• A new review of more than 300 prior studies has identified the best tools to quit smoking.
• The research looked at a variety of medications and techniques, including nicotine replacement, medication, and therapy.
• Health experts say quitting smoking is one of the most important things you can do to improve your health.

There has never been a better time to quit smoking tobacco.

More products exist today to help people snuff out cigarettes for good, but with so many options available, identifying which are the most effective isn’t always easy.

However, a comprehensive new review published this month in Society for the Study of Addiction has revealed the top three most effective means to quit.

The Cochrane Tobacco Addiction Group (CTAG) conducted this research, which included more than 300 prior studies on tobacco cessation products and 157,179 participants.

“Using the strictest and most rigorous methods, the CTAG reviews represent the gold standard in medical evidence, which is why CTAG’s work is consistently used to inform guidelines and policies around the world,” Jonathan Livingstone-Banks, PhD, a Lecturer and Senior researcher in evidence-based healthcare at the University of Oxford, and first author of the review, told Healthline.

What are the top three most effective ways to quit smoking?

Out of all the current options available, researchers identified three interventions that “emerged as the most effective treatments. They are:

• Varenicline (Chantix) – An oral prescription medication used alongside education and counseling to stop smoking.
• Cytisine – A plant-derived smoking cessation aid that has been used for decades in many European countries. Cytisine is not currently available in the USA, nor is it FDA-approved.
• E-cigarettes (with nicotine) – Evidence around e-cigarettes for smoking cessation remains somewhat controversial. The FDA has never approved an e-cigarette for this purpose. Nonetheless, the present review did find that e-cigarettes were effective at helping people quit.

Varenicline and cytisine both belong to a class of drugs known as nicotine receptor partial agonists.

“By interacting with the part of the brain that nicotine normally affects, they help to reduce the withdrawal symptoms people experience when they stop smoking, like cravings and unpleasant mood changes,” said Livingstone-Banks.

They also make smoking less pleasurable, disincentivizing smokers from using cigarettes.

Nicotine replacement therapy (NRT), which includes products like nicotine gum, patches, lozenges, and pouches, is also effective. Researchers found that NRT was even more effective when a long-lasting product, like a patch, was paired with a fast-acting product, like gum.

The oral antidepressant bupropion is also approved for smoking cessation. The Cochrane review found that this medication was helpful to quit smoking, but the evidence was not as robust as that for varenicline and cytisine.

Behavioral support, which includes things like therapy and counseling, was also effective. As was incentivizing tobacco smokers with a financial reward.

Are E-cigarettes more helpful or harmful?

E-cigarettes have boomed in popularity over the past decade.

However, numerous questions remain about their safety, their role in smoking cessation, and their appeal to teens and adolescents. The FDA has not approved any e-cigarette device for smoking cessation. Despite this, anecdotal reports and some research have indicated that nicotine-containing e-cigarettes may help people quit.

Nevertheless, research on e-cigarettes is controversial, and other studies have found the opposite to be true.

Parents and policymakers have also sounded the alarm about the appeal of e-cigarettes, particularly flavored products, to children and teens.

The dilemma has led many to ask whether the devices do more harm than good.

But, without delving into the broad social and public health implications of e-cigarette usage, the evidence for e-cigarettes as tobacco-cessation devices is substantial, according to the review.

“Our research has found that there is very strong evidence that e-cigarettes are an effective way to help people quit smoking tobacco… While e-cigarettes are unlikely to be completely safe, we can be confident that they are far safer than smoking tobacco,” said Livingstone-Banks.

Hilary Tindle, MD, PhD, the Founding Director of ViTAL, the Vanderbilt Center for Tobacco, Addiction, and Lifestyle at Vanderbilt University Medical Center, told Healthline that the research is ‘invaluable’ and that she will use this Cochrane Review (including e-cigarette evidence) to update Smoking Cessation guidelines for patients with cancer.

“In terms of e-cig safety, short term safety is addressed in the review where the rates of adverse events do not differ in participants randomized to e-cigs vs. NRT. Additionally, biomarkers of harm are reduced after switching to e-cigs,” she said

“However, The long-term safety of e-cigs is unknown. Furthermore, e-cigs are aggressively marketed to entice young people to begin using nicotine-containing products, so beyond helping adults quit smoking, there are major public health considerations,” she added.

Tindle wasn’t affiliated with the research.

The health benefits of quitting smoking

According to the American Lung Association, these are only a few of the positive health benefits you can experience when you stop smoking, and how quickly they can occur:

• Twenty minutes: heart rate and blood pressure drop.
• One day: your risk of heart attack is reduced.
• Three months: your lung function begins to improve.
• One year: your risk of coronary heart disease is half that of a person who smokes.
• Five years: your risk of mouth and throat cancer is half that of a person who smokes.
• Ten years: your risk of dying from lung cancer is about half that of a person who smokes.

To start quitting, Tindle recommends making a concrete plan:

“Set a target quit date, preferably within 2 weeks, and support your quit attempt with medication and counseling. This combination of support — rather than relying on one or neither — is key and leads to higher success rates,” she said.

Many people in the United States can access free counseling and medication through the hotline 1-800-QUIT-NOW (1-800-784-8669) and websites, including Smoke Free or the Mayo Clinic and Truth Initiative collaboration, BecomeAnEx.

“If someone does not succeed on the first quit attempt, keep trying. In the US, more than 50% of all people who ever smoked have now quit,” said Tindle.

The bottom line

There are many products and medications available to help you quit smoking, but it may be difficult to figure out which are the most effective.

A new review, which included more than 300 prior studies, has identified the three most effective tools to quit smoking.

The most effective smoking cessation tools include the medication varenicline (Chantix), the plant-derived cytisine (not available in the US), and nicotine-containing e-cigarettes.

Quitting smoking is one of the most important things you can do for your health.