No 16: Stopping smoking
Nicotine replacement therapy
The most effective aid available in the UK, sold as chewing gum, skin patches, inhalers and nasal sprays. More than 40 studies show NRT doubles success rates; about 12% more smokers give up using NRT than with no aids. For heavy smokers on more than 20 a day, higher dose (4mg) gum is better than low dose (2 mg) gum or patches. Very dependent smokers can use a spray, which delivers nicotine faster. All give your body the nicotine it craves in a safer and less addictive way. All types can be bought over the counter in pharmacists, except the nasal spray (prescription only). No serious side effects, but pregnant women or heart sufferers should consult a doctor first.
Work fairly well run by specialist counsellors: in US trials 12% more quit than would otherwise do so, but there is a high drop-out rate.
Zyban, marketed as a "miracle" smoking cure in the US, is promising. One US trial found it helps 30% of smokers quit. Combined with NRT success rises to 35%. Likely to be available here next year.
Talking to your doctor
A three-minute advice session helps 2% stop, according to studies, and a longer talk can help as many as 5%.
Quitting while pregnant
Many quit without help but talking with a health professional - such as your midwife - doubles quitting rates to 15%. See above for NRT.
Acupuncture and hypnosis
Trials show they are no more effective than a placebo. However, doctors believe they may help some smokers if they have sufficient faith.
Not much evidence that aversion therapy works. Mecamylamine tablets, which block the effect of nicotine, have shown some success, especially when used with NRT.
The Health Education Authority says 15% give up after calling a quitline, although it is not known what made them stop.
A leaflet, Stopping smoking made easier, is available free from the HEA telephone 0171 413 1900. For telephone support ring Quitline free on 0800 002200, or Pregnancy Quitline on 0800 002211.
What works? is based on reviews of the most up-to-date and reliable evidence available. It is written in collaboration with the NHS Centre for Reviews and Dissemination at York university (01904 433 634) and verified by experts.