Most smoking control programmes are built around complete cessation but new research shows that usage reduction can also bring health benefits to heavy smokers.
This suggests alternative treatments for those who find it impossible to quit, according to a Swedish research team.
"Alternative treatment approaches, such as smoking reduction, have the potential to benefit those smokers who are not aided by the current strategies of prevention and cessation," according to Dr Bjorn Eliasson of Sahlgrenska University Hospital in Sweden. His research is published this week in the journal, Nicotine & Tobacco Research.
While cessation is always the preferred goal, it remains notoriously difficult to achieve with success rates still only hitting 15 per cent to 20 per cent. The researchers note that many smokers may go through repeated attempts to quit and other more addicted smokers may be able to cut down while never quitting entirely.
The team examined 33 subjects who were able to quit after four months during which they progressively reduced their smoking. Those who took part used nicotine nasal sprays to help control their addiction.
The researchers were looking for indicators of health risk, measuring substances such as carbon monoxide levels in the smokers. This gas has been shown to raise cholesterol levels, white blood cell counts and other risk factors for heart disease.
Within nine months the subjects had reduced their smoking by about 50 per cent.
The researchers noted that this caused a 17 per cent reduction in the subjects' carbon monoxide levels, significantly lessening risk factors such as high cholesterol and low blood oxygen supply.
Previous research had shown that a 1 per cent increase in carbon monoxide levels from a smoker's breath increases the risk of tobacco-related death by 22 per cent, the researchers noted.
Conversely a decrease of 8 per cent in total cholesterol or a 1 per cent reduction in so called "bad cholesterol", low density lipoprotein, can deliver a significant reduction in the risk of heart disease.
"The clinical benefit of reductions in cigarette consumption can be monitored by measurement of established risk factors, changes which can be used to calculate reduced risk of developing heart disease," Dr Eliasson said.
"As understanding of the behavioural stages of change associated with smoking increases, it becomes evident that cessation strategies only assist part of the smoking population."
Those who find it impossible to walk away from tobacco might still improve their long term health by considering lower tobacco usage.