Switching to "lighter" cigarettes and quitting smoking.
OBJECTIVE
Smokers who switch to "lighter" cigarettes may be diverted from quitting smoking. We assessed factors associated with switching and the association between switching and (1) making a quit attempt, and (2) recent quitting, yielding a measure of net quitting (attempts x recent quitting).


METHODS
In 2003, a total of 30 800 ever-smokers who smoked in the past year provided history of switching and 3 reasons for switching: harm reduction, quitting smoking and flavour. Among those who made a past-year quit attempt, recent quitting was defined as >or=90-day abstinence when surveyed. Multivariable logistic regression identified determinants of outcomes.


RESULTS
In all, 12 009 (38%) of ever-smokers switched. Among switchers, the most commonly cited reasons were flavour only (26%) and all 3 reasons (18%). Switchers (vs non-switchers) were more likely to make a quit attempt between 2002 and 2003 (51% vs 41%, p<0.001, adjusted odds ratio (AOR) 1.58, (95% confidence interval (CI) 1.48 to 1.69)), but less likely to have recently quit (9% vs 17%, p<0.001; AOR 0.40 (95% CI 0.35 to 0.45)), yielding lower overall net quitting (4.3% vs 7.0%, p<0.001; AOR 0.54, (95% CI 0.47 to 0.61)). The effects of switching on outcomes were most pronounced for reasons including quitting smoking, whereas switching for harm reduction alone had no association with outcomes.


CONCLUSIONS
Compared with no switching, a history of switching was associated with 46% lower odds of net quitting.
Tindle
H A
HA
Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. tindleha@upmc.edu
Shiffman
S
S
Hartman
A M
AM
Bost
J E
JE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004522:Educational Status; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology; D055815:Young Adult