Monday 26 July 2010, 10:32AM
PEARLS 264, May 2010, written by Brian R McAvoy
Clinical question
How successful is reducing smoking compared with abrupt
cessation for smokers wanting to quit?
Bottom line
Reducing cigarettes smoked before quit day and quitting
abruptly, with no prior reduction, produced comparable quit rates.
This was true whether nicotine replacement therapy (NRT) was used
as part of the intervention or not, and whether participants were
offered self-help materials or behavioural support. Patients can
therefore be given the choice to quit using either of these ways.
Caveat
The review was unable to draw conclusions about the difference
in adverse events between interventions. However, recent studies
suggest pre-quit NRT does not increase adverse events.
Context
Tobacco use is the largest preventable cause of death in the
world, and is a risk factor for 6 of the 8 leading causes of death.
The standard way to stop smoking is to quit abruptly on a
designated quit day. Most smokers who try to quit using this method
end up relapsing. There is evidence to suggest reducing smoking
before quitting would be popular with smokers.
Cochrane Systematic Review
Lindson N et al. Reduction versus abrupt cessation in smokers
who want to quit. Cochrane Reviews 2010, Issue 3. Article No.
CD008033. DOI: 10.1002/14651858.CD008033.pub2. This review contains
10 studies involving 3760 participants.