Quitting Cigarettes Immediately Tied to More Health Benefits than Gradual Reduction

Cigarette smokers are better off quitting cold turkey rather than weaning themselves off of nicotine, according to research published in JAMA. 

The double-blind, randomized study included 1,250 smokers in the United States (mean age, 45 years; 549 women [44%]; 958 [77%] completed the trial) divided into three groups: those who immediately reduced their nicotine intake (0.4 mg of nicotine per gram of tobacco cigarettes), those who gradually reduced (from 15.5 mg to 0.4 mg of nicotine per gram of tobacco cigarettes with five monthly dose changes), and those who maintained their intake (15.5 mg of nicotine per gram of tobacco cigarettes). 

Over a 20-week period, those who immediately cut down their nicotine intake had significantly decreased exposure to breath carbon monoxide (CO), urine 3-hydroxypropylmercapturic acid (3-HPMA, metabolite of acrolein), and urine phenanthrene tetraol (PheT, indicator of polycyclic aromatic hydrocarbons) compared to the gradual group (CO, mean difference, -40.6 parts per million [ppm]; 3-HPMA, ratio of geometric means, 0.83; PheT, ratio of geometric means, 0.88). Exposure levels were also significantly lower for the immediate reduction group compared to the control group (CO, mean difference, -3.38 ppm; 3-HPMA, ratio of geometric means, 0.81; PheT, ratio of geometric means, 0.86). Researchers saw no significant differences between the gradual reduction and control groups. 

The immediate reduction group also had more smoke-free days, less cigarette dependence and smoked fewer cigarettes daily when compared to the gradual and control groups. 

According to Smokefree.gov, smoking is the leading cause of heart attacks and heart disease. It also leads to lung and DNA damage that could result in cancer. Just 20 minutes after quitting, a smoker’s heart rate returns to normal, per the American Lung Association; within the first two weeks to three months, risk of heart attack decreases. 

The new study also speaks to the benefits of gradual reduction, according to Dr. Dorothy Hatsukami, one of the study’s authors. 

“The results support the benefits of rapidly reducing nicotine in all cigarettes, primarily because this approach helped smokers, who initially had no immediate intentions to quit, experience smoke-free days,” Hatsukami, a psychiatry professor at the University of Minnesota, said. “This is good news because the majority of smokers want to quit smoking, but only a small percentage of smokers are successful.” 

Read about the benefits of quitting cigarettes. 

Read about the connection between passive smoking and rheumatoid arthritis. 

Sources: JAMA, University of Minnesota