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CENTURY
Yale University
School of Medicine
SAC-203
Connecticut
Mental Health Center
34 Park Street
New Haven, CT 06519

Phone:
203-974-7591

Fax:
203-974-7606

E-mail:
infocentury@yale.edu

CENTURY/TTURC Press Release

Cutting down cigarettes promotes quitting, Yale study says

New Haven, Conn. — Reducing the number of cigarettes smoked can help older smokers successfully quit smoking, according to a new study from Yale researchers.

The study will be published in January 2004 issue of Addiction, the journal of the Society for the Study of Addiction to Alcohol and Other Drugs.

The study, using data from a national study of Americans between the ages of 51 and 61, showed that reductions in the numbers of cigarettes smoked helped people quit smoking in the future, even after controlling for several variables, including initial smoking level, gender, and health.

“Most experts will say there is only one way to quit smoking and that is to stop smoking altogether,” said the lead author on the study, Dr. Tracy Falba, an associate research scientist at the Yale University School of Public Health. “But cutting down the number of cigarettes smoked seems to promote quitting. Cutting down first may be an option for people trying to quit.”

The results suggest that reducing the number of cigarettes smoked is a strategy that could be useful for smokers. While the study focused on older smokers, the concept could apply to those of any age. Research on other age groups is warranted, Dr. Falba said.

Dr. Falba said older smokers often think that, because they have been smoking for many years, there is no point to quitting. But even older, longtime smokers can reap the benefits of quitting within days and weeks of quitting, she said.

Dr. Falba said some smoking experts believe that people who cut down the number of cigarettes, in an effort to quit smoking, are just cycling through quit attempts, and that they are doomed to start smoking again. “But there wasn't a higher instance of relapse in the group that quit,” she said. “It was a stable and sustained quit effort.”

Dr. Falba and her coauthors used data from the Health and Retirement Study. A nationally representative sample of people born between 1931 and 1941, more than 12,000 people from more than 7,000 households were interviewed beginning in 1992. The survey includes information on numerous factors relating to health. Of the people surveyed who smoked, about 33 percent reported some reduction in the quantity of cigarettes smoked between 1992 and 1994. Among those who cut down, the average percentage decline was about 42 percent, or about 10 cigarettes per day. Those who cut down by more than 50 percent were more than twice as likely to quit than those whose levels remained unchanged, Dr. Falba's study says.

“Distinct from earlier studies, the results here indicate that for some smokers even smaller reductions can lead to increased likelihood of cessation. It also appears from these results that those who reduced smoking prior to quitting were not more vulnerable to relapse at the 1998 follow-up. This is potentially important for revealing that ‘reducers' do not simply have more erratic smoking patterns and greater long-run relapse potential,” Dr. Falba says in the Addiction article.

“ Using a nationally representative sample of older adults this study finds that reduced smoking increases the likelihood of later cessation, even when controlling for relevant factors. Taking advantage of a large and rich longitudinal data set allows progression beyond previous studies in this area. These findings have important policy implications for tobacco control policy and treatment. If reduced smoking is a more palatable alternative for some smokers, the results here suggest that recommending reduced smoking for some will not impede cessation but rather promote cessation among those able to success-fully reduce smoking. Thus, reducing smoking could be considered for new policy initiatives including quit lines, medical guidelines, work-site programs, and so on.”

“The health-care community and ultimately smokers them-selves may embrace this approach as more quantitative studies indicate that the approach is successful and for whom, when and how it is best used. However, the framing of the message could be of extreme importance in that for those who reduce but continue to smoke, they may have the false illusion of benefit where none exists. Smokers should know that reducing can be helpful in increasing their likelihood of quitting, but their goal should be to quit altogether.”

The other authors of the study were Drs. Mireia Jofre-Bonet, Susan Busch, Noelia Duchovny, and Jody Sindelar. The research team is part of the Center for Nicotine and Tobacco Use Research at Yale (CENTURY). CENTURY is funded by the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI) and the Robert Wood Johnson Foundation.

The citation for the study: Tracy Falba, Mireia Jofre-Bonet, Susan Busch, Noelia Duchovny, Jody Sindelar. Reduction of quantity smoked predicts future cessation among older smokers. Addiction, 99, 93–102.