• M H Zimmermann, D L Richardson, M T B Manderski, C D Delnevo, and M B Steinberg.
• Division of General Internal Medicine, Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.
• Int. J. Clin. Pract. 2014 Nov 1; 68 (11): 1358-63.

AimsDuring the recent economic downturn, trends towards fewer cigarettes smoked per day have emerged along with the practice of extinguishing and relighting cigarettes. Few studies have characterised factors related to relighting cigarettes and none have explored this behaviour in those seeking tobacco treatment. This study describes treatment-seeking patients who relight cigarettes and examines implications on tobacco policy and treatment.MethodsData were collected from a cross-sectional sample of 496 patients at a specialty tobacco treatment programme in New Jersey from 2010 to 2012.ResultsForty-six per cent of the sample reported relighting, and those subjects smoked significantly fewer cigarettes per day (CPD), despite similar levels of dependence and exhaled carbon monoxide (CO) values. In unadjusted analyses, significantly higher rates of relighting were found among females, African-Americans, smokers who had a high school diploma or less, and were unemployed, sick or disabled. Relighting was more prevalent among smokers with higher markers of dependence, menthol smoking and night smoking. In multivariate analyses, markers of dependence and economic factors (employment and education) remained significant.ConclusionsCharacteristics linked to economic factors were related to increased relighting. Implications for tobacco treatment include the impact on pharmacotherapy dosing and counselling interventions. The tobacco control community needs to be aware of this phenomenon. Collecting data on 'smoking sessions per day' might be a more accurate depiction of smoking exposure than CPD.© 2014 John Wiley & Sons Ltd.

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