Last reviewed: July 2026

What You Need to Know

Quitting aids work far better than this page used to claim. The old version said the best programs succeed 5% of the time. The real numbers are two to three times that — per attempt.
The most effective options are varenicline, cytisine, and nicotine e-cigarettes (all high-certainty evidence), followed closely by combination NRT.
Combine medication with behavioral support. Together they beat either alone.
In the US, cessation treatment is usually covered — often at no cost to you. This page used to say it isn’t. That’s out of date, and it may have cost people their quit attempt.
Relapse is normal. Most people need several attempts. That’s the process, not failure.

Start Here: Free Help, Right Now

📞 1-800-QUIT-NOW (1-800-784-8669) — free coaching, available in every US state. 💬 SmokefreeTXT — free text-message support. 🌐 smokefree.gov

Many state quitlines also send free NRT — patches, gum, lozenges — to your door. It costs nothing to find out.

The Correction: Quitting Works Better Than You’ve Been Told

A Cochrane analysis of more than 300 trials involving over 150,000 smokers produced these figures. Per quit attempt:

Approach	Roughly how many succeed
No aid at all	6 in 100
Single NRT (patch alone)	9 in 100
Combination NRT (patch + gum/lozenge)	12 in 100
Varenicline	14 in 100
Cytisine	14 in 100
Nicotine e-cigarettes	14 in 100
Varenicline + NRT together	Ranked highest of all

And these are per attempt. Most successful quitters made several. The cumulative odds of getting there are far better than any single row of that table suggests.

The old version of this page told you the best programs work 5% of the time. Using the right treatment roughly doubles or triples your odds compared with willpower alone. That’s the single most important thing on this page.

The Medications

Varenicline — the most effective single aid

Missing from the old version entirely, and it shouldn’t have been.

Varenicline partially activates the nicotine receptors in the brain — enough to blunt withdrawal, while blocking the reward you’d get from a cigarette. It more than doubles quit rates versus placebo and outperforms both bupropion and NRT in head-to-head trials.

Start it 1–2 weeks before your quit date. Many people find they smoke less during that lead-in period, without trying.
Usually taken for 12 weeks, sometimes longer.
Side effects: nausea (common, usually manageable — take it with food), vivid dreams, sleep disturbance.
Availability has been disrupted at times due to manufacturing issues. Ask your doctor — if it’s not available, the alternatives below are good.

Combination NRT — the best over-the-counter option

This is the upgrade most people don’t know about.

Don’t use a patch alone. Use a patch plus a fast-acting form — gum, lozenge, inhaler, or nasal spray.

The patch gives you a steady background level, dealing with the constant craving.
The fast-acting form handles the acute spikes — after a meal, with coffee, in the car.

Combination NRT is nearly as effective as varenicline, and much of it is available without a prescription. If you’ve tried patches alone and failed, this is why.

A common mistake: most people under-dose NRT and stop it too soon. Talk to a pharmacist about getting the dose right. See making the most of your medications and safety check: over-the-counter medications.

Bupropion (Zyban, Wellbutrin)

An antidepressant that also reduces cravings — it increases quit rates by roughly 64% over placebo. Less effective than varenicline, but a good option, especially if you also have depression, since it treats both.

Started 1–2 weeks before your quit date. Not suitable if you have a seizure history or an eating disorder. See helping loved ones through depression.

Cytisine

As effective as varenicline and much cheaper — but not currently licensed in the US or UK. A related compound (cytisinicline) is in development. Worth knowing about; not yet something you can ask for.

E-Cigarettes: The Honest Answer

This is the question most people actually have, and most health sites duck it. Here’s the balanced version.

What the evidence says:

High-certainty evidence shows nicotine e-cigarettes help more people quit than NRT does — placing them alongside varenicline and cytisine as among the most effective aids available.
They deliver nicotine without combustion — and it’s the combustion products, not the nicotine, that cause most of smoking’s harm.

The genuine caveats:

Not FDA-approved as a cessation aid. The evidence is strong; the regulatory approval isn’t there.
Not risk-free — just far less harmful than cigarettes. “Better than smoking” is a low bar, and it’s the only bar that applies here.
Long-term effects are still being studied.
Dual use is the trap. Vaping and smoking gets you the harms of both. If you switch, switch.
If you don’t smoke, don’t start. None of this is an argument for taking up vaping.
Have a plan to come off the vape too, eventually.

The honest bottom line: for an adult who smokes and hasn’t managed to quit with other methods, the evidence supports e-cigarettes as an effective option. Discuss it with your doctor — but don’t let anyone tell you the evidence doesn’t exist.

Behavioral Support Doubles Everything

Medication handles the chemistry. It doesn’t handle the 3pm cigarette you’ve had with your coffee for twenty years.

Medication + behavioral support outperforms either alone. Support can be:

A quitline (free — see above)
Group programs
Individual counseling
Text/app-based programs
Your doctor, if they’ll engage

See choosing a mental health provider and getting the most from your doctor.

Cost: The Other Big Correction

The old page said cessation programs “are often not covered by health insurance” and would cost you around $500.

That is no longer true in the US. Tobacco cessation counseling and medication are covered as preventive services by most health plans — frequently with no copay at all. Medicaid and Medicare cover cessation treatment too.

Before you pay anything, check what you’re entitled to. See do you know your medical rights, costs: Medicare and Medicaid, and how to save on prescription drugs.

And your state quitline may simply mail you free NRT. Ask.

Relapse Is Part of It

Even with the best available treatment, most people who quit will smoke again within six months on the first go.

This is not a reason for despair — it’s a reason to expect it and plan for it. Most people who successfully quit did so after multiple attempts. Each attempt teaches you something about your triggers.

A slip is not a relapse unless you decide it is. One cigarette at a party is one cigarette. Getting straight back on the plan the next morning is what separates the people who eventually quit from the people who don’t.

The Practical Stuff

Weight gain is real — an average of a few kilos — and it’s a common reason people restart. It is also vastly outweighed by the benefits of quitting. Plan for it rather than being ambushed: see fight disease with diet and exercise and weight loss diet tips.

Identify your triggers before quit day — coffee, alcohol, driving, breaks at work, stress, other smokers — and have a specific plan for each.

Alcohol is the single biggest relapse trigger. Consider cutting back during the first weeks. See alcohol dependence.

Tell people. Support genuinely helps, and so does not wanting to admit you’ve restarted.

Why It’s Worth It

20 minutes: heart rate and blood pressure begin to drop
12 hours: carbon monoxide in your blood returns to normal
2 weeks–3 months: circulation and lung function improve
1 year: excess risk of coronary heart disease is roughly halved
5 years: stroke risk falls toward that of a non-smoker
10 years: lung cancer death risk about half that of a continuing smoker

Smoking also drives heart disease, stroke, COPD, gum disease and oral cancer, peptic ulcers, and complications in pregnancy. See in tune with the beat of your heart, understand cholesterol at last, colon cancer facts to know, get the best dental care, and — if relevant — your complete guide to pregnancy.

And secondhand smoke matters, particularly for children with asthma. See asthma: help your child breathe easier.

The Bottom Line

Quitting on willpower alone works about 6% of the time. Quitting with the right medication and support works two to three times as often — per attempt — and most people get there after several.

The best plan available to most people today: varenicline (or combination NRT) + behavioral support, with e-cigarettes a legitimate option to discuss if other routes have failed.

Call 1-800-QUIT-NOW. It’s free, and it’s a better first move than another attempt on your own.

Global Statistics

How to Quit Smoking: What Actually Works in 2026