Health and Health Services Research Fund

1. This smoking reduction study examined the effectiveness of smoking reduction counselling together with free nicotine replacement therapy (NRT) for smoking cessation and tested the effectiveness of brief counselling on adherence to NRT among Chinese smokers who were not willing to quit but intended to reduce cigarette consumption. 2. The smoking reduction intervention was effective in helping the unmotivated smokers in quitting (intervention: 17.0% vs control: 10.2%, P=0.012) and in reducing their daily cigarette consumption by 50% or more (intervention: 50.9% vs control: 25.7%, P<0.001) at 6-month follow-up. 3. Our results provided evidence for the effectiveness of smoking reduction intervention, which is important for planning smoking cessation services. 4. Free NRT was widely accepted by participants (8-week NRT adherence rate: 54.5%). Free NRT together with smoking reduction counselling was a feasible and cost-effective approach to help unmotivated smokers to reduce and quit smoking, especially in developing countries like China where NRT is expensive and not used extensively. 5. The motivation to quit smoking was not undermined by smoking reduction intervention. To the contrary, offering assistance to reduce smoking could attract smokers who were not willing or ready to quit.