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Switching to “lighter” cigarettes and quitting smoking
  1. H A Tindle1,
  2. S Shiffman2,
  3. A M Hartman3,
  4. J E Bost2
  1. 1
    Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  2. 2
    University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  3. 3
    National Cancer Institute, Bethesda, Maryland, USA
  1. Correspondence to H A Tindle, 230 McKee Place, Suite 600, Pittsburgh, Pennsylvania, 15213, USA; 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 × recent quitting).

Design: 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 ⩾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.

Conclusion: Compared with no switching, a history of switching was associated with 46% lower odds of net quitting.

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  • Funding This publication was made possible by a grant from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research (KL2 RR024154-03 to HAT). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on the NCRR is available at Information on re-engineering the clinical research enterprise can be obtained from

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Ethics approval These data were deemed exempt by the University of Pittsburgh Institutional Review Board (0610085).