Effectiveness of smoking reduction intervention for hardcore smokers

Abstract

BackgroundThe prevalence and correlates of hardcore smokers, who have high daily cigarette consumption, no quitting history and no intention to quit, have been studied in several western developed countries, but no previous trials of smoking cessation have tested intervention effectiveness for these smokers. The current study examined if hardcore smokers can benefit from smoking reduction intervention to achieve cessation, and explored the underlying reasons.MethodsA posteriori analysis was conducted on data from a randomized controlled trial of smoking reduction intervention on 1,154 smokers who did not want to quit. Odds ratios of 7-day point prevalence of abstinence, smoking reduction by at least 50% and quit attempt at the 6-month follow-up comparing subgroups of smokers were analyzed.ResultsIn hardcore smokers, the odds ratio comparing the quit rate between the intervention and control group was 4.18 (95% CI: 0.51-34.65), which was greater than non-hardcore smokers (OR = 1.58, 95% CI: 0.98-2.54). The number needed to treat for hardcore and non-hardcore smokers was 8.33 (95% CI: 5.56-16.67) and 16.67 (95% CI: 8.33-233.64), respectively. In smokers who did not have quit attempt experience and those who smoked more than 15 cigarettes daily, the odds ratio comparing intervention and control group was 3.29 (95% CI: 0.72-14.98) and 1.36 (95% CI: 0.78-2.36), respectively.ConclusionsThe a posteriori analysis provided pilot results that smoking reduction intervention may be effective to help hardcore smokers to quit and reduce smoking. Having no previous quit attempt was identified as more important than having large cigarette consumption in explaining the greater effectiveness of the intervention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12971-015-0034-y) contains supplementary material, which is available to authorized users.

Impacts of Smoking and Alcohol Consumption on Workplace Presenteeism: A Cross-Sectional Study

“…In this study, alcohol drinking and smoking were found to be related to presenteeism. These ndings are consistent with previous studies [14,16,19,30]. The multiple logistic regression analysis from our study revealed that heavy smoking and high-risk alcohol drinking signi cantly affected presenteeism.…”

Smoking cessation attempts: is it useful to treat hard core smokers?

“…Each profile might require a different tobacco control approach [38]. Further gains in smoking cessation must focus on understanding the characteristics of 'hard-to-engage' populations [39]. …”

“…Moreover, new strategies focused on HCS, like smoking reduction then cessation, appear effective to help hard core smokers to quit and reduce smoking [39] which is one more argument for encouraging HCS to try to quit smoking.…”

Very brief physician advice and supplemental proactive telephone calls to promote smoking reduction and cessation in Chinese male smokers with no intention to quit: a randomized trial

“…This suggests that the very brief reduction intervention might be the critical element here, and that subsequent telephone counselling calls did not add greatly. Finally, very few of our participants were 'hardcore' smokers, which might partly explain the high reduction and quit rates [22]. Moreover, 15-20% of the participants in the control group had reduced their cigarette consumption.…”

“…While the rates in different participants under different settings may not be comparable, our high rates might be attributed to the efficacy of our intervention. Finally, very few of our participants were 'hardcore' smokers, which might partly explain the high reduction and quit rates [22]. Secondly, we warned at baseline and each follow-up that the current attempt to reduce was an intermediate step before complete smoking cessation.…”