Do smoking reduction interventions promote cessation in smokers not ready to quit?

Abstract

Background-Limited treatment options exist for smokers who are not ready to make a quit attempt. Smoking reduction may be a viable treatment approach if proven to increase the rates of long-term abstinence from smoking.Method-A systematic review of randomized, controlled trials that tested smoking-reduction interventions (pharmacological, behavioral, or both combined) among smokers who were not ready to make a quit attempt (immediately or in the next month) was conducted to assess the efficacy of these strategies in promoting future smoking abstinence. The primary outcome was the 7-day point-prevalence smoking abstinence at longest follow-up (≥ 6 months). Ten trials were included; six tested pharmacologic interventions, one evaluated a behavioral intervention, and three evaluated combined interventions.Results-Pharmacologic (2732 participants; OR 2.33, 95% CI 1.43 to 3.79) and combined (638 participants; OR 2.14, 95% CI: 1.28 to 3.60) smoking-reduction interventions significantly increased long-term abstinence from smoking. Insufficient evidence was available on the efficacy of behavioral smoking-reduction interventions (320 participants; OR 1.49, 95% CI 0.56 to 3.93). Conclusions-Further ContributorsAuthors A, B, and C designed the study. Author A conducted literature searches, provided summaries of previous research studies, identified potentially eligible articles, and extracted data from these articles. Authors B and C contributed to the idea of the study, and participated in the planning of analysis and editing the manuscript. Author D checked the extracted data for accuracy and conducted the statistical analysis. Author A wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript. Conflict of InterestThe author(s) declare that they have no conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript mechanism through which nicotine replacement therapy assisted smoking reduction in increasing abstinence rates.

Consumption of addictive substances in mariners

“…Seafarers smoked more than the general populations of France and the United States: 63.1% vs. 21.5% and 20.6%, respectively [28][29][30]. Several reasons may contribute to these findings, such as unusual work patterns and lack of sleep [31].…”

Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit

“…There are two possible benefits of smoking reduction. Most importantly, it can be a way to gradually achieve stopping smoking altogether [152]. The other possible benefit is to reduce the harm from smoking where complete cessation is not achieved.…”

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“…Several studies have proved that smoking reduction can increase motivation to quit among those smokers who are not interested in quitting abruptly [18]. The use of nicotine replacement therapy can be beneficial to help these Table 1.…”

“…The results shown that pharmacologic and combined smoking reduction interventions significantly increased long-term abstinence from smoking: OR 2.33, 95% CI 1.43 to 3.79 for pharmacological interventions and OR 2.14, 95% CI: 1.28 to 3.60 for combined interventions. Insufficient evidence was available on the efficacy of behavioral smoking-reduction interventions (OR 1.49, 95% CI 0.56 to 3.93) [18].…”