A Recent Study on the Most Effective Tools to Quit Smoking
A recent large-scale study has identified nicotine e-cigarettes, along with the medications varenicline and cytisine, as the most effective tools for helping people quit smoking. The study, which reviewed over 300 trials involving more than 150,000 smokers, shows that about 14 out of every 100 smokers successfully quit using one of these aids, compared to just 6 out of 100 who tried without any assistance.
Other methods, such as combination nicotine replacement therapy (NRT)—using a nicotine patch along with gum, lozenges, or nasal sprays—also help around 12 out of 100 smokers quit. However, using just one form of NRT, like a patch alone, leads to fewer success stories, with about 9 out of 100 people quitting.
Varenicline and Chantix: Risks and Market Withdrawal
While varenicline (also known as Chantix in the U.S.) is one of the most effective smoking cessation drugs, it has faced significant challenges. Varenicline works by blocking nicotine’s effects on the brain, reducing cravings and withdrawal symptoms. Despite its effectiveness, Chantix was pulled from the market in 2021 after it was discovered that the drug contained high levels of nitrosamines, chemicals linked to cancer. This led to its withdrawal in many countries, including Europe, the U.S., and parts of South America. Although the drug was once considered a powerful tool for quitting smoking, the safety concerns have made it unavailable in most regions, including the EU and UK.
Additionally, varenicline has been associated with serious side effects in some users, including mental health issues, such as depression and suicidal thoughts, as well as cardiovascular risks. This has further complicated its reintroduction, as regulatory agencies in many countries have been cautious about allowing the drug back on the market, even after potential reformulations.
Cytisine: An Effective but Limited Option
Cytisine, another effective quit-smoking aid, is a plant-based medication that has shown success rates similar to varenicline. However, it remains largely unavailable outside of central and Eastern Europe, limiting its use for many smokers. Cytisine is known to have fewer reported side effects than varenicline, but because it is not widely marketed or approved in most countries, including the UK and U.S., access remains a major barrier.
What About Zyban?
Another drug that has been used to help people quit smoking is Zyban (also known as bupropion). Initially developed as an antidepressant, bupropion was later found to help people quit smoking. It works by affecting the brain’s dopamine and norepinephrine levels, which are involved in nicotine addiction. However, its effectiveness in smoking cessation is lower compared to varenicline and combination NRT. Like varenicline, Zyban has some mental health-related side effects, including mood changes and insomnia, which can make it less appealing to some users. While it’s still available, its success rates are typically lower than the leading options.
The Safest and Most Effective Approach to Quitting
Given the risks associated with varenicline and its current unavailability in many countries, nicotine e-cigarettes and combination NRT (such as a nicotine patch combined with gum or lozenges) emerge as the most practical and safest options for many smokers looking to quit. E-cigarettes have been shown to help around 14 out of 100 smokers quit, making them one of the most effective aids, while using two forms of NRT together helps around 12 out of 100 smokers quit.
E-cigarettes are considered a safer option because they provide nicotine without many of the harmful chemicals found in traditional cigarettes. However, while the long-term effects of e-cigarette use are still being studied, they are widely regarded as significantly less harmful than smoking.
Conclusion
For smokers looking to quit, nicotine e-cigarettes and combination NRT are currently the most accessible and effective tools, particularly given the safety concerns and unavailability of varenicline and cytisine in many parts of the world. Though medications like Zyban are still available, they are generally less effective than other options.
Smoking remains a leading cause of preventable death worldwide, and having reliable, effective tools for quitting is crucial. This study provides strong evidence for the best methods to help smokers quit successfully, guiding smokers, healthcare professionals, and policymakers toward the safest and most effective strategies.
See the study here