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INTRODUCTION  The aim of this review is to test whether a gradual reduction in smoking results in a superior quit rate compared to abrupt cessation.    METHODS  This review was based on Cochrane methodology for conducting meta-analysis. Only randomized controlled trials were eligible for this review. The participants were adult smokers who were addicted to tobacco, defined as those who smoked at least 15 cigarettes or 12.5 grams of loose-leaf tobacco daily or who had an end-expiratory carbon monoxide concentration of at least 15 ppm. Both groups used an equal amount of nicotine replacement therapy (NRT) before and after quitting smoking. The Review Manager Database (RevMan version 5.3) was used to analyze selected studies.    RESULTS  Three randomized controlled trials involving 1607 patients were included. The prolonged abstinence rate of the gradual cessation group was significantly lower than that of the abrupt group (relative risk, RR=0.77). The result of 7-day smoking cessation rate was also lower in the gradual group (RR=0.76).    CONCLUSIONS  Comparing the combination of NRT and abrupt cessation, the smoking cessation rate of the combination of NRT and gradual cessation is significantly lower. No significant adverse events were found in either group.

A meta-analysis of the effectiveness of gradual versus abrupt smoking cessation