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Smoking reduction in the Lung Health Study
John Hughes1, Paula Lindgren, John Connett
1Departments of Psychiatry, Psychology and Family Practice, University of Vermont, Burlington, VT 05401-1419, USA. john.hughes@uvm.edu
Summary
Smokers who failed to quit smoking could reduce cigarette intake, with some maintaining this reduction. However, reducing cigarettes per day did not predict future smoking cessation success.
Area of Science:
- Pulmonology
- Addiction Medicine
- Behavioral Science
Background:
- The Lung Health Study investigated smoking cessation interventions in individuals with early lung disease.
- Many smokers struggle to quit entirely and may attempt to reduce their cigarette consumption.
Purpose of the Study:
- To assess the ability of smokers to reduce daily cigarette intake after failing initial cessation attempts.
- To determine if cigarette reduction is sustainable over time.
- To investigate whether cigarette reduction predicts future smoking cessation success.
Main Methods:
- Analysis of data from 3923 participants in the Lung Health Study randomized to smoking cessation interventions (counseling, nicotine gum) and bronchodilator therapy or placebo.
- Assessment of cigarette consumption and expired-air carbon monoxide levels at baseline and follow-up points.
- Evaluation of quit attempts and abstinence rates over a 5-year period.
Main Results:
- Among smokers still smoking at year 1, 30% reduced intake by at least 50%, 43% by 1-49%, and 27% maintained their smoking levels.
- Cigarette reduction correlated with decreased expired-air carbon monoxide and was associated with nicotine gum use.
- Approximately half of moderate reducers and one-fifth of substantial reducers maintained their reduced smoking levels for 4 years.
- Year 1 reduction predicted more quit attempts in year 2, but not increased abstinence rates.
Conclusions:
- Smokers who fail initial quit attempts can successfully reduce cigarette consumption and maintain this reduction.
- Cigarette reduction is not a reliable predictor of future successful smoking cessation.
- Nicotine gum use was associated with greater cigarette reduction.