Smoking reduction did not promote future smoking cessation in a general population

Introduction: Smoking reduction (SR) has been introduced as a strategy for smokers who are unwilling or unable to quit. We wanted to investi tigate whether SR at one-year follow-up increased the probability of abstinence from smoking at three and five-year follow-up. Methods: we included a random sample from a general population, the Inter99 study, Copenhagen, Denmark. A total of 1975 participants were daily smokers (from both the intervention and the control group) with information on tobacco consumption at both baseline and one-year follow-up (year 1999 to 2001). Of these, 112 had reduced their tobacco consumption substantially, by minimum 50%, at one-year follow-up. Information on tobacco consumption and smoking status was available on 1441 and 1308 participants at three-year and five-year follow-up, respectively. Outcome was self-reported point abstinence at three and five-year follow-up. Logistic regression analyses were adjusted for confounders. Results: One out of five smokers (20.5%) had maintained their reduced tobacco consumption at five-year follow-up. About twice as many reducers as non-reducers reported that they had tried to quit since baseline (p < 0.05). In adjusted logistic regression analyses we found no association between SR at one-year follow- up and being point abstinent at three-year (OR: 0.57;CI: 0.28 - 1.15) or five-year follow-up (OR: 1.08;CI: 0.56 - 2.09). Conclusions: Our study, including smokers from a general population found no association between substantial SR and future smoking cessation at three- and five-year follow-up. No studies so far have reported that SR undermines smoking cessation, but it is still controversial whether SR significantly increases future smoking cessation.

Implementation of Smoking Ban in Mental Hospitals： Views of Patients, Relatives and Staff

The Law on Tobacco Control of the Republic of Lithuania （issued in 1996） prohibits smoking in health care facilities. The security implementation is particularly problematic in psychiatric hospitals, where patients with adaptation problems are used to smoking feeling anxiety. Meanwhile, experts and scholars do not agree on the benefits or harm of smoking for individuals suffering from mental disorder. Republican Vilnius Psychiatric Hospital undertook an investigation of the attitudes of those mostly concerned--the patients, their relatives and the staff of the hospital, also of their views on the ways and feasibility to reduce smoking in the hospital. It was concluded that the main cause of patients＇ smoking is addiction, and hospital staff recognize that mental disorders contribute to the increase in dependency. Other reasons--smoking reduces tension, facilitates adaptation to environments, enhances contacts. Most patients and their relatives believe that smoking should not be banned, while the staff believes it should be prohibited in part by a variety of increasing of constraints. The most effective means to reduce smoking in the hospital would be rich leisure activities, education and professional help.