Nicotine fading and self-monitoring for cigarette abstinence or controlled smoking

Abstract

This study compared four treatment approaches to cigarette smoking: (1) a nicotine fading procedure, in which subjects changed their cigarette brands each week to ones containing progressively less nicotine and tar; (2) a self-monitoring procedure in which subjects plotted their daily intake of nicotine and tar; (3) a combined nicotine fading/self-monitoring procedure; and (4) a slightly modified American Cancer Society Stop Smoking Program. Thirty-eight habitual smokers were assigned to one of the treatment groups. The study had two goals: (1) to achieve a clinically significant percentage of abstinence, and (2) to reduce the nonabstainers' smoking to a "safer" level by having them smoke low tar and nicotine cigarettes. The 18-month followup results showed that the nicotine fading/self-monitoring group was the most successful: 40% were abstinent and all who had not quit were smoking cigarettes lower in tar and nicotine than their baseline brands. Half the nonabstainers had decreased their rate of smoking relative to baseline while the other half had increased. Furthermore, the fading/self-monitoring group achieved the largest reductions from baseline in daily nicotine and tar intake (61% and 70% respectively). The results suggest that the study's goals were achieved and that the nonaversive combined procedure could be used to treat not only habitual smokers but also smokers with severe cardiovascular and respiratory problems, because it does not have some of the inherent limitations of the successful aversive smoking cessation procedures.