Tuesday, November 6, 2012

Can’t quit smoking? Cutting back may be an option.


The negative health effects of smoking are clear and well established. As a result, smokers have been encouraged to completely quit smoking in order to reduce the risk of health problems. However, despite repeated attempts, most smokers find quitting to be extremely difficult. Without help, less than 1 in 20 smokers can quit; even with outside help, less than 1 in 4 smokers are successful at quitting.

Despite these rather gloomy statistics, the potential benefit of simply reducing the amount of smoking (as opposed to quitting) has not received much attention from the scientific community. However, a recent study changes this. A team of researchers from the School of Public Health at Tel Aviv University followed individuals over a 40 year time period. Smoking habits were recorded for the first two years of the study. The study found that, although quitting resulted in the greatest benefit to survival, reducing smoking was also beneficial. Individuals who reduced their smoking within the first two years lived longer than those who did not change smoking habits. Survival of individuals who quit smoking was even greater than those who reduced smoking habits.

While previous research has focused primarily on the benefits of quitting smoking, this study is among the first to show a health benefit from a reduction in smoking. Jennifer Taussig, MPH, of Emory University notes that “These findings should provide encouragement for smokers who haven’t been able to quit. For these individuals, reducing the number of cigarettes smoked per day may have a positive effect on long-term health.”

If quitting doesn’t seem to be an option, current smokers should consider how to reduce their overall intake of cigarettes. Physicians should use the results of this study to encourage patients to reduce their overall smoking, especially those patients who feel frustrated by not being able to quit.

In addition to smoking cessation programs, this study shows that smoking reduction programs may have the potential to improve health and may be a stepping stone towards quitting. For the larger healthcare system, smoking reduction programs should be designed, researched and implemented, possibly in conjunction with existing cessation programs.

While this is a single study, the results provide evidence that any reduction in smoking may improve health. Although quitting is the best option, for those who currently smoke, these new findings provide a second option to improve health throughout a lifetime.


Adam Vaughan, MPH, MS is a PhD student in epidemiology at Emory University’s Rollins School of Public Health.


Reference: Gerber, Y. et al. Smoking Reduction at Midlife and Lifetime Mortality Risk in Men: A Prospective Cohort Study. American Journal of Epidemiology. 2012;175(10):1006–1012

12 comments:

  1. Hi Adam,
    I thought this post was great. Definitely informative and to the point. I think it would definitely catch people's attention, especially if they are in the target population of thinking of or already trying to quit smoking. It would be a hopeful message to them that maybe the hurdle they have to climb is not so daunting if there is benefit to only reducing their smoking habits. As a suggestion, I think your language at the beginning could be even less formal and more conversational. Like..."we all know by now that quitting smoking is a good idea"..etc. Lastly, I also really liked the ideas you had about the clinical implications of this study. Nice job :)

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  2. Great job, Adam! As a former smoker who struggled with quitting, I can tell you that this would be very well received by the nicotine-dependent community. This step-down approach would likely appear much more manageable as a goal than cold-turkey quitting does (at least for some people). I think the layout/outline of the post is great, and very intuitive to follow: you start with describing the study, talk about why the study's worth discussing, and then let the reader know how to incorporate the study's findings into their own life. I think some of the sentence/paragraph structure could be reworked to make it easier for the reader to follow your train of thought. For example, the first lines of both the 2nd and 3rd paragraphs are redundant and could be streamlined. Other than that, excellent job!

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  3. Adam-great post! I really liked the intro to the article to give some background before stating the findings. I thought the language used was very clear, concise and appropriate for the lay audience. It could be interesting to mention harm reduction strategies in your case for reduced cigarette consumption for people who can't seem to quit.

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  4. Hey Adam good choice for an article and nice job summarizing.

    This is really an interesting study. It's a case where different people could look at the same data and have completely different interpretations. It all comes down to the reference group. You could say that those who reduce smoking have elevated risk compared to those who quit, or reduced risk compared to those that keep smoking.

    Anyway neat study and nice job.

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  5. Adam, good post! This is a very relevant topic for many people, and as you stated, one that might not get much attention in research. I think you did a great job translating the study, putting it in the context of prior research, and giving some ideas about potential clinical practice. You could add a few intro sentences targeting your audience -- more conversational, like your title.

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  6. Very interesting study. I don't think I ever considered reduction in smoking as an alternative to quitting altogether. This should bring hope to many smokers (including many of my friends who I have seen quit and restart smoking in a matter of months). I like the picture.

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  7. Hi Adam, nice post! I thought you described the study and its findings in a very clear way that would be understandable for a lay person. I also think that this was a very relevant article to choose and I think your blog post would be very well received by many people who have struggled to quit smoking. I wonder if a strategy to gradually decrease the number of cigarettes smoked until a person has quit completely would be successful - it seems feasible given the findings in this article!

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  8. Hi Adam,

    Great topic for something that is relevant to many people. I really like your title and also the picture -- catchy and informative.

    I agree with the other suggestions -- one way to make the tone more conversational is to use more simple words. Even using "people" instead of "individuals" or "doctors" instead of "physicians" makes it sound more accessible to everyone and less like a researcher is talking.

    I think your second to last paragraph sounds particularly academic and seems to take you away from your original audience. Rather than continuing to refer back to the study at the very end, I'd again keep your audience in mind and speak to them directly (ala some of Beverly's comments above). Keep the greater impact (better health) in mind and focus on how you will persuade them to work towards that goal.

    Thanks!

    Ariela



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  9. This is a great study because it takes one of those "A ha. . ." kind of "solutions" that we simply don't think about. In most literature it seems like the focus is on cessation programs, and doesn't really take a look at the benefit of a gradual weening off of cigarettes. I imagine this could have great translational impact if folded into current smoking cessation programs, as quitting cold-turkey is probably the biggest hurdle individuals face.

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  10. A helpful solution, but will the result of "smoking less is not too bad" be interpreted as "smoking a little is OK" by the public, especially teenagers?

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  11. Good post, Adam! The blog conveys the benefits of reduction in smoking clearly . It's really amazing that researchers have ignored the benefits of simply reduction in smoking.
    I like the idea that we cannot expect totally quitting smoking among most of the smokers, at least we could help them benefit from less smoking.

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  12. Good job, Adam! Your blog post was clear and an easy read. I think the language in the article was fine, although there were a couple points where you could have been more casual. I like that you mentioned how the study's results could be implemented.

    I don't know much about cessation programs, I thought most existing programs discouraged the cold-turkey approach and focused on gradual independence.

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