Objective

Total abstinence has long been regarded as the singular goal of most smoking cessation treatment models. Unfortunately, most quit attempts are unsuccessful in sustaining long-term abstinence. The majority of smokers are unwilling or unable to quit. Interventions tailored to these smokers are virtually absent.

In this study, LIFETECHniques, Inc. addressed this need by investigating the feasibility of a smoking reduction program utilizing SmokeSignals®, a computerized cigarette case that delivers a scheduled smoking reduction regimen.

Smokers who were not currently interested in quitting but were receptive to reducing their overall exposure utilized the device in an effort to achieve smoking reduction goals.

Description

Participants were N = 47 smokers who were willing to reduce smoking by 50% for four weeks, with encouragement to then proceed toward cessation, if desired. Of this group, 14 had partially missing data and were eliminated from analysis. 33 smokers followed protocols flawlessly, recording all cigarettes. (18 females and 15 males, average age = 43, average years smoking = 25).

After a 7-day baseline period of device-monitored ad-lib smoking, participants received tailored 28-day reduction schedules, calculated from baseline data and delivered by the SmokeSignals® device.

The protocol called for 25% reduction from baseline the first week, 25% the second week, and maintenance at 50% of baseline for Weeks
3-4.

This Figure depicts participants’ cigarette use across the 35 days of the study. (n=33)

Results

An observed 82.5% of the participants achieved targeted reductions of at least 50%. Average cigarette consumption declined from 25.2 cigarettes per day at baseline to 10.9 cigarettes post-treatment, a mean decrease of 56.7%.

Participants smoked 90.01% of scheduled cigarettes (M prescribed = 397, SD = 126; M smoked = 358, SD = 142). Furthermore, mean cotinine values decreased by 28%, indicating reductions in exposure had indeed occurred.

Increases in self-efficacy and success in moving reticent smokers along stages of change were also observed.

Quite encouraging was the finding that 23 of the 33 program completers chose to reset devices and continue protocols toward total abstinence and that 16 of these subjects demonstrated 24-hour point-prevalence cessation.

Conclusions

The findings of the study support the efficacy of utilizing harm reduction technology for cessation-resistant smokers. Participants showed significant reductions in smoking rate and biochemical measures of exposure with the assistance of the scheduled smoking reduction regimens delivered by means of the SmokeSignals® device.

Reticent smokers moved along stages of change measures, and a large percentage of subjects (48% of the initial 47) chose to attempt smoking cessation following reduction. These findings support the use of harm reduction as a "foot-in-the-door" technique to subsequently introduce the option of total abstinence or further exposure reductions.

SmokeSignals® thus shows promise as a technology for reducing smoking among those who are unwilling or unable to quit.