Smoking reduction did not promote future smoking cessation in a general population
Charlotta Pisinger, Mette Aadahl, Ulla Toft, Torben Jørgensen
.
DOI: 10.4236/ojpm.2011.13011   PDF    HTML     4,630 Downloads   9,235 Views   Citations

Abstract

Introduction: Smoking reduction (SR) has been introduced as a strategy for smokers who are unwilling or unable to quit. We wanted to investi tigate whether SR at one-year follow-up increased the probability of abstinence from smoking at three and five-year follow-up. Methods: we included a random sample from a general population, the Inter99 study, Copenhagen, Denmark. A total of 1975 participants were daily smokers (from both the intervention and the control group) with information on tobacco consumption at both baseline and one-year follow-up (year 1999 to 2001). Of these, 112 had reduced their tobacco consumption substantially, by minimum 50%, at one-year follow-up. Information on tobacco consumption and smoking status was available on 1441 and 1308 participants at three-year and five-year follow-up, respectively. Outcome was self-reported point abstinence at three and five-year follow-up. Logistic regression analyses were adjusted for confounders. Results: One out of five smokers (20.5%) had maintained their reduced tobacco consumption at five-year follow-up. About twice as many reducers as non-reducers reported that they had tried to quit since baseline (p < 0.05). In adjusted logistic regression analyses we found no association between SR at one-year follow- up and being point abstinent at three-year (OR: 0.57; CI: 0.28 - 1.15) or five-year follow-up (OR: 1.08;CI: 0.56 - 2.09). Conclusions: Our study, including smokers from a general population found no association between substantial SR and future smoking cessation at three- and five-year follow-up. No studies so far have reported that SR undermines smoking cessation, but it is still controversial whether SR significantly increases future smoking cessation.

Share and Cite:

