Dec. 25, 2000 ROCHESTER, MINN. -- Heavy cigarette smokers who cut back their smoking -- rather than quit -- might not see any health benefits, according to a Mayo Clinic study published in the December 15 issue of Nicotine and Tobacco Research.
"Many people -- smokers and medical professionals alike -- assume that if smokers can simply cut back, there will be some health benefits," says Richard Hurt, M.D., a physician who treats patients at Mayo Clinic's Nicotine Dependence Center and principal researcher on the study. "Our results didn't show that."
The study included 23 heavy smokers -- adults who smoked more than 40 cigarettes a day. Over the course of nine weeks, they tried to gradually cut back to 10 cigarettes a day. Participants received information and counseling on strategies to help deal with stress, hunger and other typical signs of nicotine withdrawal. Participants also could use a nicotine inhaler to help them reduce their desire for cigarettes. (With an inhaler, nicotine stays in the mouth and does not produce the ill health effects associated with tobacco products.)
At the end of 12 weeks, researchers measured several biomarkers in each participant that indicate harm from cigarettes. "One biomarker improved, showing less harm," says Dr. Hurt. "Four stayed the same, meaning no health benefits, and one got worse, indicating increased harm. We don't know why results were so varied."
And participants found it difficult to reach the smoking reduction goals to which they had agreed. On average, they were able to cut their smoking rate in half by the 12th week, short of the study's goal of a reduction to 10 cigarettes a day. Only two participants were able to cut back to 10 cigarettes a day, and at a 24-week recheck, they had increased their daily smoking rate.
"The study found that cutting back on cigarettes isn't easy, even with help, and the health benefits are unclear," says Dr. Hurt. The conclusion: more research is needed before promoting smoking reduction as a treatment strategy.
For smokers motivated to improve their health, research shows that abstinence is the best approach.
"Heavy smokers who use nicotine replacement therapy and receive counseling and support can stop smoking," says Dr. Hurt. "And when smokers stop, there are measurable and almost immediate health benefits."
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