==Description==

Research in Western countries has found that approximately 3-5% of quit attempts succeed using willpower alone (Hughes et al, 2004). The British Medical Journal and others have reviewed the evidence regarding which methods are most effective for smokers interested in breaking free of the smoking habit, and concluded that

Nicotine dependence is most effectively treated with a combination of drugs and specialist behavioural support . . .Managing smoking cessation |

Paul Aveyard, National Institute of Health research career scientist, Robert West, professor of health psychology and director of tobacco studies |

Clinical Review |

BMJ 2007; 335:37-41 (7 July) |

doi:10.1136/bmj.39252.591806.47 |

http://bmj.bmjjournals.com/cgi/content/full/335/7609/37?fmr As detailed in the Statistics section below, multi-session psychological support from a trained counselor, either individually or in groups has been shown in clinical trials to provide the greatest benefit.

An even better chance of success can be obtained by combining medication and psychological support (see below) (USDHHS, 2000). Medication or pharmacological quitting-aids that have shown evidence of effectiveness in clinical trials include medical nicotine replacement patches or gum, the tricyclic anti-depressant nortriptyline, bupropion (Zyban, or Quomem in some countries), and the nicotinic partial agonist, varenicline (Chantix in the US and Champix elsewhere).

There are many people and organizations touting what are claimed to be effective methods of helping smokers to stop. Any smoker thinking of paying money for such help would be well advised to ask whether the claims of success are backed up by independent comparative clinical trials, how the success rates have been calculated and what numbers of smokers have been included in the figures. It is very easy to make misleading claims of success rates which are not adequately supported by evidence. A separate thorough review of the evidence for each of several methods and aids for stopping smoking is available via the Cochrane Library website, Cochrane Library.Cochrane Topic Review Group: Tobacco Addiction http://www.cochrane.org/reviews/en/topics/94.html

A range of population level strategies such as advertising campaigns, smoking restriction policies, and tobacco taxes have been used to promote smoking cessation. Of these, raising the cost of smoking is the one that has the strongest evidence (West, 2006).

Smoking cessation will almost always lead to a longer, happier and healthier life. Stopping in early adulthood can add up to 10 years of healthy life and stopping in one's 60s can still add 3 years of healthy life (Doll et al, 2004). Stopping smoking is associated with better mental health and spending less of one's life with diseases of old age.

The most common short-term effects of stopping smoking are increased irritability, depression, anxiety, restlessness, difficulty concentrating, increased appetite, constipation, mouth ulcers and increased susceptibility to upper respiratory tract infections. These mostly last for up to 4 weeks, though increased appetite typically lasts for more than 3 months. The most obvious long-term effect is weight gain (Hughes, 2007).