countries exhibited higher rates of initiation. In contrast, older adults and individuals with higher health literacy were more likely to attempt and succeed in cessation. Psychosocial factors such as mental health conditions, peer and family influence, cultural norms, and access to support services significantly shaped both initiation and cessation outcomes. Notably, the interaction between structural disadvantage and psychosocial vulnerability emerged as a critical barrier to successful cessation. Smoking behavior is the outcome of a complex interplay between socio-demographic positioning and psychosocial context. Effective tobacco control strategies must address these intersecting factors through culturally tailored, equity-driven interventions. Future research should prioritize underrepresented populations and explore integrated, context-specific cessation approaches that align with individuals’ lived experiences.
References
Akanbi, M. O., Carroll, A. J., Achenbach, C., O'Dwyer, L. C., Jordan, N., Hitsman, B., ... & Murphy, R. (2019). The efficacy of smoking cessation interventions in low‐and middle‐income countries: a systematic review and meta‐analysis. Addiction, 114(4), 620-635.
Ali, A., Kaplan, C. M., Derefinko, K. J., & Klesges, R. C. (2018). Smoking cessation for smokers not ready to quit: meta-analysis and cost-effectiveness analysis. American journal of preventive medicine, 55(2), 253-262.
Baxter, S., Gillespie, D., Chilcott, J., Hock, E., Franklin, M., & Clowes, M. (2023). Covariates of success in quitting smoking in the community and secondary acute or mental health care services: a rapid systematic review
Bonello, K., Figoni, H., Blanchard, E., Vignier, N., Avenin, G., Melchior, M., ... & Ibanez, G. (2023). Prevalence of smoking during pregnancy and associated social inequalities in developed countries over the 1995–2020 period: A systematic review. Paediatric and Perinatal Epidemiology, 37(6), 555-565.
Bhardwaj, A., Prakash, R., Raza, S., Gupta, D., Jose, N. A., & Jiloha, R. C. (2024). Socio-demographic Correlates and Association between Level of Tobacco Intake and Severity of Depression. Indian Journal of Public Health Research & Development, 15(3).
Cheung, K. L., de Ruijter, D., Hiligsmann, M., Elfeddali, I., Hoving, C., Evers, S. M., & de Vries, H. (2017). Exploring consensus on how to measure smoking cessation. A Delphi study. BMC Public Health, 17, 1-10.
Chwał, J., Kostka, M., Kostka, P. S., Dzik, R., Filipowska, A., & Doniec, R. J. (2025). Analysis of Demographic, Familial, and Social Determinants of Smoking Behavior Using Machine Learning Methods. Applied Sciences, 15(8), 4442.
De, G., Sondhi, N., Bhattacharjee, A., & Joshi, H. (2024). Preventive healthcare behavior: A hybrid systematic literature review (1998–2023). International Journal of Consumer Studies, 48(1), e13000.
Hawes, M. R., Roth, K. B., & Cabassa, L. J. (2021). Systematic review of psychosocial smoking cessation interventions for people with serious mental illness. Journal of dual diagnosis, 17(3), 216-235.
Hersi, M., Beck, A., Hamel, C., Esmaeilisaraji, L., Pussegoda, K., Austin, B., ... & Stevens, A. (2024). Effectiveness of smoking cessation interventions among adults: an overview of systematic reviews. Systematic Reviews, 13(1), 179.
Hersi, M., Traversy, G., Thombs, B. D., Beck, A., Skidmore, B., Groulx, S., ... & Stevens, A. (2019). Effectiveness of stop smoking interventions among adults: protocol for an overview of systematic reviews and an updated systematic review. Systematic reviews, 8, 1-21.
Hock, E. S., Franklin, M., Baxter, S., Clowes, M., Chilcott, J., & Gillespie, D. (2023). Covariates of success in quitting smoking: a systematic review of studies from 2008 to 2021 conducted to inform the statistical analyses of quitting outcomes of a hospital-based tobacco dependence treatment service in the United Kingdom. NIHR Open Research, 3, 28.
Hock, E. S., Franklin, M., Baxter, S., Clowes, M., Chilcott, J., & Gillespie, D. (2023). Covariates of success in quitting smoking in the community and secondary acute or mental health care services: a rapid systematic review. medRxiv, 2023-01.
Huimin, T., Zheng, T., Jingchun, H., Dajun, L., Zhijun, Z., Yuan, L., ... & Lan, W. (2024). A Scoping Review of Factors Influencing Smoking Cessation in Patients with Chronic Obstructive Pulmonary Disease. COPD: Journal of Chronic Obstructive Pulmonary Disease, 21(1), 2390988.
Karuveettil, V., Ramanarayanan, V., Fernandez, R., Green, H., Sanjeevan, V., & Janakiram, C. (2023). Exploring the perceived sociocultural factors in the initiation of smokeless tobacco among adolescents: a qualitative systematic review protocol. JBI Evidence Synthesis, 21(1), 230-235.
Kilian, C., Lemp, J. M., & Probst, C. (2023). Who benefits from alcohol screening and brief intervention? A mini-review on socioeconomic inequalities with a focus on evidence from the United States. Addictive behaviors, 145, 107765.
Kocher, S., Kumar, H., Jain, T., & Kumar, A. (2024, March). Predicting Student Smoking Likelihood: A Machine Learning Regression Analysis. In 2024 International Conference on Distributed Computing and Optimization Techniques (ICDCOT) (pp. 1-6). IEEE.
Kraiss, J., Viechtbauer, W., Black, N., Johnston, M., Hartmann‐Boyce, J., Eisma, M., ... & de Bruin, M. (2023). Estimating the true effectiveness of smoking cessation interventions under variable comparator conditions: A systematic review and meta‐regression. Addiction, 118(10), 1835-1850.
