It’s time to follow-through on your New Year’s resolution to quit smoking!
There are so many reasons to live smoke free – most of them related to your health, longevity and quality of life. But for many people the physical addiction to nicotine is incredibly difficult to battle. Nonetheless, that doesn’t mean you should quit trying to quit smoking. It is never too late to reap the benefits, some of which occur within days of quitting (1).
Here are five evidence-based strategies for becoming – and staying – smoke-free. Click the links in the reference list to read summaries of the research findings.
1. Smart use of that smartphone
Why not use your phone to help smooth your road to smoke-free living? A systematic review of 12 studies showed that support programs delivered via mobile phone can help you quit smoking and stay on the wagon (2). Most of the studies involved texts sent to participants’ smartphones with information, advice and motivational messages.
Can programmes delivered by mobile phones help people to stop smoking (2)?
Motivational text messages also worked to help people quit smoking in a previous review (3).
Text-messaging helps people quit smoking (3).
2. Seek out support
Quitting is hard and there is no shame in seeking personal support – in fact, this can increase your chances of quitting successfully. Two high quality systematic reviews show that ‘behavioural support’ such as talking to medical professionals, one-on-one or group counseling, and receiving customized resource materials can encourage people to quit smoking. The more regular and intense the support, the more likely participants were to still be non-smokers six months after quitting (4;5).
Behavioural support and pharmacotherapy improve smoking quit rates in adults (4).
Does a combination of stop smoking medication and behavioural support help smokers to stop (5)?
Telephone quit lines – especially those with call-back counselling – may also provide the support you need to quit (6).
Is telephone counselling effective as part of a programme to help people stop smoking (6)?
3. Try nicotine replacement options
Nicotine is a powerful addiction and there are medication which can help you overcome it. Two systematic reviews measured nicotine replacement therapy (including nicotine patch or gum) and other drugs such as bupropion (e.g. Wellbutrin®, Zyban®) to help people quit smoking (4;5). Compared to the control group (who received minimal support only) participants taking nicotine replacements were more likely to quit successfully. In fact, all licensed forms of NRT, from patches to sprays to tablets, can help increase the chances of quitting in people who make a quit attempt (7).
Behavioural support and pharmacotherapy improve smoking quit rates in adults (4).
Does a combination of stop smoking medication and behavioural support help smokers to stop (5)?
Can smokers be helped to reduce the harm caused by cigarette smoking by smoking fewer cigarettes or using different tobacco products (8)?
Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation (9).
This approach is not for everyone: side effects of some drugs include increased risk of heart problems. Consult your doctor to find out if this type of strategy is right for you.
4. If one strategy is good, two or more is better!
Research supports a “multi-modal” approach: using more than one strategy to help you quit smoking. Ideally, each strategy addresses a specific challenge (nicotine withdrawal, stress and anxiety, boredom etc.) so that you are better able to resist the temptation to light up. For example, research shows that people who take nicotine replacement drugs while getting supportive counseling are more successful at staying smoke free than those who tried just one of the two strategies.
What is the best way to help people with chronic obstructive pulmonary disease stop smoking (10)?
Behavioural support and pharmacotherapy improve smoking quit rates in adults (4).
Does a combination of stop smoking medication and behavioural support help smokers to stop (5)?
5. Feel encouraged: Older smokers can quit (successfully) too!
Do older adults – who may have smoked for many years – have a harder time trying to quit? Are some strategies more effective than others for older adults? A systematic review of 29 randomized controlled trials has ignited what will likely be more research into smoking cessation programs for this population (11).
So far the good news is that not only do seniors respond to drug and behavioural therapies, they have a slightly higher success rate than younger groups (12).
Other promising options:
Financial incentives (such as vouchers or cash) do seem to encourage people to quit, but are unlikely to last after the incentive is removed and unlikely to help you break the habit for good.
Financial incentives can help motivate people to make lifestyle changes (13).
E-cigarettes show some promise of helping people quit smoking in the long term – their effectiveness may be similar to nicotine patches – but so far our confidence in this approach is not strong and the long-term safety of e-cigarettes isn’t yet known. More research is needed before recommending e-cigarettes as a way to quit smoking.
Electronic cigarettes for smoking cessation (14).
If you still haven’t ‘kicked the habit,’ try some or all of the five tips listed above, or try something else. Everyone is different and there is no simple solution to nicotine addiction. Just don’t give up until you’ve found the one that works for you!
