Cold turkey is the best way to quit smoking. New smoking cessation research reveals that smokers who quit in one go are 25 percent more likely to stay off tobacco than those who try to quit in increments.
While current health guidelines recommend that smokers select a date to quit completely, statistics show that people prefer quitting gradually rather than abruptly.
The latest study, conducted at Oxford University, involved 697 adult smokers who were randomly assigned to quit abruptly or to quit gradually. Participants in the abrupt group were asked to set a quit day to completely stop smoking, and those in the gradual group were asked to bit by bit reduce their tobacco use in the two weeks leading up to an agreed-upon quit date.
Participants in both groups received advice, support and access to nicotine patches, nicotine gum or mouth spray.
Researchers then compared the four-week and six-month abstinence between the abrupt smoking cessation group and the gradual smoking cessation group.
"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," researchers wrote in the study.
The results revealed that 39 percent of the gradual cessation group and 49 percent of the abrupt cessation group had successful kept off tobacco at four weeks. Study results revealed that 15 percent of the gradual cessation group and 22 percent of the abrupt cessation group successfully kept off tobacco at six months.
Researchers said the findings suggest that people who quit tobacco abruptly are 25 percent more likely to succeed compared to those who quit gradually.
"The difference in quit attempts seemed to arise because people struggled to cut down. It provided them with an extra thing to do, which may have put them off quitting altogether. If people actually made a quit attempt then the success rate was equal across groups. We also found that more people preferred the idea of quitting gradually than abruptly; however, regardless of what they thought, they were still more likely to quit in the abrupt group," said lead researcher Dr. Nicola Lindson-Hawley of Oxford University.
"It is important to note that these results were found in people who wanted to quit soon and who were receiving counselling support and using nicotine replacement therapy. For these people, the best advice appears to be to pick a day and stop smoking completely on that day. However, as we found that at the start of the study many people cannot imagine being able to stop completely. For these people, it is much better to attempt to cut down their smoking than do nothing at all and we should increase support for gradual cessation to increase their chances of succeeding," Lindson-Hawley concluded.
Despite the latest findings, experts writing in an accompanying article say that gradual smoking cessation should not be completely abandoned. While seemingly less effective than quitting cold turkey, editorial writers Dr. Gabriela S. Ferreira and Dr. Michael B. Steinberg say that gradual smoking cessation may be useful for certain types of smokers.
"Although gradual reduction was inferior to abrupt cessation in this trial, this approach may still have utility in other smokers. All participants were willing to quit within 2 weeks of enrollment. In the general population, however, many smokers have tried several times to quit abruptly and have been unsuccessful. They may not wish to set a quit date to avoid another unsuccessful attempt, but they might be willing to gradually reduce smoking with the goal of achieving cessation," wrote Ferreira and Steinberg.
"Gradual reduction may encourage these smokers, perhaps those less motivated, or those with lower self-efficacy, to make a quit attempt. Therefore, this method should not be entirely abandoned," they added.
The findings and accompanying editorial are published in journal Annals of Internal Medicine.
