Trying to Quit Cigarette Smoking by Cutting Down or Stopping Abruptly
Mené sur 697 fumeurs adultes, cet essai randomisé évalue, du point de vue du taux d'abstinence tabagique à 4 semaines et à 6 mois, l'efficacité d'un sevrage tabagique progressif par rapport à un arrêt brusque du tabagisme
What is the problem and what is known about it so far ? Although cigarette smokers are generally advised to quit by setting a date on which they will stop abruptly, whether some people will be more successful by gradually reducing cigarette smoking (“cutting down”) before quitting altogether is not clear. Why did the researchers do this particular study ? To find out if gradual reduction is as good as abrupt quitting for attempts to stop cigarette smoking. Who was studied ? 697 adult cigarette smokers. How was the study done ? The smokers were randomly assigned to 2 groups. In the “gradual-cessation” group, the participants were given instructions on how to progressively decrease (“cut down”) the number of cigarettes they smoked over a 2-week period before a planned quit date, on which they were instructed to try to stop all cigarette smoking. Participants in the “abrupt-cessation” group were told to continue smoking as they normally would until the scheduled quit date 2 weeks later. Participants in both groups were given nicotine patches before and after their quit date, as well as either short-acting nicotine gum or lozenges after the quit date to further reduce their urge to smoke. Participants in the gradual-cessation group were also instructed to use short-acting nicotine replacement products, such as gum or lozenges, before the quit date. The researchers then followed the participants after the quit date to assess whether they had been able to quit and whether symptoms differed between the groups. What did the researchers find ? At both 4 weeks and 6 months after their planned quit dates, more participants in the abrupt-cessation group than in the gradual-cessation group had quit completely. Overall, participants who said they would prefer to gradually reduce their cigarette use before the quit date were less likely to stop altogether regardless of group assignment. There were no important differences between the 2 groups in the symptoms that bothered the participants (for example, urges to smoke). What were the limitations of the study ? To avoid influencing the results, it is preferable that the participants and researchers not know which group each participant is in during the study. That was not possible in this study. What are the implications of the study ? Although gradually cutting down smoking first may help some smokers quit, overall it is better to abruptly stop.