Smoking reduction can help the recalcitrant smoker

Smoking cessation has been the sole goal in studies on the treatment of tobacco dependence, but for many smokers who are either unable or unwilling to stop abruptly a sustained reduction in smoking might be an initial alternative. On p 329 Bolliger et al report the first long term study of concomitant use of an oral nicotine inhaler. Active treatment was significantly better than placebo in achieving a sustained reduction (50% reduction in the number of cigarettes smoked daily) at four months and at two years and proved to be safe. The authors conclude that smoking reduction with or without nicotine substitution seems to be a feasible first step for people unable or unwilling to stop abruptly.