Stop smoking treatments 

Stop smoking treatments 

Stop smoking

There are 10 million ex-smokers in the UK. See how some of them kicked the habit and their reasons for wanting to quit.

Media last reviewed: 25/09/2013

Next review due: 25/09/2015

Cutting down before you quit

If you don't feel ready to stop smoking completely, your GP may suggest a method of quitting known as nicotine-assisted reduction to stop. This involves using NRT to cut down before you eventually stop smoking.

If your GP suggests this approach, you will be prescribed NRT gum or an inhalator to use between cigarettes. These forms of NRT are best for use between cigarettes because they release a short burst of nicotine rather than say patches, which release a steady, constant supply of nicotine and could make you feel unwell if you use them while you still smoke cigarettes.

When cutting down, you should try and prolong the gaps between cigarettes for as long as you can, and steadily reduce the number of cigarettes you smoke.

By six weeks of NRT treatment, you should aim to have cut your usual cigarette consumption by half and have stopped smoking completely by six months.

Compare your options

Treatment options for quitting smoking

If you smoke, giving up is probably the greatest single step you can take to improve your health.

Smoking is responsible for one in every five deaths in adults aged over 35 in England, and half of all long-term smokers will die prematurely due to a smoking-related disease.

Giving up smoking increases your chances of living a longer and healthier life. You'll start to notice the benefits soon after quitting. For example:

  • after one month your skin will be clearer, brighter and more hydrated
  • after three to nine months your breathing will have improved, and you will no longer have a cough or wheeze
  • after one year your risk of heart attack and heart disease will have fallen to about half that of a smoker

Read more health benefits of stopping smoking.

If you want to quit smoking, it's is a good idea to see your GP. They can provide help and advice about quitting, and refer you to an NHS Stop Smoking support service. These services offer the best support for people who want to give up smoking.

Studies show that you are four times more likely to quit smoking if you do it through the NHS. For more information, call the NHS Stop Smoking helpline on 0300 123 1044 (England only).

Read more about how NHS stop smoking advisers can help you to quit.

Stop smoking help from your GP

If you don't want to be referred to an NHS Stop Smoking support service, your GP can still offer treatment to help you quit.

You'll be assessed to get an idea of your level of addiction and to outline the benefits of quitting.  This is also a chance to identify potential triggers, such as if you live with others who smoke or you're under stress.

Your GP can prescribe several different stop smoking treatments. The type prescribed will depend on your personal preference and whether you've used any before.

Read more about how your GP can help you to quit smoking.

Nicotine replacement therapy (NRT)

Nicotine is highly addictive, and it's the nicotine in cigarettes that causes you to become addicted to smoking. Nicotine replacement therapy (NRT) works by releasing nicotine steadily into your bloodstream at much lower levels than in a cigarette, without the tar, carbon monoxide and other poisonous chemicals present in tobacco smoke.

This helps control your cravings for a cigarette that happen when your body starts to miss the nicotine from smoking.

Read more about coping with cravings for a cigarette.

NRT comes in different forms, including:

  • skin patches
  • chewing gum 
  • inhalators, which look like plastic cigarettes through which nicotine is inhaled
  • tablets and lozenges, which you put under your tongue
  • nasal spray
  • mouth spray 

Your GP can prescribe NRT or you can buy it from a pharmacist.

There's no evidence that one particular type of NRT is more effective than another. The one you choose is down to personal preference.

When deciding, it helps to think about the type of smoker you are. For example, are you a heavy smoker who needs a cigarette as soon as you wake up, or are you an occasional smoker who only smokes when they are out having a drink, or after a meal?

Some heavy smokers find a 24-hour patch useful, as it helps to relieve the cigarette craving when waking up. Others prefer using an NRT nasal spray or mouth spray, because they're the fastest-acting form of NRT.

Some smokers find it useful to combine NRT products. For example, they wear patches through the day, then use gum or an inhalator to help relieve a sudden craving for a cigarette.

Most courses of NRT last eight to 12 weeks before you gradually reduce the dose and eventually stop. Most people stop using NRT altogether within three months, although heavy smokers may need to use it for longer.

Side effects of NRT include:

  • skin irritation when using patches
  • irritation of nose, throat or eyes when using a nasal spray
  • disturbed sleep, sometimes with vivid dreams
  • upset stomach
  • dizziness
  • headaches 

Side effects are usually mild to moderate, but if they become particularly troublesome, contact your GP as your dosage or type of NRT may need to be adjusted.

Also, the nasal spray can cause sneezing and watering eyes for a short time after use. So, don't use an NRT nasal spray while driving, or just before driving.

Read more about the different types of NRT.

Nicotine replacement therapy and pregnancy

If you are pregnant or breastfeeding and you want to quit smoking, it's best to stop completely and immediately without any treatment.

