This study used one longitudinal and two cross-sectional population surveys to compare stability of low-rate daily smokers (<5 CPD) with other daily smokers and occasional smokers. Most low-rate smokers do not maintain consumption level for long; 36% retained their smoking status after 20 months compared to 82% and 44% for regular daily and occasional smokers, respectively. Analysis revealed a dynamic process; established smokers of all consumption levels quit smoking as well as modified (decreased or increased) consumption level. Low-rate and occasional smokers quit at higher rates than regular daily smokers (odds ratios > 3:1), but were continuously replenished by new members, many "converted" from regular daily smokers. The overall trend is an increasing proportion of low-consumption smokers, even while smoking prevalence declines. The dynamic process described has implications for tobacco control efforts and for addiction theory.Key words: Low-rate smokers, chippers, occasional smokers, smoking reduction, cessation, dynamics of smoking behavior.Low-rate smokers 3 Low-rate smoke rs consume five or fewer cigarettes per day (CPD). Their low consumption behavior is of theoretical and practical interest. Theoretically, there is the question of how many of them will maintain such a low daily consumption , given that nicotine regulation is generally ineffective when people smoke 5 CPD or less (Benowitz, Jacob, Kozlowski, & Yu, 1986). More practical questions include: how many of these low-rate smokers used to smoke more but cut down their CPD in response to anti-smoking campaigns, and whether the reduced consumption increases the probability of cessation.Previous studies have shown that a subgroup of low-rate smokers maintains low consumption for an extended period of time. Shiffman called these smokers "chippers" and defined them as smokers who have maintained < 5 CPD for at least two years (Shiffman, 1989). He and his colleagues demonstrated that chippers do not exhibit characteristic features of nicotine dependence (Shiffman, Paty, Gyns, Kassel, & Elash, 1995), even though they absorb the same amount of nicotine per cigarette and show similar cardiovascular responses as dependent smokers (Shiffman, Fischer, Zettler-Seg al, & Benowitz, 1990;Shiffman et al., 1992). These studies, however, do not address the question of how many low-rate smokers in the general smoking population are chippers. Hence, the issue of how many low-rate smokers will maintain daily low consumption has not been resolved.With regard to the probability of cessation, a lower consumption generally predicts a higher cessation rate (USDHHS, 1988). However, this is not always true (Hughes, 2000). Smokers who cut down CPD to a certain level may not share the characteristics of smokers who have always consumed that same level, and nicotine intake is only one of many factors that affect cessation rate. In fact, consumption that is consistently as low as 5 CPD suggests that factors other than nicotine regulation must also play a significant ro...
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