Smoking elimination by gradual reduction

Two methods of gradual reduction in smoking over a 12-week period were compared. The first required subjects to smoke at pre-set random times using a signalling device. The second allowed subjects to smoke at times of their choice using a mechanical counter to self-regulate their daily smoking quota. Each method was tested with and without group meetings. More subjects in the counter groups finished the program; however, groups using the signalling device were more successful in eliminating smoking at the time of a 3-month follow-up. The use of the signalling device was associated with a tendency to reduce the effects of situational cues on smoking, and group meetings seemed to raise morale among participants. The greatest difficulty in further smoking reduction occurred at the 12–14 cigarettes per day level for all groups. It was hypothesized that, despite the decrease in learned cues, further reduction is inhibited by the manifestation of withdrawal symptoms caused by some physiological addiction. These results suggest that a successful smoking elimination program should combine psychological and physiological approaches.