However, if you feel you cannot stop smoking without help, your GP may recommend NRT to control your cravings.

Nicotine is not good for your baby, but the greatest risk from smoking is posed by carbon monoxide, which can cause foetal hypoxia (a severe lack of oxygen). So although using NRT is not ideal for your baby, the risks of nicotine are far outweighed by the risks of continuing to smoke.

Read more about how to stop smoking during pregnancy.

Stop smoking medication

Two medications are available on the NHS to help you stop smoking.

Zyban (bupropion)

Bupropion was originally designed to treat depression, but it was discovered that it also helped people quit smoking. It's not entirely clear why, but most experts believe it affects parts of the brain involved in addictive behaviour.

Bupropion is prescribed as one to two tablets a day.

You need to take bupropion for 7-14 days before you try to quit as the medication takes this long to reach its maximum effect. A course of treatment usually lasts seven to nine weeks.

Bupropion is not suitable for:

  • children and young people under 18
  • women who are pregnant or breastfeeding
  • people with anorexia or bulimia
  • people with a central nervous system tumour
  • people with severe cirrhosis of the liver

Bupropion can also increase your risk of having a seizure (fit), so it's not suitable for people who already have a higher-than-average risk of having seizures, such as people:

Bupropion can cause several side effects, including:

  • dry mouth
  • upset stomach
  • insomnia (trouble sleeping)
  • headaches
  • difficulty concentrating
  • dizziness
  • drowsiness

Read more about Zyban.

Champix (varenicline)

Varenicline is currently the only medication specifically designed to help you quit smoking.

It works by preventing nicotine from binding to receptors (parts of your brain that respond to nicotine), which eases cravings and reduces the rewarding and reinforcing effects of smoking.

If you've not stopped smoking completely before starting varenicline, aim to do so within 7-14 days of starting treatment. It's recommended you take varenicline for 12 weeks. If you successfully stop smoking in this time, you may be prescribed another 12 weeks of treatment to ensure you do not start smoking again.

Varenicline is not suitable for:

  • children and young people under 18
  • women who are pregnant or breastfeeding
  • people with epilepsy
  • people with advanced kidney disease

Side effects of varenicline include:

  • nausea and vomiting
  • headaches
  • insomnia (trouble sleeping)
  • unusual dreams
  • increased appetite
  • constipation or diarrhoea
  • swollen stomach
  • slow digestion
  • flatulence 
  • dry mouth
  • tiredness
  • dizziness
  • drowsiness

There have been reports of people experiencing feelings of depression and suicidal thoughts after beginning treatment with varenicline.

While there's no evidence these symptoms are directly linked to the medication, if you feel depressed or have thoughts of suicide, stop taking varenicline immediately as a precaution, and contact your GP.

Read more about Champix.

Read 10 myths about stop smoking treatments

Electronic cigarettes

Electronic cigarettes – or e-cigarettes – are electrical devices that mimic real cigarettes but using an electronic cigarette or ‘vaping’ as its come to be known, produces a vapour that’s potentially less harmful than tobacco smoke. Many e-cigarettes contain nicotine and, when they do, it’s the vapour that gives the nicotine hit.

E-cigarettes are currently not available on the NHS. They are not the same as the inhalator, which is a type of nicotine replacement therapy that is available on the NHS.

Since their emergence around five years ago, e-cigarettes have become increasingly popular. They’re typically marketed as a healthier (and cheaper) alternative to traditional cigarettes. And, because they don’t smell or produce smoke, they may be used in places where smoking is banned, like bars, restaurants, public transport, planes and even hospitals (though it is courteous to get permission from those around you beforehand).

While e-cigarettes may be safer than conventional cigarettes, we don’t yet know the long-term effects of vaping on the body. There are other potential drawbacks to using them:

  • Electronic cigarettes aren’t currently regulated as medicines so you can’t be sure of their ingredients or how much nicotine they contain – whatever it says on the label
  • The amount of nicotine you get from an e-cigarette can change over time
  • They aren’t proven as safe. In fact, some e-cigarettes have been tested by local authority trading standards departments and been found to contain toxic chemicals, including some of the same cancer-causing agents produced from tobacco
  • So far, there’s no proof that they can help people to stop smoking

There are clinical trials in progress to test the quality, safety and effectiveness of e-cigarettes, but until these are complete, the government can’t give any advice on them or recommend their use.

Read more about electronic cigarettes.

Read more articles to help you stop smoking.




Page last reviewed: 27/04/2012

Next review due: 27/04/2014

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Comments

The 9 comments posted are personal views. Any information they give has not been checked and may not be accurate.

barmygal said on 31 July 2014

My delightful doctor (who I have refused to see again due to how rude they are) told me that unless I could get to the stp smoking clinc (help at 9.15am on a Monday) then they would not be willing to help me. Strangely enough, I, like thousands others, work Monday - Friday, 9.15 - 5.15. I tried to explain this to but they just would not help me. I have tried everything I can, and actually ended up in hospital after having a very bad reaction to the patches. The irony of that is not lost on me.

