News for Smokers: Cutting Back Isn't Good Enough
New research debunks the belief that cutting down on cigarette smoking can buy you time. The study, published in the current issue of Tobacco Control, found that heavy smokers who halved their daily cigarette intake had the same overall mortality rates as people who continued to smoke 15 or more cigarettes per day. Lead researcher Kjell Bjartveit, an epidemiologist for Norway's National Health Screening Service, says that believing you can lower your risk of death and disease by reducing intake is "nonsense," and health educators and doctors who promote the idea need to reassess the tactic. "The message is: If you want to do something with your cigarette smoking, quit entirely."
More than 51,000 adults ages 20 to 49 were screened initially in Norway during the mid-1970s, with either one, two or three follow-up screenings over the next three to 13 years. They answered questionnaires on smoking habits, and had blood pressure, height, weight, and several blood tests taken to determine cardiovascular risk.
For both men and women, the heavy smokers who reduced daily cigarette smoking by half saw no significant difference in risk of death from any cause, including cardiovascular disease, ischemic heart disease, and smoking-related cancers, than that ofthe heavy smokers. Risk was adjusted for age, family history of coronary heart disease, cholesterol, blood pressure, body mass, and other variables.
The group that had a third follow-up screening included a subgroup of participants who initially halved daily smoking, then quit altogether. These "ex-smokers" had a 50 percent lower overall mortality rate than those who continued to smoke heavily.
Bjartveit acknowledges that slowing down could be beneficial as a means to an end: quitting. But lighter use shouldn't go on for more than a few weeks, he says. Use "reduction as a temporary measure but not as a permanent solution."
But going cold turkey often fails, says Bill Blatt, manager of tobacco control programs at the American Lung Association. He recommends pairing a cessation medication, like nicotine gum, a patch, or an oral medicine like Zyban, with counseling.
Reducing the number of cigarettes can be a step toward quitting, says Blatt–who hasn't seen the Norwegian study so can't comment on it directly. But ultimately, "there's no safe way to smoke. There's no safe amount to smoke. There's no safe cigarette."
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