SRNT is the only international scientific society dedicated to fostering and disseminating research on tobacco and nicotine treatobacco.net logo Society for the Study of Addiction
Search treatobacco.net
* see translation disclaimer below
Some key links


Pharmacotherapy, including nicotine replacement therapy (NRT) and prescription drugs, is effective in treating tobacco dependence, increasing quit rates, and increasing long-term smoking abstinence rates in clinical trials.



More than 100 studies have concluded that NRT, bupropion, varenicline, and cytisine are efficacious and safe tobacco dependence treatments. Research shows that smokers in the US, the UK, Canada, and Australia using varenicline, bupropion, or nicotine patches are more likely to succeed in their quit attempts. In the context of behavioral support, bupropion is a useful cessation aid for moderately heavy or heavy smokers, and is at least as effective as single form NRT. Varenicline is more effective than bupropion or single form NRT, and at least as effective as combination NRT. Cytisine is effective for moderately heavy or heavy smokers. The most effective combination of interventions is face-to-face behavioral support together with NRT or varenicline.
While there is insufficient evidence to demonstrate that one form of NRT is more effective than another, data suggest that a higher dose of NRT may be more effective than a lower dose.

However, the evidence of the impact of pharmacotherapy on population smoking cessation trends is mixed. Small population based studies, like a 2012 study in Massachusetts have failed to find a positive effect of NRT use in promoting cessation. Additionally, millions of successful quit attempts were undertaken in the years before NRT was released onto the market and even today, more smokers quit without assistance from pharmacotherapy than with chemical assistance. Based on studies published 2005 and 2012, 54% to 69% of Australian ex-smokers quit unassisted and 41% to 58% of current smokers had attempted to quit unassisted.



Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence: 2008 Update.Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

Cummings KM, Hyland K. Impact of nicotine replacement therapy on smoking behaviour. Annu Rev Public Health. 2005;26:583-99.

Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews. 2012, Issue 11. Art. No.: CD000146.pub4.

Woolacott NF, Jones L, Forbes CA, Mather LC, Sowden AJ, Song FJ, Raftery JP, Aveyard PN, Hyde CJ, Barton PM. The clinical effectiveness and cost-effectiveness of bupropion and nicotine replacement therapy for smoking cessation: a systematic review and economic evaluation. Health Technol Assess. 2002; 6(16): 1-245.

Alpert HR, Connolly GN, Biener L. A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation. Tob Control. 2013;22(1):32-37.

Chapman S, Wakefield MA. Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control. Tob Control. 2013; 22(Suppl 1): i33–i35.

Kasza KA, Hyland AJ, Borland R, McNeill AD, Bansal-Travers M, Fix BV, Hammond D, Fong GT, Cummings KM. Effectiveness of stop-smoking medications: findings from the International Tobacco Control (ITC) Four Country Survey. Addiction. 2013; 108: 193-202.

West R, Raw M, McNeill A, Stead L, Aveyard P, Bitton J, Stapleton J, McRobbie H, Pokhrel S, Lester-George A, Borland R. Health-care interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development. Addiction. 2015; 110: 1388-1403.

Smith AL, Chapman S, Dunlop SM. What do we know about unassisted smoking cessation in Australia? A systematic review, 2005–2012. Tob Control. 2015; 24: 18-27.

treatobacco.net logo
Home | Sitemap