MedicalResearch.com Interview with:
Dr Nicola Lindson-Hawley PhD
Cochrane Tobacco Addiction Group (TAG) Managing Editor
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Lindson-Hawley: For many people, the obvious way to quit smoking is to cut down gradually until they stop. After all, that’s how we accomplish most other goals that are hard. With addictions other than smoking, we aim to get people to cut down gradually rather than stop abruptly. But with smoking, the norm is to advise people to stop all at once. Around the world, physicians and others who support smoking cessation help people to quit abruptly and not to cut down first. However, if physicians are not providing support to people who want to quit by reduction, then they will have less chance of success as we know that people who receive support to quit are more likely to succeed. On the other hand, if cutting down is a bad way to quit, then we need to persuade people to abandon their common sense idea and quit abruptly instead. Therefore, this study investigated this by comparing a group of smokers advised to quit gradually by cutting down with a group who quit all at once. What we found was that cutting down first, was a less successful way to quit than smoking as normal and then stopping. Smokers who quit abruptly were 25% more likely to have quit after 4 weeks than those who quit gradually.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Lindson-Hawley: Smokers who would like to quit are more likely to be successful if they stop smoking all at once rather than cutting down the amount they smoke before quitting. Our results should be particularly useful for those smokers who want to quit and have no strong feelings about how they want to do it. In this case we can tell smokers and the people who treat them that the best approach to try is abrupt quitting rather than gradual quitting. In most cases this is the standard approach that is already offered by healthcare services, and so no major change is necessary. However, despite the fact less people quit in the reduction group, 40% were still successful in stopping smoking and this is better than what we would expect if people received no support at all. Therefore, we still believe that those smokers who really feel that they are unable to stop smoking all at once should be offered support to cut down before quitting as it is better to encourage people to quit than turn them away. UK clinical guidance now recommends this approach, however this is not the case in the US.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Lindson-Hawley: If we are to offer a cutting down to quit approach to smokers it is important that stop smoking advisors know the best way to do this. Reducing is a less straight forward approach than quitting all at once and so there is potential for a variety of reduction methods which may differ in their success. This is an issue that future research should investigate.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Lindson-Hawley: The Cochrane Tobacco Addiction Group are currently surveying anyone interested in smoking and tobacco (through work or personal interest) to see what they think are the most important unanswered questions on the topics of smoking and tobacco. This short survey is available online here:https://www.surveymonkey.co.uk/r/CochraneTAG and closes at the end of March. The goal is that researchers will be able to use the results to inform their future research to ensure that it is relevant and useful. The results will be published and presented to the research community and so gives people the chance to be involved in the future of research in this area. More information about the study is available here: http://tobacco.cochrane.org/ctag-taps-project.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial. Ann Intern Med. [Epub ahead of print 15 March 2016] doi:10.7326/M14-2805
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Dr. Nicola Lindson-Hawley (2016). Quitting Smoking Cold Turkey Leads To More Success MedicalResearch.com