The feasibility of smoking reduction: an update

Authors

  • John R. Hughes,

    Corresponding author
    1. University of Vermont, Burlington, VT and
      John R. Hughes
      University of Vermont
      Department of Psychiatry, Psychology and  Family Practice
      38 Fletcher Place
      Burlington
      VT 05401–1419
      USA
      Tel: (802) 656 9610
      Fax: (802) 656 9628
      E-mail: john.hughes@uvm.edu
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  • Matthew J. Carpenter

    1. Medical University of South Carolina, Charleston, SC, USA
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John R. Hughes
University of Vermont
Department of Psychiatry, Psychology and  Family Practice
38 Fletcher Place
Burlington
VT 05401–1419
USA
Tel: (802) 656 9610
Fax: (802) 656 9628
E-mail: john.hughes@uvm.edu

ABSTRACT

Aim  To update conclusions of a previous review of smoking reduction on the extent to which (1) smokers spontaneously reduce their smoking, (2) smokers who try to quit and fail return to smoking less, (3) smokers can substantially reduce and maintain reductions via pharmacological and behavioral treatments and (4) smokers compensate when they reduce.

Method  Qualitative systematic review.

Data sources  Systematic computer searches and other methods.

Study selection  Published and unpublished studies of smokers not trying to stop smoking. We located 13–26 studies for each of the four aims.

Data extraction  The first author entered data with confirmation by second author.

Data synthesis  Due to the heterogeneity of methods and necessity of extensive recalculation, a meta-analysis was not feasible.

Results  Few daily smokers spontaneously reduce. Among those who try to stop smoking and relapse, some return to reduced smoking but whether they maintain this reduction is unclear. Nicotine replacement (and perhaps behavior therapies) can induce smokers not interested in quitting to make significant reductions in their smoking and maintain these over time. Some compensatory smoking occurs with reduction but significant declines in smoke exposure still occur.

Conclusions  These results indicate that reduction is feasible when aided by treatment. Whether reduction should be promoted will depend on the effect of reduction on health outcomes and future cessation.

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