Last updated Mon 3 July 2017
By Catharine Paddock PhD
Reviewed by Timothy J. Legg, PhD, CRNP
1. Nicotine replacement therapy (NRT)
Many people find it easier to replace the nicotine in their system with replacement therapies like gum or patches.
Nicotine in cigarettes is addictive, which is why people experience unpleasant withdrawal symptoms when they try to quit. Nicotine replacement therapy (NRT) provides a low level of nicotine without the other poisonous chemicals in tobacco smoke.
This helps to ease some of the symptoms of nicotine withdrawal, such as intense cravings, nausea, tingling of hands and feet, insomnia, mood swings, and difficulty concentrating. NRT is available as:
Patches can be bought in a pharmacy without prescription. They act by slowly releasing nicotine, which is absorbed into the body through the skin. Over 8-12 weeks, the amount of nicotine the body is exposed to is gradually reduced by switching to lower-dose patches until it is no longer required. Some people wear their patches all the time and provide a steady dose of nicotine over 24 hours, while others remove their patches at night. Discuss which option is right for you with your doctor.
Inhalers, gum, lozenges, and sprays work quickly, but their effects only last for a short time. As such, it is often recommended that a patch is used to provide a daily dose of nicotine and the fast-acting products used to relieve intense cravings.
Evidence shows that using a combination of NRTs can significantly increase the chances of success compared with using just a single product.
Varenicline (Champix) works by triggering the release of dopamine. Dopamine is a chemical messenger that helps control the brain's reward and pleasure centers. Smoking raises levels of this feel-good chemical in the body artificially. So, when smokers quit, they often experience depression and anxiety until their natural dopamine production levels are restored.
Varenicline helps to counteract these low dopamine levels and lessen some of the symptoms caused by nicotine withdrawal. At the same time, it blocks the satisfying effects of nicotine should the person relapse and smoke. As such, it is also useful to reduce the reinforcing effects of nicotine.
Bupropion (Zyban) is an antidepressant, but it has been found to help people stop smoking. Like varenicline, it reduces the dopamine shortfall experienced in nicotine withdrawal and so may reduce the irritability and difficulty in concentrating linked to quitting smoking.
Bupropion may be particularly useful for those concerned about potential weight gain while quitting smoking as it has been shown to decrease appetite and the tendency to overeat.
An e-cigarette is an electronic device that allows for the inhalation of nicotine in a vapour without the other harmful byproducts of tobacco, such as tar and carbon monoxide.
New research suggests that e-cigarettes can help in quitting smoking because people can gradually reduce the nicotine content of the e-liquid in a similar way to NRT. However, there is some controversy in the literature about this approach to smoking cessation.
Many people have successfully quit smoking using Allen Carr's Easyway. It is the world's bestselling book on how to stop smoking. It works by helping smokers understand common misconceptions about why they smoke and helps them to address the fears that keep them hooked on smoking.
This study shows that smokers following the Allen Carr method were six times more likely to have not smoked after 13 months compared with those going cold turkey.
There is anecdotal evidence which suggests that lobelia (also called Indian tobacco) can help people to stop smoking. Lobeline, the active ingredient in the lobelia plant, is thought to work by binding to the same receptor sites in the brain as nicotine, causing a release of dopamine, therefore helping with the mood swings and cravings that occur when stopping smoking.
Lobelia may also be effective in helping to clear excess mucus from the respiratory tract, including the throat, lungs, and bronchial tubes that smokers often experience on quitting, however, more research is needed to determine if this is accurate.
Various studies have shown that smokers generally have lower concentrations of circulating B vitamins and lower levels of vitamin C as compared with non-smokers. Smokers often cite stress as one of the triggers that increases the craving for a cigarette. The B vitamins are known as the "anti-stress" vitamins and they can help to balance mood.
Vitamin C is a powerful antioxidant that may help to protect the lungs from the oxidative stress caused by cigarette smoke. So supplementing with these vitamins may help when stopping smoking.
Certain apps can help to track and cut down on smoking cigarettes.
Habits such as smoking are triggered in response to certain cues. Research has shown that repetition of a simple action in a certain setting leads to that action being activated in similar settings; for example, automatically smoking with your morning coffee.
But healthy habits can be formed by repeating healthy actions consistently in the same context, and there are a variety of free apps online that can help track your progress.
These apps can help track smoking consumption and nicotine-craving cues; this information can then be used to plan when and where to reinforce a new healthy habit in place of the old unhealthy one.
For those smokers who are planning to quit cold turkey, making a list to stay motivated may be helpful when times get tough. Such reasons may include:
Improving overall health.
Setting a good example for children.
Looking better and smelling better.
Taking control and becoming free of addiction.
By reviewing the list every day and especially in difficult moments, smokers can train the mind to focus on the positive aspects of their goal and reinforce their will to quit.
A study in the Journal of Addiction and Therapy suggests that practicing Tai Chi three times a week is an effective means to help people "either stop smoking or reduce their habit." An added benefit of Tai Chi is that it improves blood pressure and reduces stress. Mind-body practices such as yoga, meditation, and Tai Chi offer an alternative drug-free treatment option to those trying to quit.
Why not try some of the above measures to quit smoking today? A combination of therapies is more likely to result in success than any single approach. If relapse occurs, try to pinpoint the reason for the slip up and try again; most smokers try to quit a few times before they finally kick the habit.