We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
In adults, quitting smoking abruptly improved abstinence more than quitting gradually.
- Authors
Wilson, Hannah; Sherman, Scott
- Abstract
Question In adult smokers, what is the efficacy of abrupt smoking cessation compared with gradual cessation? Methods Design Randomized controlled noninferiority trial. ISRCTN22526020. Allocation Concealed.* Blinding Unblinded*. Follow-up period 6 months. Setting 31 primary care practices in England, UK. Participants 697 adult smokers (mean age 49 y, 50% men, 94% white) who were addicted to tobacco (≥15 cigarettes or 12.5 g loose-leaf tobacco smoked/d or end-expiratory carbon monoxide [CO] concentration ≥15 ppm) and were willing to quit smoking 2 weeks after enrollment. Exclusion criteria included current use of cessation treatment or contraindications to nicotine replacement therapy (NRT). Intervention Abrupt (n=355) or gradual (n=342) smoking cessation. Before the quit date, the abrupt cessation group received nicotine patches, 21 mg/d, but were asked to continue smoking as usual for 2 weeks and not to reduce smoking between the baseline appointment and quit date. 2 weeks before quit day , the gradual cessation group chose 1 of 3 structured reduction programs; received nicotine patches, 21 mg/d, and a choice of short-acting NRT products; and created reduction schedules with a nurse, all with the aim of reducing smoking by 50% in the first week and 75% by quit day. After quit day, both groups received withdrawal-oriented behavioral counseling, nicotine patches, and choice of short-acting NRT. Outcomes Primary outcome was abstinence from smoking at 4 weeks, validated by exhaled CO concentration >10 ppm. Secondary outcomes included validated abstinence at 6 months. Participant follow-up 84% at 6 months (intention-to-treat analysis). Main results Smoking abstinence was higher with abrupt cessation than with gradual cessation at 4 weeks and 6 months (Table). Conclusion In adult smokers, abrupt smoking cessation increased abstinence at 4 weeks and 6 months compared with gradual smoking reduction before a quit day.
- Subjects
ENGLAND; CAPNOGRAPHY; CLINICS; CONFIDENCE intervals; COUNSELING; PRIMARY health care; SMOKING cessation; TOBACCO products; RANDOMIZED controlled trials; TREATMENT effectiveness; TREATMENT duration; DESCRIPTIVE statistics; NICOTINE replacement therapy
- Publication
ACP Journal Club, 2016, Vol 165, Issue 2, p2
- ISSN
1056-8751
- Publication type
Article
- DOI
10.7326/ACPJC-2016-165-2-003