Does Cold Turkey Work Best?

Blog Post created by Dr.Hays on Mar 23, 2016

A recent study examining abrupt smoking cessation vs. gradual reduction to quit in the Annals of Internal Medicine has been making the rounds on television, in newspapers, and via social media over the past week.  However, it seems one reason this study has gone “viral” has less to do with the content of the study, and more so the headlines news outlets have been attaching to it:


“Want to quit smoking?  Cold turkey approach works best, study says”

“Cold Turkey Still The Best Way To Kick Smoking To Curb”

“Quitting Smoking Cold Turkey May Be Your Best Bet”


I experienced a great sense of dismay upon reading these article titles using the phrase “cold turkey”, especially considering it is not mentioned once in the study itself.  Among the vast majority of patients we treat at the Mayo Clinic Nicotine Dependence Center, the most commonly understood meaning of cold turkey is “to quit abruptly with no treatment support or replacement medications.”  This idea is closely tied to a long-standing misconception that the most effective method for quitting is to “white knuckle it” with willpower alone (a.k.a. quitting cold turkey).  Much of the work my colleagues and I do is to dispel the myths surrounding stopping smoking treatment so that each patient will be given the very best chance of successfully quitting.  As I have shared before, research over the past 25 years has shown that out of 100 people trying to quit smoking cold turkey, about three to five will succeed past six months.  While some people can and do quit cold turkey, 95% or more are unsuccessful.


So what did this recent Oxford study actually demonstrate?


The authors sought to determine how stopping abruptly – smoking normally up until a quit date – compared to individuals that gradually reduced their smoking two weeks prior to stopping.  Of note, both of the groups in this study were provided with counseling support and nicotine replacement medication.  At the one month mark, 39.2% of those gradually quitting and 49% of the abrupt quitters were smoke-free.  At the six month mark, 15.5% of gradual quitters and 22% of those who quit abruptly were smoke-free.  Overall, the study provided evidence that individuals who stop smoking abruptly, when receiving counseling and using cessation medications, were more likely to be smoke-free in the short- and long-term compared to those who gradually cut down. 


I know that I can sound like a broken record at times when discussing stop smoking treatments.  My hope here on BecomeAnEx is to share the knowledge I have gained through research and clinical experience about stopping smoking and combine it with your own expertise to determine what will work best for you.  There are many wise minds within the Ex Community so I encourage you to stick around, continue listening and learning, and to keep walking your path to a smoke-free life. 



Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial. Ann Intern Med. [Epub ahead of print 15 March 2016] doi:10.7326/M14-2805

Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004; 99: 29-38