Tobacco cessation

Smoking cessation (colloquially quitting smoking) is the process of discontinuing tobacco smoking. Tobacco contains nicotine, which is addictive. Nicotine makes the process of quitting often very prolonged and difficult.

Smoking is the leading preventable cause of death worldwide, and quitting smoking significantly reduces the risk of dying from tobacco-related diseases such as heart disease and lung cancer. Seventy percent of smokers would like to quit smoking, and 50 percent report attempting to quit within the past year. Many different strategies can be used for smoking cessation, including quitting without assistance ("cold turkey" or cut down then quit), medications such as nicotine replacement therapy (NRT), cytisine or varenicline, and behavioral counseling. The majority of smokers who try to quit do so without assistance, though only 3% to 6% of quit attempts without assistance are successful. Use of medications and behavioral counseling both increase success rates, and a combination of both medication and behavioral interventions has been shown to be even more effective.

Because nicotine is addictive, quitting smoking leads to symptoms of nicotine withdrawal such as craving, anxiety and irritability, depression, and weight gain. Professional smoking cessation support methods generally endeavor to address both nicotine addiction and nicotine withdrawal symptoms.

Major reviews of the scientific literature on smoking cessation include:

It is common for ex-smokers to have made a number of attempts (often using different approaches on each occasion) to stop smoking before achieving long-term abstinence. A recent study estimated that ex-smokers make between 6 and 30 attempts before successfully quitting. Identifying which approach or technique is eventually most successful is difficult; it has been estimated, for example, that only about 4% to 7% of people are able to quit smoking on any given attempt without medicines or other help. A recent review of unassisted quit attempts in 9 countries found that the majority of quit attempts are still unassisted, though the trend seems to be shifting. In the U.S., for example, the rate of unassisted quitting fell from 91.8% in 1986 to 52.1% during 2006 to 2009. The most frequent unassisted methods were "cold turkey", a term that has been used to mean either unassisted quitting or abrupt quitting and "gradually decreased number" of cigarettes, or "cigarette reduction".

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