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A comprehensive analysis conducted by scientists, including a health policy expert from the University of Massachusetts Amherst, has identified the most effective strategies for quitting smoking. The study, led by Jamie Hartmann-Boyce, assistant professor at UMass Amherst, highlights the benefits of three key interventions: varenicline, cytisine, and nicotine e-cigarettes. The findings were published on September 4, 2024, in the journal Addiction.
Smoking: A Global Health Concern
Globally, smoking remains the leading cause of preventable death and disease, contributing to over seven million deaths annually. “For those who smoke, the single best thing they can do for their health is to quit,” said Hartmann-Boyce, who is also a Cochrane editor. However, quitting smoking is often a challenging journey, requiring strong evidence-based support.
The analysis was conducted by the Cochrane Tobacco Addiction Group (CTAG), which specializes in reviewing evidence on interventions for smoking cessation. The group’s review, co-authored by Jonathan Livingstone-Banks of the University of Oxford, examined findings from 319 studies involving 157,179 participants.
The Top Three Smoking Cessation Methods
- Varenicline: Commonly sold under the brand names Chantix and Champix, varenicline has been shown to be a highly effective prescription medication for smoking cessation.
- Cytisine: A plant-derived compound, cytisine is available over-the-counter in countries like Canada, Central, and Eastern Europe and by prescription in the UK. Although less common in the U.S., cytisine’s effectiveness is backed by high-certainty evidence.
- Nicotine E-cigarettes: The review found that nicotine e-cigarettes increased quit rates compared to nicotine replacement therapy (NRT), and are now recognized as a viable option for smokers aiming to quit.
The researchers noted that these methods work best when combined with behavioral support, such as counseling and programs that reward smoking cessation efforts.
Other Effective Strategies
Besides the top three, the study confirmed the effectiveness of bupropion and nicotine replacement therapy (NRT). NRT, particularly when combining fast-acting forms like gum or lozenges with long-acting patches, was also found to help more people quit than using just one form.
“For behavioral support, evidence is strongest for counseling and programs that reward people for quitting,” Hartmann-Boyce emphasized.
Recent Cochrane Reviews on Smoking Cessation
The analysis draws from 14 Cochrane reviews published between 2021 and 2023. Among the most significant reviews:
- NRT for smoking cessation: Combining fast-acting NRT with NRT patches significantly improves success rates.
- E-cigarettes for smoking cessation: Nicotine e-cigarettes were found to outperform NRT and non-nicotine e-cigarettes in increasing quit rates.
- Pharmacological and e-cigarette interventions: Varenicline, cytisine, and nicotine e-cigarettes were all deemed highly effective, with no significant difference between cytisine and varenicline for their ability to help smokers quit.
A Commitment to Public Health
Hartmann-Boyce emphasized the importance of continuing research into effective cessation methods: “Our team will continue to review evidence on the best ways to help people quit smoking, as we know how vitally important this is to people who smoke and to public health.”
Conclusion
With smoking-related illnesses being a major public health challenge, the findings offer renewed hope for those looking to quit. By combining proven interventions like varenicline, cytisine, or nicotine e-cigarettes with behavioral support, smokers have a better chance of achieving long-term success in their efforts to quit.
Reference: “Effects of interventions to combat tobacco addiction: Cochrane update of 2021 to 2023 reviews,” by Jonathan Livingstone-Banks, Nicola Lindson, and Jamie Hartmann-Boyce, published September 4, 2024, in Addiction. DOI: 10.1111/add.16624.
