Going Slow May Not Be Best When Quitting Smoking
Authors: Gabriela S. Ferreira, Michael B. Steinberg
Journal: Annals of Internal Medicine (2016)

Editorials3 May 2016Going Slow May Not Be Best When Quitting SmokingGabriela S. Ferreira, MD and Michael B. Steinberg, MD, MPHGabriela S. Ferreira, MDFrom Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Search for more papers by this author and Michael B. Steinberg, MD, MPHFrom Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0362 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Current guidelines for smoking cessation sponsored by the U.S. Public Health Service (1) and developed by the U.S. Preventive Services Task Force (2) recommend that physicians provide tailored pharmacotherapy and behavioral interventions to all smokers who want to quit. A 2012 systematic review of combined intensive behavioral therapy and pharmacotherapy (3) showed 6-month abstinence rates of 14.5% compared with 8% for patients receiving no or brief advice on quitting. Pharmacotherapies approved by the U.S. Food and Drug Administration for smoking cessation include nicotine replacement therapy (NRT), sustained-release bupropion, and varenicline. A systematic review of these therapies (4) showed that they ...References1. Tobacco Use and Dependence Guideline Panel. Treating tobacco use and dependence: 2008 update. Rockville, MD: U.S. Department of Health and Human Services; 2008. Accessed at http://bphc.hrsa.gov/buckets/treatingtobacco.pdf on 8 March 2016. Google Scholar2. Siu AL; U.S. Preventive Services Task Force. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women. U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:622-34. [PMID: 26389730]. doi:10.7326/M15-2023 LinkGoogle Scholar3. Stead LF, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2012;10:CD008286. [PMID: 23076944] doi:10.1002/14651858.CD008286.pub2 CrossrefMedlineGoogle Scholar4. Patnode CD, Henderson JT, Thompson JH, Senger CA, Fortmann SP, Whitlock EP. Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women. A review of reviews for the U.S. Preventive Services Task Force. Ann Intern Med. 2015;163:608-21. [PMID: 26389650]. doi:10.7326/M15-0171 LinkGoogle Scholar5. Cheong Y, Yong HH, Borland R. Does how you quit affect success? A comparison between abrupt and gradual methods using data from the International Tobacco Control Policy Evaluation Study. Nicotine Tob Res. 2007;9:801-10. [PMID: 17654293] CrossrefMedlineGoogle Scholar6. Lindson-Hawley N, Aveyard P, Hughes JR. Reduction versus abrupt cessation in smokers who want to quit. Cochrane Database Syst Rev. 2012;11:CD008033. [PMID: 23152252] doi:10.1002/14651858.CD008033.pub3 CrossrefMedlineGoogle Scholar7. Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual versus abrupt smoking cessation. A randomized, controlled noninferiority trial. Ann Intern Med. 2016;164:585-92. doi:10.7326/M14-2805 LinkGoogle Scholar8. Hughes JR, Solomon LJ, Livingston AE, Callas PW, Peters EN. A randomized, controlled trial of NRT-aided gradual vs. abrupt cessation in smokers actively trying to quit. Drug Alcohol Depend. 2010;111:105-13. [PMID: 20537810] doi:10.1016/j.drugalcdep.2010.04.007 CrossrefMedlineGoogle Scholar9. West R, Brown J. Smoking and smoking cessation in England 2011. London: Smoking in England; 2012. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Disclosures: Dr. Steinberg reports personal fees from Arena Pharmaceuticals (March 2015), Major League Baseball (2015 to present), and Pfizer (2006 to 2007) outside the submitted work. Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0362.Corresponding Author: Michael B. Steinberg, MD, MPH, Rutgers Robert Wood Johnson Medical School, Division of General Internal Medicine, 125 Paterson Street, Suite 2300, New Brunswick, NJ 08903; e-mail, michael.[email protected]edu.Current Author Addresses: Drs. Ferreira and Steinberg: Rutgers Robert Wood Johnson Medical School, Division of General Internal Medicine, 125 Paterson Street, Suite 2300, New Brunswick, NJ 08903.This article was published at www.annals.org on 15 March 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGradual Versus Abrupt Smoking Cessation Nicola Lindson-Hawley , Miriam Banting , Robert West , Susan Michie , Bethany Shinkins , and Paul Aveyard Metrics 3 May 2016Volume 164, Issue 9Page: 622-623KeywordsDisclosureDrug therapyMedical servicesMotivationNicotineNicotine replacement therapyObservational studiesRelative riskSmoking cessationSystematic reviews ePublished: 15 March 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...