INFLUENCE OF SMOKING REDUCTION ON LUNG DISEASE FACTORS

Cigarette smoking is a major cause of lung disease. In particular, heavy
cigarette smokers are predisposed to the development of lung cancer and two
forms of chronic lung disease, chronic bronchitis and emphysema. It is
generally accepted that smoking cessation is a desirable preventative
measure for health maintenance. Unfortunately, nearly two thirds of smokers
who desire to quit are unable to achieve complete abstinence. For them,
reducing lifetime exposure to cigarette smoke may be an alternative
preventative medicine strategy. Current approaches to smoking reduction are basically ineffective. Few
smokers can sustain nicotine reduction, achieved by smoking fewer
cigarettes or by switching to lower tar cigarettes. Smokers who do reduce
or switch tend to compensate for reduced nicotine yield by puffing more
frequently per cigarette thereby probably negating any health benefits. In a previous uncontrolled pilot study of heavy smokers, we examined the
role of alternative nicotine delivery using 2 mg nicotine gum to reduce the
risk of cigarette smoke induced lung disease. Our results in this short
term (8 weeks) study indicated that smoking reduction was associated with
an improvement in several of the inflammatory features present in the lower
respiratory tract of normal smokers. This investigation will address
several key questions: 1)How important is alternative nicotine delivery in smoking reduction?
Could favorable results have been obtained had smokers reduced on their own
or switched to lower tar cigarettes? 2)Can smoking reduction be maintained for a six month period? 3)Will the cellular, biochemical and morphological improvements achieved
in a previous study persist long term?