Abstract:
Aim: To examine whether smokers who reduce their quantity of cigarettes smoked between two
periods are more or less likely to quit subsequently.
Study Design: Data come from the Health and Retirement Study, a nationally representative
survey of older Americans aged 51-61 in 1991 followed every 2 years from 1992 to 1998. The
2,064 participants smoking at baseline and the first follow-up comprise the main sample.
Measurements: Smoking cessation by 1996 is examined as the primary outcome. A secondary
outcome is relapse by 1998. Spontaneous changes in smoking quantity between the first two
waves make up the key predictor variables. Control variables include gender, age, education,
race, marital status, alcohol use, psychiatric problems, acute or chronic health problems, and
smoking quantity.
Findings: Large (over 50%) and even moderate (25-50%) reductions in quantity smoked
between 1992 and 1994 prospectively predict increased likelihood of cessation in 1996 compared
to no change in quantity (OR 2.96, p<.001 and OR 1.61, p<.01 respectively). Additionally, those
who reduced and then quit were somewhat less likely to relapse by 1998 than those who did not
reduce in the two years prior to quitting.
Conclusions: Successfully reducing the quantity of cigarettes smoked appears to have a
beneficial effect on future cessation likelihood, even after controlling for initial smoking level
and other variables known to impact smoking cessation. These results indicate that the harm
reduction strategy of reduced smoking warrants further study.
