Does smoking reduction increase future cessation and decrease disease risk? A qualitative review

Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA.
Nicotine & Tobacco Research (Impact Factor: 3.3). 01/2007; 8(6):739-49. DOI: 10.1080/14622200600789726
Source: PubMed


This review examines whether reduction in smoking among smokers not currently interested in quitting (a) undermines or promotes future smoking cessation or (b) decreases the risks of developing smoking-related diseases. Systematic computer searches and other methods located 19 studies examining reduction and subsequent cessation and 10 studies examining reduction and disease risk. Because of the heterogeneity of methods and results, a meta-analysis could not be undertaken. None of 19 studies found that reduction undermined future cessation, and 16 found that reduction was associated with greater future cessation, including the two randomized trials of reduction versus nonreduction. The 10 trials of disease risk found conflicting results, and none was an adequate test. We conclude that (a) smoking reduction increases the probability of future cessation and (b) whether smoking reduction decreases the risks of smoking-related diseases has not been adequately tested.

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    • "Reduced tobacco consumption Pharmacotherapy to safely reduce and avoid compensatory smoking and elevated CO levels [28] [29], or long-term reduction [30]. NRT to reduce smoking associated with a higher likelihood of quitting compared with reducing unaided [31]. "
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    ABSTRACT: Patient-centred tobacco management approaches tobacco smoking as a chronic disease and can be offered to all smokers irrespective of their attitude to quitting. Maintaining a long-term relationship with smokers enables the adoption of flexible solutions and shared goals. It is argued that patient-centred tobacco management potentially heightens the chances of eventual abstinence for smokers who are unable, or not yet ready to quit. [Gould, GS. Patient-centred tobacco management. Drug Alcohol Rev 2013].
    Drug and Alcohol Review 11/2013; 33(1). DOI:10.1111/dar.12082 · 1.55 Impact Factor
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    • "The preventative effects of a reduction in smoking on smokers’ own tobacco-related diseases differs across studies [6-9]. Although it is still uncertain if a reduction in smoking has any preventative effect on smokers’ tobacco-related diseases, several studies have confirmed the health benefits of quitting smoking [10]. However, almost all the surveyed smokers were unwilling to quit smoking right now in spite of current school policy. "
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    ABSTRACT: Smoking bans in public places have been shown to have an impact on smoking habits, however the potential influence of a university smoking ban on faculty and staff smoking habits remains elusive. This cross sectional study was implemented in Nayoro City, Japan in 2011, among the faculty and students of the Nayoro City University. Five years after the declaration of a total ban on smoking on a university campus, the smoking characteristics of all students, teachers and office workers, and the policy's impact on smokers were investigated. The survey was conducted through an anonymous, self-administered, multiple-choice questionnaire. Information was gathered on the characteristics and smoking characteristics of respondents, and the smokers attitudes toward smoking. The recovery rate was 62.1%. Among respondents, smoking prevalence was 17.9% in teachers and office workers, and 4.0% in students. Among all smokers, 46.4% did not abstain from smoking while at the university and they indicated their smoking areas were "on the streets next to the campus": 16 and "outdoors on campus": 3, respectively. As for smokers, 29.6% of them reduced the number of cigarettes smoked per day as a result of the smoking ban. None of the ex-smokers replied that their principal motivation for quitting smoking was the smoking ban. The ban on smoking served a motivator for smokers to reduce in smoking, but not serve as an effective motivator to quit smoking.
    Tobacco Induced Diseases 09/2013; 11(1):19. DOI:10.1186/1617-9625-11-19 · 1.50 Impact Factor
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    • "the title or abstract. Additional papers were sought from references cited in reviews (Hughes and Carpenter, 2006; Pisinger and Godtfredsen, 2007) and in papers obtained. Papers were grouped by the studies they gave results for. "
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    ABSTRACT: Searches identified 14 studies investigating effects of reducing cigarette consumption on lung cancer, CVD, COPD or FEV1 decline. Three were case-control studies, six cohort studies, and five follow-up studies of FEV1. Six studies consistently reported lower lung cancer risk in reducers. Compared to non-reducers, meta-analysis (random-effects) showed significantly lower risk (RR 0.81, 95%CI 0.74-0.88 for any reduction, and RR 0.78, 0.66-0.92 for the greatest reduction), with no between-study heterogeneity. Four cohort studies presented CVD results, the combined RR for any reduction being a non-significant 0.93 (0.84-1.03). An effect of reduction was not consistently seen for COPD or FEV1 decline. Four cohort studies presented all-cause mortality results, the combined RR of 0.91 (0.86-0.97) being significant. The RR of 0.95 (0.88-1.02) for total smoking-related cancer, from three studies, was non-significant. The evidence has various weaknesses; few studies, few cases in reducers in some studies, limited dose-response data, incomplete adjustment for baseline consumption, questionable accuracy of the lifetime smoking history data in case-control studies, and bias in cohort studies if reducers are likelier than non-reducers to quit during follow-up. Also, the variable definitions of reduction make meta-analysis problematic. Though the results suggest some benefits of smoking reduction, more evidence is needed.
    Regulatory Toxicology and Pharmacology 09/2013; 67(3). DOI:10.1016/j.yrtph.2013.08.016 · 2.03 Impact Factor
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