Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial

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Gradual Versus Abrupt Smoking Cessation : A Randomized, Controlled Noninferiority Trial. / Lindson-Hawley, Nicola; Banting, Miriam; West, Robert; Michie, Susan; Shinkins, Bethany; Aveyard, Paul.

In: Annals of internal medicine, Vol. 164, No. 9, 03.05.2016, p. 585-92.

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@article{22f3e07d63544477be1588e921036d15,
title = "Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial",
abstract = "BACKGROUND: Most smoking cessation guidelines advise quitting abruptly. However, many quit attempts involve gradual cessation. If gradual cessation is as successful, smokers can be advised to quit either way.OBJECTIVE: To examine the success of quitting smoking by gradual compared with abrupt quitting.DESIGN: Randomized, controlled noninferiority trial. (International Standardized Randomized Controlled Trial Number Register: ISRCTN22526020).SETTING: Primary care clinics in England.PARTICIPANTS: 697 adult smokers with tobacco addiction.INTERVENTION: Participants quit smoking abruptly or reduced smoking gradually by 75% in the 2 weeks before quitting. Both groups received behavioral support from nurses and used nicotine replacement before and after quit day.MEASUREMENTS: The primary outcome measure was prolonged validated abstinence from smoking 4 weeks after quit day. The secondary outcome was prolonged, validated, 6-month abstinence.RESULTS: At 4 weeks, 39.2% (95% CI, 34.0% to 44.4%) of the participants in the gradual-cessation group were abstinent compared with 49.0% (CI, 43.8% to 54.2%) in the abrupt-cessation group (relative risk, 0.80 [CI, 0.66 to 0.93]). At 6 months, 15.5% (CI, 12.0% to 19.7%) of the participants in the gradual-cessation group were abstinent compared with 22.0% (CI, 18.0% to 26.6%) in the abrupt-cessation group (relative risk, 0.71 [CI, 0.46 to 0.91]). Participants who preferred gradual cessation were significantly less likely to be abstinent at 4 weeks than those who preferred abrupt cessation (38.3% vs 52.2%; P = 0.007).LIMITATIONS: Blinding was impossible. Most participants were white.CONCLUSION: Quitting smoking abruptly is more likely to lead to lasting abstinence than cutting down first, even for smokers who initially prefer to quit by gradual reduction.PRIMARY FUNDING SOURCE: British Heart Foundation.",
keywords = "Journal Article",
author = "Nicola Lindson-Hawley and Miriam Banting and Robert West and Susan Michie and Bethany Shinkins and Paul Aveyard",
year = "2016",
month = may,
day = "3",
doi = "10.7326/M14-2805",
language = "English",
volume = "164",
pages = "585--92",
journal = "Annals of internal medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "9",

}

RIS

TY - JOUR

T1 - Gradual Versus Abrupt Smoking Cessation

T2 - A Randomized, Controlled Noninferiority Trial

AU - Lindson-Hawley, Nicola

AU - Banting, Miriam

AU - West, Robert

AU - Michie, Susan

AU - Shinkins, Bethany

AU - Aveyard, Paul

PY - 2016/5/3

Y1 - 2016/5/3

N2 - BACKGROUND: Most smoking cessation guidelines advise quitting abruptly. However, many quit attempts involve gradual cessation. If gradual cessation is as successful, smokers can be advised to quit either way.OBJECTIVE: To examine the success of quitting smoking by gradual compared with abrupt quitting.DESIGN: Randomized, controlled noninferiority trial. (International Standardized Randomized Controlled Trial Number Register: ISRCTN22526020).SETTING: Primary care clinics in England.PARTICIPANTS: 697 adult smokers with tobacco addiction.INTERVENTION: Participants quit smoking abruptly or reduced smoking gradually by 75% in the 2 weeks before quitting. Both groups received behavioral support from nurses and used nicotine replacement before and after quit day.MEASUREMENTS: The primary outcome measure was prolonged validated abstinence from smoking 4 weeks after quit day. The secondary outcome was prolonged, validated, 6-month abstinence.RESULTS: At 4 weeks, 39.2% (95% CI, 34.0% to 44.4%) of the participants in the gradual-cessation group were abstinent compared with 49.0% (CI, 43.8% to 54.2%) in the abrupt-cessation group (relative risk, 0.80 [CI, 0.66 to 0.93]). At 6 months, 15.5% (CI, 12.0% to 19.7%) of the participants in the gradual-cessation group were abstinent compared with 22.0% (CI, 18.0% to 26.6%) in the abrupt-cessation group (relative risk, 0.71 [CI, 0.46 to 0.91]). Participants who preferred gradual cessation were significantly less likely to be abstinent at 4 weeks than those who preferred abrupt cessation (38.3% vs 52.2%; P = 0.007).LIMITATIONS: Blinding was impossible. Most participants were white.CONCLUSION: Quitting smoking abruptly is more likely to lead to lasting abstinence than cutting down first, even for smokers who initially prefer to quit by gradual reduction.PRIMARY FUNDING SOURCE: British Heart Foundation.

AB - BACKGROUND: Most smoking cessation guidelines advise quitting abruptly. However, many quit attempts involve gradual cessation. If gradual cessation is as successful, smokers can be advised to quit either way.OBJECTIVE: To examine the success of quitting smoking by gradual compared with abrupt quitting.DESIGN: Randomized, controlled noninferiority trial. (International Standardized Randomized Controlled Trial Number Register: ISRCTN22526020).SETTING: Primary care clinics in England.PARTICIPANTS: 697 adult smokers with tobacco addiction.INTERVENTION: Participants quit smoking abruptly or reduced smoking gradually by 75% in the 2 weeks before quitting. Both groups received behavioral support from nurses and used nicotine replacement before and after quit day.MEASUREMENTS: The primary outcome measure was prolonged validated abstinence from smoking 4 weeks after quit day. The secondary outcome was prolonged, validated, 6-month abstinence.RESULTS: At 4 weeks, 39.2% (95% CI, 34.0% to 44.4%) of the participants in the gradual-cessation group were abstinent compared with 49.0% (CI, 43.8% to 54.2%) in the abrupt-cessation group (relative risk, 0.80 [CI, 0.66 to 0.93]). At 6 months, 15.5% (CI, 12.0% to 19.7%) of the participants in the gradual-cessation group were abstinent compared with 22.0% (CI, 18.0% to 26.6%) in the abrupt-cessation group (relative risk, 0.71 [CI, 0.46 to 0.91]). Participants who preferred gradual cessation were significantly less likely to be abstinent at 4 weeks than those who preferred abrupt cessation (38.3% vs 52.2%; P = 0.007).LIMITATIONS: Blinding was impossible. Most participants were white.CONCLUSION: Quitting smoking abruptly is more likely to lead to lasting abstinence than cutting down first, even for smokers who initially prefer to quit by gradual reduction.PRIMARY FUNDING SOURCE: British Heart Foundation.

KW - Journal Article

U2 - 10.7326/M14-2805

DO - 10.7326/M14-2805

M3 - Article

C2 - 26975007

VL - 164

SP - 585

EP - 592

JO - Annals of internal medicine

JF - Annals of internal medicine

SN - 0003-4819

IS - 9

ER -