Review of smoking cessation techniques

Some people are unwilling or unable to stop smoking, but are prepared to try and reduce the numbers of cigarettes they smoke each day.

After studying healthcare literature, a team of Cochrane Researchers could find only a few reports that assessed methods aimed at helping people reduce use. It is also unclear whether cutting down the number of cigarettes delivers clear health benefits.

The main effort in therapies aimed at smokers has been at helping them to stop smoking completely. Little attention has been given to the idea of helping them reduce their use. This is partly for the fear of creating the false impression that reducing the number of cigarettes you smoke a day will lead to an equivalent reduction in a person's risk of smoking-related disease.

Even so, the team of Cochrane Researchers found that they could glean some useful pointers from the currently published data.

Firstly, they found that between 6% and 9% of people using nicotine replacement therapy delivered by either chewing gum or inhaler managed to reduce their use of cigarettes. "This may not seem like a large result, but it is a significantly greater proportion than the 1-3% of people who reduced use in control groups where no NRT was given," says lead researcher Lindsay Stead, who works at the Department of Primary Care at Oxford University.

Secondly they found no evidence that the treatments that aimed to help people reduce their use diverted them from attempting to stop completely. "In fact cessation rates were higher, not lower, in nicotine replacement treatment groups," says Stead.

Thirdly, the researchers point out that there is currently no evidence whether reducing cigarette use, or using products that potentially reduces exposure to the most harmful substances in tobacco products (PREPs) has any long-term benefit on a person's health. "The only clear benefit is that aiming to reduce use often leads to people eventually stopping completely," says Stead.

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