Which Smoking Cessation Method Is More Effective: Gradual Reduction or Quitting Abruptly?

Smoking and smoking-related diseases are leading causes of death worldwide. Smoking accounts for 5 million deaths annually worldwide and 100 thousand in Türkiye. It causes 90% of lung cancer deaths, 90% of chronic obstructive pulmonary disease (COPD) deaths, 35% of all cancer deaths in men and 15% in women.

Smoking clearly causes serious illnesses and losses of life, lifespan and quality of life. Therefore, smoking is the largest preventable cause of cancer.

Smoking cessation studies continue showing that alternative tobacco products do not achieve desired success and the idea “I will quit by cutting down” continues to be shown by studies, contrary to common belief, not to be sufficiently effective for achieving smoking cessation.

A recent controlled Oxford University study compared abrupt and gradual quitting. Randomly selected 697 smokers were assessed at 4 weeks and 6 months.

The team noted that although communities consider gradual reduction helpful, stopping all at once was more effective.

The researchers worked with two groups of adult smokers: a group of 355 adults who stopped smoking all at once and another group of 342 adults who stopped smoking gradually.

Abrupt quitters chose a quit day within 2 weeks. Gradual quitters reduced smoking by 50% by the first week’s end and sought another 25% reduction in the second week.

Nurses provided behavioral support and nicotine replacement patches before and after cessation in both groups. Abrupt quitters also followed somewhat challenging, advanced coping strategies to resist reuse during this period. At subsequent visits, researchers assessed salivary cotinine (a nicotine end product) and exhaled carbon monoxide concentration.

At week 4, 39.2% of gradual quitters maintained abstinence versus 49.0% of abrupt quitters.

At month 6, the researchers observed that 15.5% of participants in the gradual smoking cessation group had maintained abstinence; in the group stopping smoking all at once, 22.0% had maintained abstinence.

In conclusion, as this study’s clear evidence indicates, although gradual cessation is considered effective, quitting all at once works better in both the short and long term.