A new comprehensive review published in the journal Addiction identifies the most effective strategies to quit smoking, offering hope to those struggling to quit. The review, conducted by leading researchers, highlights three top approaches: varenicline, cytisine, and nicotine e-cigarettes.
These methods, combined with behavioural support like counselling, provide the strongest chance for smoking cessation.
VARENICLINE: A PROVEN PRESCRIPTION MEDICATION
Varenicline, sold under the brand names Chantix and Champix, is a prescription medication specifically designed to help people quit smoking. It works by targeting nicotine receptors in the brain, reducing cravings and withdrawal symptoms. Varenicline has been shown to be highly effective, particularly when paired with behavioural support like counselling or therapy sessions.
CYTISINE: A PLANT-BASED SMOKING CESSATION AID
Cytisine is a natural plant-based compound. It is available by prescription in some regions, including the United Kingdom. It is also sold over-the-counter in countries like Canada and parts of Europe under the name Cravv®. Cytisine has been used for decades as a smoking cessation aid and has been proven to significantly increase quit rates. Like varenicline, it targets nicotine receptors. It is derived from plant sources. This makes it a popular option for those seeking a natural solution.
NICOTINE E-CIGARETTES: A MODERN APPROACH TO QUITTING
Nicotine e-cigarettes have emerged as a highly effective tool for quitting smoking. Recent review evidence indicates that e-cigarettes with nicotine are more effective. They surpass nicotine replacement therapies (NRT), such as patches and gum. E-cigarettes offer smokers a way to manage nicotine cravings without the harmful tar and chemicals found in traditional cigarettes.
The Cochrane review on e-cigarettes for smoking cessation is regularly updated to show the latest research. The most recent data suggest that nicotine e-cigarettes increase quit rates compared to traditional nicotine replacement therapy. They also show improvement compared to non-nicotine e-cigarettes.
COMBINING STRATEGIES FOR BEST RESULTS
Varenicline, cytisine, and nicotine e-cigarettes are the top strategies. Experts agree that combining these methods with behavioural support significantly increases success rates. Behavioral counselling, whether in person or over the phone, helps individuals manage cravings and triggers linked to smoking.
Financial incentives have been proven effective in motivating people to quit smoking. This is especially true in populations where access to smoking cessation aids may be limited.
THE ROLE OF NICOTINE REPLACEMENT THERAPY (NRT)
Nicotine replacement therapy (NRT) remains a popular and accessible way to quit smoking. The updated Cochrane review found that using a combination of NRT patches and fast-acting forms of NRT was more effective. These forms include gum, lozenges, or sprays. This dual approach helps to manage both long-term cravings and sudden urges to smoke, increasing the chances of success.
A Decade of Research: Cochrane Reviews and Smoking Cessation
For nearly 30 years, the Cochrane Tobacco Addiction Group (CTAG) has been conducting systematic reviews of smoking cessation strategies. The findings from these reviews give high-quality, evidence-based guidance for healthcare professionals and individuals seeking to quit smoking.
Between 2021 and 2023, CTAG published 14 Cochrane reviews. These reviews offer critical insights into the most effective ways to stop smoking. Three reviews, in particular, stand out:
- Nicotine Replacement Therapy (NRT): Evidence is highly certain. Using a combination of fast-acting forms of NRT (gum, lozenges, sprays) helps more people quit smoking. Combining these with NRT patches is effective. This is more effective than a single form of NRT.
- E-Cigarettes for Smoking Cessation: E-cigarettes with nicotine significantly increase quit rates. This increase is compared to traditional NRT and non-nicotine e-cigarettes.
- Pharmacological and E-Cigarette Interventions: The 2023 review examined various drug-based and e-cigarette interventions for quitting smoking. Nicotine e-cigarettes, varenicline, and cytisine proved to be the most effective methods.
PHARMACOLOGICAL TREATMENTS: VARENICLINE VS. CYTISINE
The updated Cochrane review on nicotine receptor partial agonists includes medications such as varenicline and cytisine. The review shows that both medications are effective for quitting smoking. They have similar effectiveness. Varenicline is more widely available. Cytisine is a viable option. It is especially useful in regions where it is accessible over the counter.
The review included data from 75 trials. This adds further confidence to the conclusion. Either medication can be used as part of a successful smoking cessation strategy.
IMPORTANCE OF BEHAVIORAL SUPPORT AND COUNSELING
Behavioural support is a critical part of any smoking cessation plan. Counselling, whether one-on-one or in a group setting, helps individuals recognize triggers. It also assists in developing coping mechanisms. Additionally, it keeps them motivated throughout their quitting journey.
Besides counselling, many smoking cessation programs offer financial incentives, which have been shown to boost quit rates. Offering rewards or cash payments for staying smoke-free can serve as a powerful motivator for some people.
FINANCIAL INCENTIVES: A BOOST FOR QUIT RATES
Financial incentives are an often-overlooked but highly effective tool in the battle against smoking. Offering small cash rewards or gift vouchers to individuals who successfully quit smoking is a proven method. It improves long-term quit rates. The effect is particularly strong when these are mixed with other cessation strategies.
This approach is especially useful in lower-income populations. In these groups, the cost of smoking cessation aids can create a barrier to quitting. By offering financial rewards, individuals are more likely to stay smoke-free and motivated throughout the process.
QUITTING SMOKING: A PERSONALIZED APPROACH
Lead author Dr. Jonathan Livingstone-Banks emphasizes that quitting smoking can be challenging, and different people may need different strategies. “Tobacco is uniquely deadly among legal consumer products, so it’s important to seek help quitting,” Dr. Livingstone-Banks stated. “There’s a range of effective forms of support for smoking cessation. Cytisine, varenicline, and e-cigarettes are all evidence-based ways. These methods greatly increase people’s chances of successfully quitting smoking.”
The latest scientific review offers hope for smokers trying to quit. With effective tools like varenicline, cytisine, and nicotine e-cigarettes, smokers have more options than ever before. Combining these methods with behavioural support and, where applicable, financial incentives, further boosts the chances of quitting for good.
Smokers looking to quit should consult with healthcare professionals to find the most appropriate method for their needs. With the right strategy and support, achieving a smoke-free life is within reach.