Which reduction methods work best and how you can use them?

Author:
Paul Aveyard

Presenters:
Paul Aveyard
Clinical Reader / NIHR Career Scientist

Nicola Lindson
PhD Researcher

Sarah Clarke
Trial Co-ordinator, Primary Care Clinical School, University of Birmingham, UK

Abstract
We recently published a Cochrane Review which concluded that reducing smoking before a quit day produces comparable quit rates to quitting abruptly, therefore smokers could be given the option to quit either way. However, although there is little opportunity for variation in an abrupt quit attempt there are a variety of different ways a smoker could reduce before quitting, which may have different success rates. For example there is evidence to suggest that a structured reduction attempt is more successful than an unstructured reduction attempt. We are currently carrying out a review of studies which have asked participants to reduce their smoking to identify and create a taxonomy of reduction methods. We also aim to identify randomised controlled trials that compare reduction interventions to get an idea of which is the best way to reduce. Available findings will be presented. We are also carrying out a randomised controlled trial comparing abrupt quitting to rapid reduction before a quit day. Participants randomised to the reduction arm are given a choice of one of three ways to reduce: scheduled reduction, hierarchical reduction and smoke-free periods reduction. We will explain these reduction methods in detail and share the materials that we have developed to carry these out. To conclude we will explain the implications this could have for practice and where further research needs to go from here.

Source of funding: Paul Aveyard’s salary is part-funded by the,
University of Birmingham, the National Institute for Health Research and the National Health Service of the UK.

Nicola Lindson’s PhD is funded by the Economic and Social Research Council through the UK Centre for Tobacco Control Studies.

Declaration of interest: Paul Aveyard has done research and consultancy for the biotechnology and pharmaceutical industry manufacturing products for smoking cessation (McNeil, Pfizer, and Xenova/Celtic).

About the presenters:
Paul Aveyard is a public health physician and general practitioner and reader in behavioural medicine at the University of Birmingham.
He qualified as a doctor from St George’s Hospital London and worked as a junior doctor in London, South Africa, and Oxford before training in public health in Birmingham. In the mid 2000s, he decided that he missed clinical practice and so he completed his general practice training part time alongside his university commitments. He now works one afternoon a week as a GP.

His research has been largely in the area of tobacco control, mostly in the area of smoking cessation. He works in a team with eight others at the University of Birmingham who are part of the UK Centre for Tobacco Control Studies (www.ukctcs.org). The current trial portfolio includes studies on smoking reduction and gradual cessation, preventing weight gain on stopping smoking, and work on something called attentional bias. We are also working with lung cancer patients that continue to smoke to find ways to help them stop. In the past, he has worked on trials of computerised interventions to help pregnant women stop smoking, but these did not work well.

You should know that Paul has done research and consultancy for the biotechnology and pharmaceutical industry manufacturing products for smoking cessation (McNeil, Pfizer, and Xenova/Celtic).

Nicola Lindson is a PhD student in Primary Care Clinical Sciences at the University of Birmingham, and is part of the UK Centre for Tobacco Control Studies. Her PhD research is focused on smoking reduction, including comparing abrupt quitting with reduction to quit, investigating reduction methods and their relative success, and interviewing trial participants about their experiences of different quitting methods.