Summary: A comprehensive scientific review has identified varenicline, cytisine, and nicotine e-cigarettes as the most effective strategies for quitting smoking, especially when combined with behavioral support.
Estimated reading time: 6 minutes
Smoking remains the leading cause of preventable disease and death worldwide, claiming over seven million lives annually. However, a new scientific review published in the journal Addiction offers hope for those looking to kick the habit. The study, conducted by the Cochrane Tobacco Addiction Group (CTAG), has pinpointed the three most effective methods for quitting smoking.
Why it matters: With millions of smokers struggling to quit, understanding the most effective cessation methods can significantly impact public health and save lives.
The Big Three: A Closer Look at the Most Effective Quitting Methods
- Varenicline: A prescription medication sold under various brand names, including Chantix and Champix, varenicline works by reducing cravings and withdrawal symptoms associated with quitting smoking.
- Cytisine: This plant-based compound, while not widely available in the U.S., is sold as an over-the-counter natural health product in Canada and throughout Central and Eastern Europe. In the UK, it’s available by prescription.
- Nicotine e-cigarettes: Electronic cigarettes that deliver nicotine have shown promising results in helping smokers quit traditional cigarettes.
Dr. Jamie Hartmann-Boyce, assistant professor of health policy and management at the University of Massachusetts Amherst School of Public Health and Health Sciences and senior author of the review, emphasizes the importance of these findings: “For people who smoke cigarettes, the single best thing they can do for their health is to quit smoking. However, many people find it difficult to do so. Fortunately, there is strong evidence to support the use of a number of different ways to quit smoking.”
The Power of Combination Therapy
The review highlights that these top three strategies work best when combined with behavioral support, such as counseling. Additionally, the study found that bupropion and nicotine replacement therapy (NRT) are also effective, particularly when NRT patches are used in conjunction with fast-acting forms like gum.
“For behavioral support, evidence is strongest for counseling and for programs that reward people for stopping smoking,” adds Hartmann-Boyce.
New Insights from Recent Cochrane Reviews
The CTAG’s summary draws on 14 Cochrane reviews published between 2021 and 2023. Three of these reviews provide particularly noteworthy findings:
- Nicotine Replacement Therapy (NRT): High-certainty evidence shows that combining a fast-acting form of NRT (such as gum, lozenges, or sprays) with NRT patches helps more people quit than using a single form of NRT alone.
- E-cigarettes for Smoking Cessation: This living systematic review, which is updated monthly, concluded with high-certainty evidence that nicotine e-cigarettes increase quit rates compared to NRT. There’s also moderate-certainty evidence that they outperform non-nicotine e-cigarettes in helping smokers quit.
- Pharmacological and E-cigarette Interventions: A comprehensive review of 319 studies involving 157,179 participants found that nicotine e-cigarettes, varenicline, and cytisine were the most effective interventions, all supported by high-certainty evidence. These were closely followed by combination NRT.
The Role of Nicotine Receptor Partial Agonists
An updated Cochrane review on nicotine receptor partial agonists (varenicline and cytisine) for smoking cessation, which included 75 trials, found that there may be no significant difference between cytisine and varenicline in their effectiveness for quitting smoking.
Dr. Jonathan Livingstone-Banks, a researcher at the University of Oxford and lead author of the review, emphasizes the importance of seeking help when trying to quit: “Quitting smoking is difficult, and some people find it harder to quit than others, but tobacco is uniquely deadly among legal consumer products, so it’s important to seek help quitting. There’s a range of effective forms of support for smoking cessation, and cytisine, varenicline and e-cigarettes are all evidence-based ways to greatly increase people’s chances of successfully quitting smoking.”
As research in this field continues to evolve, the CTAG team remains committed to reviewing and updating evidence on the most effective ways to help people quit smoking. This ongoing work is crucial for informing public health policies and supporting individuals in their journey to become smoke-free.
Quiz: Test Your Knowledge on Smoking Cessation
- What are the three most effective strategies for quitting smoking, according to the recent scientific review?
- True or False: Combining nicotine patches with fast-acting forms of nicotine replacement therapy (like gum or lozenges) is more effective than using a single form of NRT.
- Which type of behavioral support showed the strongest evidence for helping people quit smoking?
Answer Key:
- Varenicline, cytisine, and nicotine e-cigarettes
- True
- Counseling and programs that reward people for stopping smoking
