Quitting Cigarettes Cold Turkey Better Than Cutting Down Gradually

woman quit smoking

Smoking is a tough habit to break. By most estimates, about two out of every three smokers wants to quit, but studies have found that smokers may need to try to quit anywhere from eight to 11 times before they finally succeed. To make quitting easier, research has been ongoing about the best way to approach kicking the habit, from patches to gum to medications. New research released this week looks at another aspect of quitting: how fast to cut down. The researchers’ findings show that cutting down gradually may not help your chances of kicking the habit for good.

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Why is it so hard to quit smoking?
The key ingredient in cigarettes is a drug called nicotine that’s found in the tobacco leaf. While there are lots of other chemicals that hit your body when you inhale smoke from a cigarette, it’s the hit of nicotine that keeps you coming back for more. Nicotine is highly addictive and acts on different parts of your brain to set up the cravings smokers feel when they go too long without smoking. Cravings happen when the levels of nicotine in your brain start to drop and the effects of the drug begin to wear off. That leads to the unpleasant withdrawal side effects that smokers experience, including irritability, anxiety, headaches, and nausea. While withdrawal from smoking isn’t dangerous, it’s very unpleasant, which discourages many smokers from sticking with their plans to quit. Plus, many aspects of a person’s life may remind them of smoking or encourage them to smoke, like going out with friends who also smoke, which often makes it harder to abstain.

What is normally recommended for people trying to quit?
Over the years, a variety of nicotine replacements and medications have been found to help smokers quit more easily. Nicotine replacement products, such as patches, lozenges, or gums, help provide a low level of nicotine to reduce the cravings. Two medications, bupriopion and varenicline, have also been found to help smokers quit by reducing cravings. Exactly how they do this isn’t clear, but it probably has to do with the way they change the chemistry of the brain. People trying to quit often try a few approaches at the same time, by combining a nicotine gum and a medication like varenicline for example. The medication helps reduce overall cravings and the gum helps when the cravings are worst. While most healthcare professionals recommend smokers abruptly give up smoking on a specific date, many smokers try to make quitting easier by slowly cutting down on the number of cigarettes they smoke before finally kicking the habit. This study wanted to see whether or not that was a helpful strategy.

How did the researchers compare sudden and gradual quitting?
The researchers recruited almost 700 people who smoked at least 15 cigarettes per day to participate in the study. Researchers randomly selected half of the group and had them set a quit date where they would abruptly stop smoking. The other half were given a quit date and told to cut down on the number of cigarettes they smoke over the two weeks leading up to that date. This group was also given nicotine replacement products to help, including nicotine patches and lozenges. Both groups received nicotine replacement and counseling after they quit. The researchers met up with the participants four weeks and six months later to see how many had stayed off cigarettes.

What did the researchers find?
The team found that the smokers who quit abruptly without cutting down were more likely to still be off of cigarettes at four weeks and six months than those who had quit gradually. About 40 percent of the gradual quitters were still abstinent at four weeks compared to about 50 percent of abrupt quitters. Abrupt quitters were also more likely to still be off of cigarettes at six months. This was even the case for people who said before the study they would have preferred to quit gradually. The research team believes this might have to do with motivation — people who are more motivated to quit tend to go cold turkey. People less motivated to quit might have a harder time giving up cigarettes, which is why they slowly cut down, and are more likely to go back as a result. Interestingly, craving and withdrawal symptoms were the same in both groups, indicating that cutting down gradually didn’t help you feel any better when you finally decided to quit.

What does this mean for me?
If you’re a smoker, quitting is the best thing you can do for your health. Most likely, you know that, and already want to quit. This study shows that picking a date and quitting abruptly is the best strategy. While slowly cutting down might seem to ease the pain, these results show cravings can be just a bad regardless of which method you choose. If you’ve failed in the past, don’t give up hope: About half of all people who have a history of smoking have quit. Quitting is entirely possible — the key is setting a date and having support. Let your doctor know you’re planning to quit and figure out what nicotine replacements or medications would work best for you. Once you set that date, resolve to kick the habit and don’t look back.