Short of buying Chamix on Amazon, what else can I do seeing as everyday life is ignored by the nhs.

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LESMC said on 22 June 2014

" In fact, some e-cigarettes have been tested by local authority trading standards departments and been found to contain toxic chemicals"

This is not a fact, it is a statement. If it's a fact you have to show the evidence or point us to the paper or scientific journal that this information came from.
How many E-Cigs tested ?
Level of carcinogens ?
Country of origin?
Brands to avoid?
If I put out a statement saying "e-cigs make you live longer" It would not take long to be vilified even if the evidence proved this to be true (just to clarify this is not true). But it seems that you can make any anti e cigarette claim without having to prove a thing.

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Shawn777 said on 28 April 2014

Thanks for the info, definitely some great advice. I was a smoker for over 20 years. !0 of those years I was trying to quit. I tried every method available multiple times. Although they did provide some relief from the nicotine cravings, they were horrible to use and inevitably I would be back on the smokes within a couple of days. I do know many people that quit using the gum or the patches and they swear by it. For myself, the only thing that actually worked was electronic cigarettes. If you buy them from a reputable maker, you can get exact figures on nicotine content and it's all made with pharmaceutical grade nicotine. They are as viable an option as any other, but they allowed me to actually enjoy quitting and I have come to love ecigs more than I ever loved cigarettes. They may not work for everybody but they worked for me.

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Godavari2 said on 20 February 2014

I have tried to stop several times using the Smoke stop programme, I've found the Nicotine gum works best but stopped using it due to the fact it contains Aspartame or Acesulfame. These are artificial sweeteners that have been proven to be carcinogenic and the cause of countless serious illnesses. I would like to know why our Government allow the use of these poisons. They are found in most sugar-free products and flavoured crisps as well. Scandalous.
Everyone should be made aware of this, there's lots of info on the web to be found through Google.

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Sign of Four said on 01 January 2014

I tried and failed all the NHS and GP services over several years. The only method I found to be effective - 7 months without smoking - is the e-cigarette. It is a shame the NHS and the MHRA are so negative on these products which appear to be more effective than all other methods. To balance the points made on this page I would point out that just because e cigarettes are not regulated as medicines they are still regulated by many other laws and standards. Confidence in ingredients relies on the manufacturer in the same way as food brought at my local supermarket does. Nobody can prove a medicine is safe. They can only show there is no harm caused from the evidence to date. There is a lot of anecdotal evidence that e cigarettes are very effective at helping people quit. I am one such person will real evidence.

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nessy1954 said on 17 April 2013

Hi. Everyone is different. I tried the patches and was ill for three days after using only one. I then decided to stop with just willpower and succeeded. It has been 3 years since my last cigarette. On the other hand my husband, who was a smoker for 55 years, had no trouble using the patches and has now been a non-smoker for 5 years. If you need help then contact your local pharmacist, ours couldn't have been more helpful.

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barthj said on 07 February 2012

The Nicorette mist can be bought over the counter at 17.99

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natashaaa said on 09 January 2012

Dear Tongar

I hope things have gone well and that your husband has stopped smoking.
You are correct in thinking 1 pack of quick mist is just not enough, it sounds like he may need the dual pack and maybe another product on top of that e.g. patches, gum inhalator....
Most NHS stop smoking services also have advisors who work within pharmacies so they have more flexibility in appointment times, some may also provide drop in serivces at more convenient times i.e. weekends
It may be worth calling the NHS help line 0800 022 4332 to find out what services are available in your area. It may not just be your GP that can provide your husband with smoking cessation support.

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tongar said on 24 October 2011

Hi we NEED help!!
My husband is just stopped smoking after 30 ish years of heavy cigarette abuse – 1 packet a day. So, he tried the Nicorette Mist and it helped, so far so good nearly 2 weeks without smoke. He needs help BUT as usually the Portishead HARBOURSIDE FAMILY PRACTICE which he registered with at the moment ( I moved from them, thanks GOD ) VERY VERY unhelpful and rationed him just with one pack of Nicorette mist a week which is last only 2.5 days maybe 3 max. My question is, how come they prescribed to adult men with 30 years heavy smoking with only 1 mist. NHS makes it loud everywhere that they will HELP to beat the smoking habit and its so easy to seek the help. I totally disagree, its not easy at all!! I think that 1 mist will help Nobody!! He working away 5 days a week, therefore it's quite impossible to make an appointment with Stop smoking nurse, Saturday/ Sunday they do not work so where is solution, where is HELP??

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Stop smoking

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