Kumar, N., Janmohamed, K., Jiang, J., Ainooson, J., Billings, A., Chen, G. Q., ... & Zhang, A. (2021). Tobacco cessation in low-to middle-income countries: A scoping review of randomized controlled trials. Addictive behaviors, 112, 106612.
Kundu, A., Sultana, N., Felsky, D., Moraes, T. J., Selby, P., & Chaiton, M. (2024). An overview of systematic reviews on predictors of smoking cessation among young people. Plos one, 19(3), e0299728.
Lund, L., Bast, L. S., Rubæk, M., & Andersen, S. (2022). Exploring factors associated with smokeless tobacco use among young people: A systematic scoping review. Drug and Alcohol Dependence, 240, 109627.
Mamun, M. A. (2021). Suicide and suicidal behaviors in the context of COVID-19 pandemic in Bangladesh: a systematic review. Psychology Research and Behavior Management, 695-704.
Mathew, A. R., Hogarth, L., Leventhal, A. M., Cook, J. W., & Hitsman, B. (2017). Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model. Addiction, 112(3), 401-412.
Mersha, A. G., Kennedy, M., Eftekhari, P., Lee, K. K., Upton, P., Segan, C., ... & Gould, G. S. (2023). Using the Behaviour Change Wheel and modified Delphi method to identify behavioural change techniques for improving adherence to smoking cessation medications. BMC public health, 23(1), 1362.
Mitropoulos, L., Kortsari, A., & Ayfantopoulou, G. (2021). A systematic literature review of ride-sharing platforms, user factors and barriers. European Transport Research Review, 13, 1-22.
Murphy, C. M., Scott, K., Colby, S. M., Yermash, J., Evans, E. W., Wing, R. R., ... & Rohsenow, D. J. (2024). “Healthier health in more ways than one”: Perspectives on a program for changing both smoking and obesity-related health behaviors. Eating Behaviors, 53, 101883.
Naegele, H., Petzold, M. B., Viohl, L., Bendau, A., Helmer-Ohlmeier, S., & Betzler, F. (2023). Determinants of Cannabis Initiation and Cessation among Berlin College Students–A Longitudinal Study. Substance Use & Misuse, 58(10), 1262-1272.
Nian, T., Guo, K., Liu, W., Deng, X., Hu, X., Xu, M., ... & Shang, W. (2023). Non-pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses. BMC medicine, 21(1), 378.
Obieche, O., Lee, M., & Salehi, N. (2021). Exploring attitudes towards smoking behaviour and cessation among hospitalised smokers via a socio-ecological framework: a scoping review. Addictive Behaviors, 122, 107040.
O’Connell, N., Burke, E., Dobbie, F., Dougall, N., Mockler, D., Darker, C., ... & Hayes, C. B. (2022). The effectiveness of smoking cessation interventions for socio-economically disadvantaged women: a systematic review and meta-analysis. Systematic Reviews, 11(1), 111.
Rodgers, M., South, E., Harden, M., Whitehead, M., & Sowden, A. (2025). Contextual factors in systematic reviews: understanding public health interventions in low socioeconomic status and disadvantaged populations. Archives of Public Health, 83(1), 1-14.
Rudatsikira, E., Muula, A. S., & Siziya, S. (2010). Current use of smokeless tobacco among adolescents in the Republic of Congo. BMC Public Health, 10, 1-5.
Sequeira, M., Naughton, F., Velleman, R., Murthy, P., D'souza, J., Pacheco, M. G., ... & Nadkarni, A. (2024). Perspectives of smokers, smokeless tobacco users and cessation practitioners in India: A qualitative study. Archives of Psychiatric Nursing, 51, 194-200.
Silva, C. C., Presseau, J., Van Allen, Z., Dinsmore, J., Schenk, P., Moreto, M., & Marques, M. M. (2025). Components of multiple health behaviour change interventions for patients with chronic conditions: a systematic review and meta-regression of randomized trials. Health Psychology Review, 19(1), 200-255.
Simon, P., Kong, G., Cavallo, D. A., & Krishnan-Sarin, S. (2015). Update of adolescent smoking cessation interventions: 2009–2014. Current addiction reports, 2, 15-23.
Siersbaek, R., Kavanagh, P., Ford, J., Burke, S., & Parker, S. (2024). How and why do financial incentives contribute to helping people stop smoking? A realist review. BMC Public Health, 24(1), 500.
Tatton, C., & Lloyd, J. (2023). Understanding for whom, under what conditions and how smoking cessation services for pregnant women in the United Kingdom work, a rapid realist review. BMC Public Health, 23(1), 2488.
Thomas, R. E., Baker, P. R., & Thomas, B. C. (2016). Family-based interventions in preventing children and adolescents from using tobacco: a systematic review and meta-analysis. Academic Pediatrics, 16(5), 419-429.
Vallata, A., O'Loughlin, J., Cengelli, S., & Alla, F. (2021). Predictors of cigarette smoking cessation in adolescents: a systematic review. Journal of Adolescent Health, 68(4), 649-657.
Villanti, A. C., West, J. C., Klemperer, E. M., Graham, A. L., Mays, D., Mermelstein, R. J., & Higgins, S. T. (2020). Smoking-cessation interventions for US young adults: updated systematic review. American journal of preventive medicine, 59(1), 123-136.
Yousef, H., Cano-García, F. J., & López-Núñez, C. (2024). Personality disorders and cigarette smoking in adult population: a systematic review. Current Psychology, 1-11.
Wellman, R. J., O’Loughlin, E. K., Dugas, E. N., Montreuil, A., Dutczak, H., & O’Loughlin, J. (2018). Reasons for quitting smoking in young adult cigarette smokers. Addictive behaviors, 77, 28-33.
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