Ready To Quit Smoking? Best To Go All In : Shots - Health News Quitting abruptly is more effective, a study finds, even for people who'd rather phase it out gradually.

To Quit Smoking, It's Best To Go Cold Turkey

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If you want to quit smoking, you should just rip off the Band-Aid. A study out this week says even when people are reluctant they do better when they throw the cigarettes away rather than scale them back. NPR's Rae Ellen Bichell has details.

RAE ELLEN BICHELL, BYLINE: Nicola Lindson-Hawley studies smoking behavior in England.

NICOLA LINDSON-HAWLEY: One of the reasons I find this topic very interesting and why I went into it was because my mom was a smoker when I was younger. But I remember her quitting, and I remember her finding it difficult.

BICHELL: Really difficult. Lindson-Hawley helped her mom keep track of the number of days she'd stayed away from cigarettes by putting stickers in a journal. The experience made her want to help others stop smoking. She's now a public health researcher in the Nuffield Department of Primary Care Health Sciences at the University of Oxford. In a study on hundreds of smokers...

LINDSON-HAWLEY: Around 700 adult smokers.

BICHELL: ...She found that her mom quit the right way - by going cold turkey. The results are out in the current issue of Annals of Internal Medicine. Study participants were randomly assigned to two groups. One had to quit abruptly on a given day, going from a pack a day to zero. The other tapered down over two weeks to half a pack each day, and then a quarter of a pack before quitting.

LINDSON-HAWLEY: And in both groups, they were given some nicotine replacement therapy before they quit and also after they quit.

BICHELL: Everyone got a nicotine patch in addition to a second form of nicotine replacement after they quit, like gum or nasal spray. They also had talk therapy with a nurse before and after quit day.

LINDSON-HAWLEY: After they'd quit, we rang them up four weeks later and then again six months later to see how they were getting on.

BICHELL: To double check that people were being honest, the researchers measured how carbon monoxide they exhaled. Six months out, more people who had quit abruptly had stuck with it - more than a fifth of them - compared to about a seventh in the other group. That's despite the fact that before the study started, most people had said they'd rather cut down gradually before quitting.

LINDSON-HAWLEY: If you're training for a marathon, you wouldn't expect to turn up and just be able to run it, and I think people see that for smoking as well. They think well, if I gradually reduce, it's almost practice.

BICHELL: But that wasn't the case. Lindson-Hawley says instead of giving people practice, the gradual reduction likely gave them cravings and withdrawal before they even reached the quit day, which could be why fewer people in that group actually made it to that point.

GABRIELA FERREIRA: I think that's the piece that's so convincing, which is that regardless of your stated preference, if you are ready to quit, quitting abruptly is more effective.

BICHELL: Dr. Gabriela Ferreira is an internist at the Robert Wood Johnson University Hospital in New Jersey. She says in other studies where participants didn't get behavioral support and nicotine replacement, barely anyone managed to stay off cigarettes.

FERREIRA: When you can quote a specific number like a fifth of the patients who did this were able to quit, that's a compelling number, and I think that translates to the patient. It kind of gives them the encouragement, I think, to really go for it.

BICHELL: Ferreira says studies like these are important to convince doctors what really works for patients who are ready to quit.

FERREIRA: Right, so this happened to me last week. I had a patient who came in and I said, are you ready to quit? And he said yes, I really want to quit, and I really need help, and I want my partner to come with me.

BICHELL: So she got him on the patch, connected him with a behavioral therapy nurse, and got him on his way toward a quit day. People rarely manage to quit the first time they try. But at least, she says, they're maximizing his odds of success. Rae Ellen Bichell, NPR News.

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