The authors point out that their study results indicate risk reduction is disproportionately smaller than the corresponding smoking reduction. They suggest the discrepancy between reported amount of reduction and calculated risk reduction can be largely explained by "compensatory smoking" getting the maximum number of puffs out of the limited number of cigarettes allowed.
"More data from long-term studies of smoking reduction are warranted, but for the present, smoking cessation and not smoking reduction should still be advocated as the ultimate method of reducing harm from smoking, especially since diseases such as COPD [chronic obstructive pulmonary disease] and [heart attack], which have a larger public health effect than lung cancer, have not shown any reductions in risks after smoking reduction," the authors conclude.
(JAMA.2005; 294:1505-1510. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by grants from the Danish Ministry of Health, the Health Insurance Foundation, the Danish Lung Foundation, and the Wedell-Wedellsborg Foundation.
Editorial: Reducing the Risk of Lung Cancer
In an accompanying editorial, Lawrence J. Dacey, M.D., M.S., and David W. Johnstone, M.D., of Dartmouth-Hitchcock Medical Center, Lebanon, N.H., write that it is important to inform patients who smoke that the more they can reduce the number of cigarettes they smoke, the more they will decrease their risk of lung cancer.
"Physicians and other health professionals should do all they can to help their patients who smoke reduce their risk of getting lung cancer. Total discontinuation of smoking, no matter the age of the patient, will provide the greatest benefit," the
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Contact: Nina S. Godtfredsen, M.D., Ph.D.
duegodt@dadlnet.dk
JAMA and Archives Journals
27-Sep-2005