Pick a quit date and stop smoking on that day — don’t taper gradually

4. Pick a quit date and stop smoking on that day — don’t taper gradually

Cost: No cost at all. Just choose a date on the calendar and let family and coworkers know in advance.

In plain terms: Many people try to cut back a little each day until they reach zero. Yet after six months, only 15.5% of those who gradually reduced their intake stayed smoke‑free, compared with 22% of people who set a quit date and stopped all at once. So it’s better to pick a date and quit completely on that day.

Benefit: In the UK, 697 smokers were randomly assigned to two groups. One group quit on a predetermined date; the other cut their cigarette use by 75% during the two weeks before that date. Both groups received nursing support and used nicotine replacement therapy around the quit date. At four weeks, 49.0% (95% CI 43.8–54.2) of the “quit‑on‑date” group remained smoke‑free, versus 39.2% (34.0–44.4) of the “taper‑first” group; the relative risk was 0.80 (0.66–0.93). By six months, 22.0% (18.0–26.6) of the quit‑on‑date group stayed quit, compared with 15.5% (12.0–19.7) of the taper‑first group; the relative risk was 0.71 (0.46–0.91). Even among people who preferred tapering, the quit‑on‑date approach yielded higher success rates at four weeks (52.2% vs. 38.3%).

Evidence grade: A

Sources: Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P (2016). Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial. Annals of Internal Medicine, 164(9), 585–592. <https://doi.org/10.7326/M14-2805>; Theodoulou A, Chepkin SC, Ye W, et al. (2023). Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews, 6, CD013308 (The part about using nicotine replacement in advance). <https://doi.org/10.1002/14651858.CD013308.pub2>

Notes: This is a somewhat controversial topic. Cochrane previously published a review comparing these two methods; it concluded they performed similarly (RR 0.94, 95% CI 0.79–1.13, based on 10 trials with 3,760 participants). However, that review was withdrawn in 2019 and is no longer updated. The best current evidence comes from the trial described above, which favors quitting on a set date. Both groups in that trial also used nicotine replacement therapy before the quit date, an approach itself backed by evidence: early use raises success rates by roughly 25% (RR 1.25, 95% CI 1.08–1.44, based on 9 trials with 4,395 participants; moderate‑certainty evidence). Therefore, the recommended strategy is to pick a quit date, start nicotine replacement therapy two weeks beforehand, and then quit all at once on that day.