Cognitive Behavioural Therapy (CBT)

Effectiveness: up to 55% (1 in 2 people quit for 12 months or more)

Cognitive Behavioural Therapy is an psychological approach to dealing with smoking. Smokers continue to smoke throughout the treatment which consists of rational logic and evaluation of smoking.


The process does not dwell on the ill effects of smoking but on the actual behavioural aspects of smoking including the triggers that make people smoke. CBT effectively changes the way smokers think about smoking and often leads to a complete change in attitude towards smoking.

CBT can be obtained from specialist quit smoking centres which will be available in your area or smokers can simply read about this method for quitting smoking.

There is one downloadable resource on the internet for cognitive behavioural therapy to quit smoking, found on the EasyQuit System website. Click this link:
EasyQuitSystem.com

Nicotine Replacement Therapy

Effectiveness: 10% (1 in 10)

All forms of nicotine replacement therapy (NRT) can help people quit smoking, almost doubling long term success rates

NRT aims to reduce withdrawal symptoms associated with stopping smoking by replacing nicotine in the blood. NRT is available as chewing gum, patches for the skin, nose spray, inhalers, and tablets. The review of trials found that all these forms of NRT made it more likely that a person's attempt to quit smoking would succeed. There is no evidence that one form of NRT is better than any other. NRT works with or without additional counselling.

Chantix (varenicline)

Effectiveness: 22% (1 in 5)

Chantix (Champix in the UK) or varenicline tartrate is a new type of quit smoking pill that interferes with the brain chemistry interactions found in smokers. The varenicline stops nicotine working on the smoker so reducing their will to smoke (as there is no benefit/reward associated with smoking)

Chantix does have many side effects although most of them are the same as the side effects of nicotine withdrawal to a greater or lesser extent. The most significant side effects are nausea which is found in 15% of people on the low starting dose and 30% of people on the 1mg main dose. The other main side effects are insomnia and headaches.

Zyban (bupropion, wellbutrin)

Effectiveness: 16% (4 in 25 or 1 in 6.25) compared to 1 in 20 for cold turkey

Two medications used to treat depression, bupropion and nortriptyline, help smokers who are trying to quit.

Trials of bupropion (Zyban) for smoking cessation indicate that it can approximately double the odds of quitting. The side effects of bupropion include insomnia, dry mouth and nausea. This medication can also cause seizures; at the dose used for smoking cessation the risk is estimated to be 1 in 1000. The tricyclic antidepressant nortriptyline also doubles quit rates. The side effects of this medication include dry mouth, constipation, nausea, and sedation, and it can be dangerous in overdose. The efficacy of bupropion and nortriptyline appears to be similar to that for nicotine replacement and not restricted to people with a history of depression or depressive symptoms during smoking abstinence. Selective serotonin reuptake inhibitor antidepressants (for example, fluoxetine) have not consistently been shown to help smoking cessation.

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Silver Acetate

Effectiveness: 5% (1 in 20) as per cold turkey

Silver acetate does not appear to help smokers quit

Silver acetate products (gum, lozenge, and spray) produce an unpleasant metallic taste when combined with cigarettes, so they are used as a form of aversion therapy for smoking. However, the review of trials found little evidence to show that silver acetate helps smokers quit. Any beneficial effect of silver acetate is likely to be very small, and less than the effect already proven for nicotine replacement therapy.

Lobeline

Effectiveness: 5% (1 in 20) as per cold turkey

No evidence from trials that Lobeline can help people quit smoking

Lobeline is an alkaloid derived from the leaves of an Indian tobacco plant, and has been widely used in commercial smoking remedies. Its adverse effects include dizziness, nausea, and vomiting, and tablets and pastilles containing Lobeline may lead to throat irritation. The review found no adequate longterm trials which could provide evidence that Lobeline can help people stop smoking. Even short-term studies do not indicate a consistent effect on smoking behaviour.

Aversion Therapy

Effectiveness: Possibly up to 10% (1 in 10)

Aversion therapy for smoking has not been shown conclusively to be effective, but it may be worth further research.

Aversion treatments pair undesirable behaviours with negative sensations. In smoking cessation, several approaches have been suggested such as rapid smoking, which requires smokers to take a puff every few seconds to make smoking unpleasant. The results of the existing trials suggest that this may be effective, but the evidence is not conclusive because most of the studies of this approach have methodological problems. A recent laboratory study also suggests that the method has an active ingredient. Further research may be worthwhile.