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Randomised controlled trial
After precessation nicotine replacement therapy, abrupt cessation increases abstinence more than gradual cessation in smokers ready to quit
  1. Elias M Klemperer,
  2. John R Hughes
  1. University of Vermont, Burlington, Vermont, USA
  1. Correspondence to: Elias M Klemperer, University of Vermont, UHC Campus, Mailstop 482 OH4, 1 S. Prospect St., Burlington, VT 05401, USA; elias.klemperer{at}

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Commentary on: OpenUrlCrossRefPubMed.


Most guidelines recommend abrupt smoking cessation; however, gradual cessation is common. Reducing cigarettes per day (CPD) with nicotine replacement therapy (NRT) increases cessation among smokers who are not ready to quit.1 However, whether gradual reduction is effective for smokers who want to quit now is unclear.2


This randomised controlled trial compared gradual cessation (ie, reduction in CPD) with abrupt cessation among smokers ready to quit (N=697). The gradual-cessation group received 2 weeks of NRT patches, short-acting …

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  • Funding NIDA T32 DA07242.

  • Competing interests EMK has nothing to disclose. JRH has received consulting and speaking fees from several companies that develop or market pharmacological and behavioural treatments for smoking cessation or harm reduction and from several non-profit organisations that promote tobacco control. He also consults (without payment) for Swedish match.

  • Provenance and peer review Commissioned; internally peer reviewed.