Intentionally reduced smoking among untreated general population smokers: Prevalence, stability, prediction of smoking behaviour change and differences between subjects choosing either reduction or abstinence

Aims: To compare data from the general population on intentionally reduced smoking and smoking cessation. Design: Longitudinal observation study. Setting: Northern German region. Subjects: Randomly sampled residents aged 18-64 (T1; n = 4075, response rate 70%). Daily cigarette smokers (n = 1520) were followed up after 30 (T2; n = 913) and 36 months (T3; n = 786). Measures: Self-reported smoking-related and socioeconomic variables. Participants were explicitly asked for reduction attempts (reducing cigarettes per day) and maintenance of reduction, which was defined independently of consumption measures. Findings: Between T1 and T2, reduction attempts (39%) were more frequent than quit attempts (33%), and according to self-report, reduction was more likely to be maintained for up to 12 months. Smokers maintaining reduction for up to 6 months had reduced their consumption at T3 by 34% compared with T2. Between T1 and T2, the occurrence of both a reduction and a quit attempt was most frequent (22%), followed by subjects exclusively trying to reduce (17%) and subjects exclusively trying to quit (4%). Subjects who exclusively tried to reduce had a significantly increased probability of further reduction attempts at T3 (OR = 4.4, 95% CI 2.O-10.1), while the probability of quit attempts was equal compared with subjects not attempting to reduce or quit (OR = 1.1, 95 % CI 0.3-3.2). DSM-IV nicotine dependence was less common in subjects who exclusively tried to reduce. Other smoking-related and socioeconomic variables did not predict whether individuals attempted to reduce or attempted to quit. Conclusions: A considerable proportion of general population smokers attempt to reduce, and are able to maintain reduction of, cigarette consumption over time. Reduction attempts did not reduce the probability of a subsequent cessation attempt.