Reduction of quantity smoked predicts future cessation among older smokers

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 2064 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 predict prospectively increased likelihood of cessation in 1996 compared to no change in quantity (OR 2.96, P  < 0.001 and OR 1.61, P  < 0.01, respectively). Additionally, those who reduced and then quit were somewhat less likely to relapse by 1998 than those who did not reduce in the 2 years prior to quitting. Conclusions  Reducing successfully 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.