Smoking is a major contributor to preventable diseases and deaths worldwide, making it crucial for individuals to quit the habit regardless of their age or smoking history. A recent review highlighted three effective smoking cessation strategies, noting that a combination of these strategies with behavioral therapies can significantly increase success rates. Behavioral therapies and financial incentives have also shown promise in helping smokers quit without the need for additional medications. Studies published between 2021 and 2023 have found that varenicline, cytisine, and nicotine e-cigarettes have improved success rates for smoking cessation.
The researchers behind the review, known as CTAG, published 14 reviews of tobacco addiction treatments during this period. They outlined key findings, such as new results and updated conclusions from previous studies, as well as summarizing abstinence rates and adverse side effects associated with treatments. The quality of evidence was assessed using parameters like study limitations and consistency of effect, with certainty ratings ranging from high to very low certainty. Common medications like varenicline, cytisine, and nicotine e-cigarettes were found to be the most effective treatments for smoking cessation according to the evidence.
Varenicline, a prescription oral tablet designed to aid in smoking cessation, was found to be more effective than bupropion or single forms of nicotine replacement therapy. However, evidence supporting its efficacy compared to dual-form NRT was uncertain. Cytisine, a plant-based medication available both by prescription and over-the-counter, was associated with fewer serious adverse events compared to varenicline use. Bupropion, an antidepressant, was also found to be helpful in smoking cessation, though it was linked to more serious adverse events than a placebo.
The CTAG team reported high-certainty evidence that combining fast-acting NRT formulations with transdermal patches was more effective than single-form NRT alone. There was also mixed evidence regarding the effectiveness of higher NRT doses. Behavioral therapy for smoking cessation was found to increase quit rates at 6 months or longer, with slightly lower efficacy when used in conjunction with smoking cessation medications. Further research is needed to explore the benefits of specific therapy services, such as text messages, email, and motivational components.
A Cochrane Review of e-cigarettes found that ECs with nicotine led to higher quit rates compared to NRT. The review pointed to evidence suggesting that switching from smoking to exclusive vaping could lead to reduced levels of potentially harmful biomarkers. The lead author of the study stressed the importance of focusing on helping people quit combustible tobacco use, noting that while nicotine is not without harm, most of the damage from smoking comes from other components of burnt tobacco. Ongoing research is needed to fully understand the process of quitting vaping and the effectiveness of various support strategies.
In conclusion, research on smoking cessation strategies continues to evolve, with evidence supporting the effectiveness of various medications, behavioral therapies, and e-cigarettes in helping individuals quit smoking. While more studies are needed to compare different treatments and assess their long-term safety and effectiveness, the findings underscore the importance of personalized support and tailored interventions in promoting successful smoking cessation outcomes. Future research should also focus on the impact of smoking cessation on cardiovascular health, mental well-being, and the safety and efficacy of emerging products like heated tobacco devices.
