Smoking Reduction: What can Interventions Achieve and how should they be Designed?

This review considers more recent findings on reduction of cigarette consumption among smokers who are not currently interested in smoking cessation. We performed a systematic literature search. The currently available studies do not provide clear evidence that just reducing cigarette consumption decreases the health risk. However, smoking reduction does appear to increase the probability that smokers will later quit smoking. The majority of the currently published studies provide evidence that nicotine replacement therapy (NRT) is suitable for supporting reduction. NRT, particularly in combination with behaviour-related interventions, has a positive effect both on reducing the number of cigarettes smoked daily and on longer-term abstinence. Initial positive effects of behaviour-related interventions without NRT were found in schizophrenia patients. Overall, in view of the significant health-related consequences of nicotine dependence too few studies have examined smoking reduction and the findings are inconsistent. Further clinical studies on this topic are urgently required.