Pisinger, C. , Aadahl, M. , Toft, U. and Jørgensen, T. (2011) Smoking reduction did not promote future smoking cessation in a general population. Open Journal of Preventive Medicine, 1, 73-79. doi: 10.4236/ojpm.2011.13011.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Peto, R., Lopez, A.D., Boreham, J., Thun, M., Heath, C. Jr., Doll, R. (1996) Mortality from smoking worldwide. British Medical Bulletin, 52, 12-21.
[2] Boyle, P. (1997) Cancer, cigarette smoking and premature death in Europe: A review including the Recommendations of European Cancer Experts Consensus Meeting, Helsinki, October 1996. Lung Cancer, 17, 1-60. doi:10.1016/S0169-5002(97)00648-X
[3] Cropsey, K.L., Jackson, D.O., Hale, G.J., Carpenter, M.J. and Stitzer, M.L. (2011) Impact of self-initiated prequit smoking reduction on cessation rates: results of a clinical trial of smoking cessation among female prisoners. Addictive Behaviors, 36, 73-78. doi:10.1016/j.addbeh.2010.08.026
[4] Bolliger, C.T., Zellweger, J.P., Danielsson, T., van Biljon, X., Robidou, A., Westin, A., et al. (2000) Smoking reduction with oral nicotine inhalers: Double blind, randomised clinical trial of efficacy and safety. British Medical Journal, 321, 329-333. doi:10.1136/bmj.321.7257.329
[5] Carpenter, M.J., Hughes, J.R. and Keely, J.P. (2003) Effect of smoking reduction on later cessation: A pilot experimental study. Nicotine and Tobacco Research, 5, 155- 162. doi:10.1080/146222003100007385
[6] Meyer, C., Rumpf, H.J., Schumann, A., Hapke, U. and John, U. (2003) Intentionally reduced smoking among untreated general population smokers: prevalence, stability, prediction of smoking behaviour change and differences between subjects choosing either reduction or abstinence. Addiction, 98, 1101-1110. doi:10.1046/j.1360-0443.2003.00475.x
[7] Wennike, P., Danielsson, T., Landfeldt, B., Westin, A. and Tonnesen, P. (2003) Smoking reduction promotes smoking cessation: Results from a double blind, randomized, placebo-controlled trial of nicotine gum with 2-year follow-up. Addiction, 98, 1395-1402. doi:10.1046/j.1360-0443.2003.00489.x
[8] Hughes, J., Lindgren, P., Connett, J. and Nides, M. (2004) Smoking reduction in the Lung Health Study. Nicotine and Tobacco Research, 6, 275-280. doi:10.1080/14622200410001676297
[9] Etter, J.F., Laszlo, E. and Perneger, T.V. (2004) Postin- tervention effect of nicotine replacement therapy on smoking reduction in smokers who are unwilling to quit: randomized trial. Journal of Clinical Psychopharmacology, 24, 174-179. doi:10.1097/01.jcp.0000115666.45074.d6
[10] Carpenter, M.J., Hughes, J.R., Solomon, L.J. and Callas, P.W. (2004 ) Both smoking reduction with nicotine replacement therapy and motivational advice increase future cessation among smokers unmotivated to quit. Jour- nal of Consulting and Clinical Psychology, 72, 371-281. doi:10.1037/0022-006X.72.3.371
[11] Batra, A., Klingler, K., Landfeldt, B., Friederich, H.M., Westin, A. and Danielsson, T. (2005) Smoking reduction treatment with 4-mg nicotine gum: A double-blind, randomized, placebo-controlled study. Clinical Pharmacology & Therapeutics, 78, 689-696. doi:10.1016/j.clpt.2005.08.019
[12] Rennard, S.I., Glover, E.D., Leischow, S., Daughton, D.M., Glover, P.N., Muramoto, M., et al. (2006) Efficacy of the nicotine inhaler in smoking reduction: A double-blind, randomized trial. Nicotine and Tobacco Research, 8, 555-564. doi:10.1080/14622200600789916
[13] Etter, J.F. and Laszlo, E. (2007) Postintervention effect of nicotine replacement therapy for smoking reduction: a randomized trial with a 5-year follow-up. Journal of Clinical Psychopharmacology, 27, 151-155. doi:10.1097/JCP.0b013e318033bd72
[14] Broms, U., Korhonen, T. and Kaprio, J. (2008) Smoking reduction predicts cessation: longitudinal evidence from the Finnish adult twin cohort. Nicotine and Tobacco Research, 10, 423-427.
[15] Joseph AM, Hecht SS, Murphy SE, Lando H, Carmella SG, Gross M, et al. (2008) Smoking reduction fails to improve clinical and biological markers of cardiac disease: A randomized controlled trial. Nicotine and To- bacco Research, 10, 471-481. doi:10.1080/14622200801901948
[16] McDermott, L., Dobson, A. and Owen, N. (2008) Smoking reduction and cessation among young adult women: a 7-year prospective analysis. Nicotine and Tobacco Research, 10, 1457-1466. doi:10.1080/14622200802323241
[17] Okuyemi, K.S., Thomas, J.L., Warren, J., Guo, H. and Ahluwalia, J.S. (2010) Relationship between smoking reduction and cessation among light smokers. Nicotine and Tobacco Research, 12, 1005-1010. doi:10.1093/ntr/ntq138
