'Cold Turkey' a Common and Often Successful Way to Quit Cigarettes

By Megan Brooks

October 30, 2020

NEW YORK (Reuters Health) - Quitting cigarettes "cold turkey" without any pharmacologic help can be an effective way to stop smoking long-term for many smokers, results of a small study suggest.

"We think that healthcare providers should at least consider starting with cold turkey recommendations to their patients before proceeding on to pharmacological therapy. There's really no harm in doing it," said Dr. Gary Salzman of the University of Missouri, in Kansas City, in a presentation at CHEST 2020, the virtual annual meeting of the American College of Chest Physicians.

Dr. Salzman and colleagues surveyed current and former cigarette smokers with chronic medical conditions from a general internal medicine outpatient clinic in Kansas City. Most were African American (77%) or white (22%).

Among 103 patients who successfully quit smoking for more than one year, 92 (89%) did it cold turkey and 11 (11%) did it with medication. Of the 79 current smokers, 24 (30%) tried cold turkey unsuccessfully and 55 (70%) tried pharmacologic therapy, which was not successful.

"When looking at the success rate for the different methods, we found that over 70% of the patients were successful at achieving long-term cessation with cold turkey, or abrupt cessation of quitting smoking, and only about 15% were successful with pharmacological therapy," Dr. Salzman reported in his presentation.

He noted that health concerns were the predominant motivational factor to quit smoking.

"The reasons for quitting by far was health-related incidents; patients who had heart attacks, were admitted to the hospital with a COPD exacerbation, or stroke, or cancer, those were stimulus to quit smoking, and they were rather large incentives to quit smoking based on their health-related problems," he said.

Commenting on the results in a phone interview with Reuters Health, Dr. Gillian Schauer, co-director of the Tobacco Studies Program in the University of Washington's School of Public Health in Seattle noted that smoking harms almost every part of your body, and quitting is the best thing you can do for your health.

"There is no bad way to quit smoking," she said, "and I would not discourage anyone who wants to (from) quitting cold turkey, but there are better, more effective ways to quit than cold turkey."

Dr. Schauer, who served as a senior editor of the recent Surgeon General's Report on Smoking Cessation (https://bit.ly/2J3Nekj), said, "There are better ways to quit that involve use of proven treatments like medication or counseling. Smoking is not a lifestyle choice - it's an addiction. Using quit-smoking medications and getting some coaching or counseling can help you manage feelings of withdrawal and craving that can happen when quitting."

"Usually success with quitting cold turkey at a population level is around 7 to 8% and when people use medication and counseling, they can more than double that success rate," Dr. Schauer noted.

Dr. Schauer, who was not involved in the study, cautioned that data for this study are from a small convenience sample and not a formal randomized controlled intervention trial, so there could be some sampling bias impacting the results.

"Without a randomization process, it's really hard to know if the people in the medication group had the same level of nicotine addiction as the people who opted not to use pharmacological therapy medication and to instead quit cold turkey. That's just one caveat, one major limitation I see to these findings," Dr. Schauer said.

SOURCE: https://chestmeeting.chestnet.org/ CHEST 2020, American College of Chest Physicians' virtual annual meeting, October 18-21, 2020.