News Release

'Cold turkey' wins for successful smoking cessation

Peer-Reviewed Publication

American College of Physicians

1. "Cold turkey" wins for successful smoking cessation


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Quitting smoking abruptly is more likely to lead to lasting abstinence compared to quitting gradually, according to a study published in Annals of Internal Medicine.

Current guidelines recommend abrupt smoking cessation, where smokers choose a quit date and stop smoking; however, more people seem to prefer taking a gradual approach to quitting, where they cut back on the amount they smoke over time. Physicians need to know if both approaches are effective so they can provide evidence-based advice to their patients.

Researchers randomly assigned 697 adult smokers to quit abruptly or to gradually cut back on smoking before quitting. Participants in the abrupt cessation group chose a quit date with support from a nurse and stopped smoking on that day. Participants in the gradual cessation group reduced their smoking by 75 percent in the 2 weeks leading up to an agreed-upon quit date. Other than the cessation strategy, treatment was similar for both groups. Participants received behavioral support from nurses and used nicotine replacement therapy before and after their quit date.

The researchers compared 4-week and 6-month abstinence between the two groups, and also assessed whether outcomes differed based on participants' preferred method of quitting. The researchers found that patients in the abrupt quitting group were 25 percent more likely to stop smoking in both the short and long term, regardless of their method preference. These findings suggest that clinicians should recommend abrupt quitting over gradual quitting to patients who want to stop smoking.

Note: For an embargoed PDF, please contact Cara Graeff. To interview the lead author, Dr. Nicola Lindson-Hawley, please contact Thomas Calver at

2. Flu vaccine safe for surgical inpatients


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A study published in Annals of Internal Medicine finds that the seasonal influenza vaccine is safe to administer to hospitalized surgical patients in the preoperative period. These data support current recommendations to vaccinate surgical inpatients against seasonal flu.

Flu vaccine is recommended for hospitalized patients awaiting surgery, but vaccination rates remain low. Surgeons and other health care providers have expressed concern about potential adverse effects associated with vaccination that may lead to unnecessary evaluations, emergency department visits, or rehospitalizations.

Researchers studied health records for patients at Kaiser Permanente, Southern California who had inpatient surgery between 2010 and 2013 to evaluate whether the flu vaccine in the preoperative period increases health care utilization and evaluations for postsurgical infection after discharge. They found no strong evidence of increased risk for postdischarge emergency department or inpatient visits, fever, or clinical work-ups for infection in those who received the flu vaccine. However, they did detect a minimal increase in risk for outpatient visits in the 7 days following discharge.

Note: For an embargoed PDF, please contact Cara Graeff. For an interview, please contact Navneet Miller at or 415-262-5972.

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