A randomized controlled trial of a smoking reduction plus nicotine replacement therapy intervention for smokers not willing to quit smoking
Article first published online: 7 MAR 2011
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 106, Issue 6, pages 1155–1163, June 2011
How to Cite
Chan, S. S. C., Leung, D. Y. P., Abdullah, A. S. M., Wong, V. T., Hedley, A. J. and Lam, T.-H. (2011), A randomized controlled trial of a smoking reduction plus nicotine replacement therapy intervention for smokers not willing to quit smoking. Addiction, 106: 1155–1163. doi: 10.1111/j.1360-0443.2011.03363.x
- Issue published online: 12 MAY 2011
- Article first published online: 7 MAR 2011
- Accepted manuscript online: 13 JAN 2011 06:14AM EST
- Submitted 18 May 2010; initial review completed 9 August 2010; final version accepted 28 January 2011
- Adherence counselling;
- behavioural counselling;
- nicotine replacement therapy;
- smoking reduction;
- tobacco abstinence;
- unmotivated smokers
Aims To examine the effectiveness of smoking reduction counselling plus free nicotine replacement therapy (NRT) for smokers not willing to quit.
Design, setting and participants A total of 1154 Chinese adult smokers not willing to quit but who were interested in reducing smoking were allocated randomly to three arms. Intervention group A1 (n = 479) received face-to-face counselling on smoking reduction and adherence to NRT at baseline, 1 week and 4 weeks with 4 weeks of free NRT. Group A2 (n = 449) received the same intervention, but without the adherence intervention. Control group B (n = 226) received simple cessation advice at baseline.
Measurements Self-reported 7-day point prevalence of tobacco abstinence and reduction of cigarette consumption (≥50%) at 6 months and continuous use of NRT for 4 weeks at 3 months.
Findings Using intention-to-treat analysis, compared to control group B, the intervention groups (A1 + A2) had achieved higher 6-month tobacco abstinence (17.0% versus 10.2%, P = 0.01) and reduction rates (50.9% versus 25.7%, P < 0.001). There was no significant difference in the 4-week NRT adherence rate at 3 months, but group A1 achieved a higher abstinence rate than group A2 at 6 months (20.9% versus 12.9%; P = 0.001).
Conclusions In smokers with no immediate plans to quit, smoking reduction programmes with behavioural support and nicotine replacement therapy are more effective than brief advice to quit. Current guidelines recommend advice to quit on medical grounds as the best clinical intervention in this group of smokers, but smoking reduction programmes offer an alternative and effective option.