We assessed interventions and identified psychosocial predictors of cessation among smokers who may need specific help: the underprivileged, pregnant smokers and light smokers (under 10 cigarettes/day). The French national smoking cessation database contains data on smokers in cessation services. 80.5% of 682 pregnant smokers in 2004-2006 are heavy smokers. 59.8% are lost to follow-up. Low dependence and nicotine patches predict cessation. In 2006-2007, motives to quit expressed by 13746 smokers show that smoke-free social networks trigger cessation through motives like "motivated or pressured by others" (1-month follow-up cessation rate: 20.9%), "setting a good example" (20.7%), "smoke-free social network" (20.3%). Neither pregnancy nor other motives (cost, health, negative image of smoking, social concerns) improve cessation among the 587 pregnant smokers (5.6% quit smoking). Cost of smoking does not trigger cessation among the unemployed and/or uneducated who may deprive themselves from the essentials to afford tobacco. 69.3% of 259 smokers who enjoy smoking and are reluctant to quit, have low-level or no education. Compelled to quit and addressed by a doctor, 10.4% quit. Among 36594 adult smokers in 2007-2008, 13.3% of 6001 light smokers quit smoking versus 14.5% of heavy smokers. Light smokers are less often offered pharmacotherapy even though it doubles their cessation rate, especially for those with several previous quit attempts. Cognitive behavioural therapy improves cessation among pregnant and light smokers only when associated with patch. We suggest tailored interventions for these smokers whose needs are not met by current anti-smoking measures and interventions.
