Quitting Smoking – Cold Turkey vs Gradual Cessation

Background:  Most guidelines recommend a “quit date” rather than quitting gradually, but what’s the evidence?
UK study, n = 697, mean 1 pk/day
Randomized to set quit date/abrupt vs quit date/gradual cut back x 2 weeks prior.
All got nicotine replacement and behavioral support.
Abstinence confirmed by exhaled CO measurement.
At 4 weeks, 49% in abrupt cessation group abstinent vs 39% in gradual cessation group.
At 6 mos, 22% abrupt vs 16% gradual.
At baseline, 51% said they’d prefer gradual cessation, and 32% abrupt cessation.
At 4 weeks, those who preferred gradual cessation were less likely to be abstinent.
Conclusion:  Supports current guidelines to set a quit date and stop abruptly.  However, some may benefit from gradual cessation. Willingness to quit abruptly may be related to higher motivation to quit.
Ann Intern Med 2016 May 3; 164:585

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