[18] Falba, T., Jofre-Bonet, M., Busch, S., Duchovny, N. and Sindelar, J. (2004) Reduction of quantity smoked predicts future cessation among older smokers. Addiction, 99, 93-102. doi:10.1111/j.1360-0443.2004.00574.x
[19] Farkas, A.J. (1999) When does cigarette fading increase the likelihood of future cassation? Annals of Behavioral Medicine, 21, 71-76. doi:10.1007/BF02895036
[20] Hyland, A., Levy, D.T., Rezaishiraz, H., Hughes, J.R., Bauer, J.E., Giovino, G.A., et al. (2005) Reduction in amount smoked predicts future cessation. Psychology of Addictive Behaviors, 19, 221-225. doi:10.1037/0893-164X.19.2.221
[21] Pisinger, C., Vestbo, J., Borch-Johnsen, K. and Jorgensen, T. (2005) Smoking reduction intervention in a large population-based study. The Inter99 study. Preventive Medicine, 40, 112-118. doi:10.1016/j.ypmed.2004.05.014
[22] Jorgensen, T., Borch-Johnsen, K., Thomsen, T.F., Ibsen, H., Glumer, C. and Pisinger, C. (2003) A randomized non-pharmacological intervention study for prevention of ischaemic heart disease: Baseline results Inter99. European Journal of Cardiovascular Prevention & Rehabilitation, 10, 377-386. doi:10.1097/01.hjr.0000096541.30533.82
[23] Homepage of the Inter99 study (2008), www.Inter99.dk
[24] Osler, M., Linneberg, A., Glumer, C. and Jorgensen, T. (2011) The cohorts at the Research Centre for Prevention and Health, formerly “The Glostrup Population Studies”. International Journal of Epidemiology, 40, 602-610. doi:10.1093/ije/dyq041
[25] Pisinger, C. and Godtfredsen, N.S. (2007) Is there a health benefit of reduced tobacco consumption? A systematic review. Nicotine and Tobacco Research, 9, 631- 646. doi:10.1080/14622200701365327
[26] Pisinger, C. (2007) High risk strategy in smoking cessation is feasible on a population-based level. The Inter99 study. Master of Public Health, University of Copenhagen, Copenhagen.
[27] Toft, U., Kristoffersen, L.H., Lau, C., Borch-Johnsen, K. and Jorgensen, T. (2007) The dietary quality score: Validation and association with cardiovascular risk factors: the Inter99 study. European Journal of Clinical Nutrition, 61, 270-278. doi:10.1038/sj.ejcn.1602503
[28] Saltin, B. AND Grimby, G. (1968) Physiological analysis of middle-aged and old former athletes. Comparison with still active athletes of the same ages. Circulation, 38, 1104-1115.
[29] Lochen, M.L. AND Rasmussen, K. (1992) The Tromso study: Physical fitness, self reported physical activity, and their relationship to other coronary risk factors. Journal of Epidemiology and Community Health, 46, 103-107. doi:10.1136/jech.46.2.103
[30] Ware, J. Jr., Kosinski, M. and Keller, S.D. (1995) SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales. The Health Institute, New England Medical Center, Boston.
[31] Bjorner, J.B., Damsgaard, M.T., Watt, T., Bech, P., Rasmussen, N.K., Modvig, J., et al. (1997) Dansk manual til SF-36. Et sporgeskema om helbredsstatus. Lif-Lagemid-delindustriforeningen, Copenhagen.
[32] Hughes, J.R. and Carpenter, M.J. (2006) Does smoking reduction increase future cessation and decrease disease risk? A qualitative review. Nicotine and Tobacco Research, 8, 739-749. doi:10.1080/14622200600789726
[33] Godtfredsen, N.S., Prescott, E., Osler, M. and Vestbo, J. (2001) Predictors of smoking reduction and cessation in a cohort of danish moderate and heavy smokers. Preventive Medicine, 33, 46-52. doi:10.1006/pmed.2001.0852
[34] Garcia, M., Fernandez, E., Schiaffino, A., Peris, M. and Borras, J.M. (2005) Smoking reduction in a population- based cohort. Preventive Medicine, 40, 679-684. doi:10.1016/j.ypmed.2004.09.007
[35] Joseph, A.M., Bliss, R.L., Zhao, F. and Lando, H. (2005 ) Predictors of smoking reduction without formal intervention. Nicotine and Tobacco Research, 7, 277-282. doi:10.1080/14622200500056176
[36] Pisinger, C., Vestbo, J., Borch-Johnsen, K. and Jorgensen, T. (2005) Smoking cessation intervention in a large randomised population-based study. The Inter99 study. Preventive Medicine, 40, 285-292. doi:10.1016/j.ypmed.2004.06.001
[37] Godtfredsen, N.S., Prescott, E., Vestbo, J. and Osler, M. (2006) Smoking reduction and biomarkers in two longitudinal studies. Addiction, 101, 1516-1522. doi:10.1111/j.1360-0443.2006.01542.x
[38] Pisinger, C., Vestbo, J., Borch-Johnsen, K., Thomsen, T. and Jorgensen, T. (2005) Acceptance of the smoking cessation intervention in a large population-based study: the Inter99 study. Scandinavian Journal of Public Health, 33, 138-145. doi:10.1080/14034940410028370

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.