Smoking out the best way to quit smoking

Science News, Dec 2, 1989 by B. Bower

Smoking out the best way to quit smoking

Surveys show millions of people in the United States have quit smoking cigarettes, the vast majority of them without the help of a formal cessation program. Some studies indicate that smokers who quit on their own are two to three times more successful at kicking the nicotine habit than those who use various "stop smoking" manuals.

But that conclusion is challenged by a report in the November AMERICAN PSYCHOLOGIST, which presents data compiled from 10 long-term studies of smokers attempting to quit either on their own or with the help of instructive manuals. A total of 5,389 people participated in the studies.

Approximately 4 percent of both groups of smokers abstained from smoking for either six months or one year after their initial attempt to give up cigarettes, note psychologist Sheldon Cohen of Carnegie Mellon University in Pittsburgh and his colleagues. Researchers checked abstinence at varying intervals in the studies by examining biochemical indicators of recent smoking, such as saliva levels of cotinine, a nicotine metabolite.

Abstinence rates among self-quitters and those using manuals were largely the same, the researchers found. "Hardcore" smokers were not more likely to have chosen the formal programs.

Previous studies have gone astray in assessing only the success of single attempts to quit smoking rather than charting the outcome of multiple attempts over a prolonged period, the investigators say.

Cohen and his co-workers also found that smokers who consume less than one pack of cigarettes a day were significantly more likely to quit smoking for a full year than were heavier smokers.

There is a significant relapse rate among people who give up cigarettes on a long-term basis, however. In the four studies with relapse data, 7 to 35 percent of those who did not smoke for six months returned to regular smoking within the following six months.

Quitting smoking by oneself or with the aid of a program often requires a series of attempts to achieve success, particularly because cigarette use is a central part of many persons' daily lives, the scientists maintain.

In a related study of people who smoke one pack a day or more, Peter Franks of the University of Rochester (N.Y.) School of Medicine and Dentistry and his colleagues found that the anti-hypertensive drug clonidine does not ease withdrawal symptoms or promote quitting over a one-month treatment period. Clonidine suppresses alcohol and opiate withdrawal symptoms, and some have suggested it reduces cigarette dravings (SN: 11/17/84, p.310).

Among the 155 smokers who completed four weeks of either clonidine or placebo treatment, about one in five persons in both groups abstained throughout the study, the researchers report in the Dec. 1 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. They caution that clonidine frequently causes side effects, including dizziness and nausea.