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Switching to “Lighter” Cigarettes and Quitting Smoking
  1. Hilary A Tindle1,*,
  2. Saul Shiffman1,
  3. Anne M Hartman2,
  4. James E Bost1
  1. 1 University of Pittsburgh, United States;
  2. 2 National Cancer Institute, United States
  1. Correspondence to: Hilary Tindle, Medicine, University of Pittsburgh, Center for Research on Health Care, 230 McKee Place, Suite 600, University of Pittsburgh, Pittsburgh, 15213, United States; tindleha{at}


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).

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

Results: 12,009 (38%) of ever-smokers switched. Among switchers, most commonly cited reasons were flavor 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<0.0001, adjusted odds ratio 1.58, (95% CI [1.48-1.69])), but less likely to have recently quit (9% vs. 17%, p <0.001; adjusted odds ratio 0.40 (95% CI [0.35-0.45])), yielding lower overall net quitting (4.3% vs. 7.0%, p < .0001; adjusted odds ratio 0.54, (95% CI [0.47-0.61]). 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 a 46%lower odds of net quitting.

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