How to tell if a smoking cessation aid works.

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In previous posts I’ve discussed some of the behavioral steps you can take to increase your chances of successfully quitting. It is sensible to also consider using a product designed to help people quit smoking. But there are hundreds on the market, so how do you tell which ones are likely to be helpful?

It can certainly be confusing, particularly because many products have similar sounding names (e.g. there are over 20 beginning with the letters, “nic….”). I can’t pretend to have looked at all the available products. That would be a full-time job in itself, but there are some fairly simple guidelines to help you avoid wasting money on a product that’s at best useless and at worst, dangerous.

The most basic piece of advice for a drug or medicines is to only use a smoking cessation medicine that has been approved by the US Food and Drug Administration (FDA) as an aid to smoking cessation. Currently, only a relatively small number of medicines fall into this category. These are:
  • Nicotine replacement products available over-the-counter (without a prescription):
    • Nicotine gum (brand name: Nicorette, plus generic versions)
    • Nicotine patch (brand names: Nicoderm and Nicotrol, plus generics)
    • Nicotine lozenge (brand name: Commit)
  • Prescription-only nicotine replacement products:
    • Nicotine inhaler (brand name Nicotrol)
    • Nicotine nasal spray (brand name Nicotrol)
  • Prescription-only, non-nicotine pills:
    • Bupropion (brand names Zyban or Welbutrin)
    • Varenicline (brand name Chantix)
The FDA has approved all of the medicines mentioned above, and their product labeling, as safe and effective for smoking cessation.

Two medicines not approved by the FDA for smoking cessation have good evidence that they help smokers quit (nortriptyline and clonidine). These prescription-only medicines typically have more serious side effects than the medicines mentioned above, and so should only be used on the advice of a medical doctor with appropriate experience in tobacco treatment.

Currently the medicines mentioned above are the only ones that are likely to help you to quit smoking. They each have very solid evidence showing that they work. This means that your chances of successfully quitting are roughly doubled if you use one of these medicines, as compared with not using one. There is enough choice from these 7 medicines such that most smokers should be able to find one that suits them, without needing to resort to using a product without solid evidence on its safety and efficacy. Many others are currently being studied in clinical trials but are not yet approved. Similarly, there are numerous herbal products, fake cigarettes, and other gadgets that are being offered to desperate smokers. Smokers should generally save their money for something more likely to be helpful.

There is an excellent website that describes most of the available smoking cessation aids, shows photographs of them, and lists the specific claims made on the labeling or advertising. The address is: https://secure.tobaccofreekids.org/cessation/ . When you visit this site, clicking on “FDA Approved Product List” will provide a description of each medicines approved by the FDA for smoking cessation. Each of these medicines has been shown to be safe and effective for smoking cessation.

Clicking on “Other Cessation Product List” will provide access to descriptions of a long list of unapproved products. I don’t recommend the use of any of these products. None of them have adequate evidence that they help people to stop smoking.
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    About the Author


    MA, MAppSci, PhD

    Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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