Background: Two recommended quit methods in standard cessation program involve either a gradual reduction of smoking prior to complete abstinence (“Cut Down”) or sudden abstinence from cigarettes (“Cold Turkey”). However, little is known about both the prevalence of use of these two methods and the effects they have on quit success. This study examined the reported use, characteristics of users and impact of self-selected strategy choice on quitting success and relapse.

Method: Analyses employed the first two waves of the ITC-4, a random digit dialed telephone survey of a cohort of over 8,000 adult smokers from UK, US, Canada, and Australia, with follow-up rate = 75%.

Results: The results indicated that 68% of the smokers who had made a quit attempt between waves reported using the Cold Turkey method for quitting. Multivariate analyses revealed that Cold Turkey users were more likely to be aged 25 to 39 years, male, from the UK, and have lower perceived difficulty of going without cigarettes for a whole day. Controlling for socio-demographic and known predictors of quitting including NRT use, smokers who employed the Cold Turkey method to quit were 2 times more likely to succeed in their attempt and also less likely to relapse.

Conclusions: Adult smokers who quit on their own via sudden abstinence have better outcomes compared to those who do so by cutting down.

Implications: The findings suggest that with some caution, Cold Turkey should be the recommended strategy for smokers who want to quit on their own.