Smoking is a danger to health, expensive, and very often off-putting to others in social situations; but it’s also highly addictive. One study found that approximately one half of all smokers try to give up every year, but only two to three per cent of all smokers manage to stop in the long term.

There are several treatments available to help someone when they decide to quit; some of them require a prescription, while others are available over the counter.

This article will detail the numerous options open to people who are looking to kick the habit, how they work and where you can get them.

If you want to give up smoking, see your doctor first. They will be able to help you determine which method is best for you. You can also visit your local NHS Stop Smoking service for advice and support.

Champix

These tablets are only available on prescription.

The tablets contain the functioning agent varenicline, and are a type of medication called a nicotinic acetylcholine receptor partial agonist.

Champix acts on the nicotine receptors in your brain to reduce feelings of withdrawal. They also block the effects of nicotine when you do smoke, reducing the pleasurable feelings you get when you have a cigarette.

How are they taken?

A normal initial course would last for 12 weeks; you will first be prescribed with a starter kit, taking tablets of a lower than normal strength for the first week prior to the day you stop smoking.

  • On the first three days of this first week, you may be advised to take one white tablet (0.5mg) once a day.
  • On the remaining four days of this week, you may be advised to take one white (0.5mg) tablet twice day.
  • On the following week, you may then be advised to commence taking one blue tablet (1mg) twice a day, stopping smoking on a day during this second week of the course.
  • Your doctor may advise you to carry on taking this dose for the remainder of the 12 week course, before beginning to reduce your dose if you have managed to stop smoking.

Zyban

The active ingredient of this medication is bupropion hydrochloride, and can only be obtained with a prescription.

It is thought to work by stopping dopamine and noradrenaline from being absorbed by the neurotransmitters in the brain. These are the chemicals which control the feelings of enjoyment and satisfaction when you smoke. Because these chemicals are still active, your cravings and withdrawal symptoms are diminished. They are prolonged release tablets, so they can help you control your cravings during the course of the day.

How are they taken?

  • You would start by taking one tablet each day for the first six days, followed by two tablets a day from day seven and for the rest of the course (usually up to nine weeks).
  • If the treatment proves to be successful, your doctor may recommend that you stop taking it or continue the course on a reduced dose.

Nicotine Replacement Therapy (NRT)

NRT comes in a number of forms, and works by allowing the user to reduce their nicotine intake over a period of about two to three months.

They all contain small quantities of nicotine, but without harmful cigarette smoke.

Some people stop smoking completely when starting with NRT, while others use it regularly while reducing the amount they smoke.

People may find that different forms of NRT work better for them.

  • Patches are placed on an area of skin and release nicotine directly into the bloodstream consistently over a period of 16 or 24 hours.
  • Chewing gum and lozenges release nicotine more quickly and are useful in controlling sudden cravings.
  • Nasal sprays and inhalers provide an instant ‘hit’ of nicotine. They are less discreet than gum or lozenges, but an advantage of an inhaler is that it can be held and inhaled like a cigarette so you are less likely to miss the physical act of smoking.

Many people find that using more than one form of NRT as combination therapy makes quitting easier.

While NRT can be bought over the counter, they can also be issued with a prescription from your doctor or your local NHS Stop Smoking service.

E-Cigarettes

The popularity of e-cigarettes has boomed since they were first made available in 2004. As they are a relatively recent innovation, there is little firm evidence regarding their effectiveness or long term risks; so the benefits (or risks) of using them has been the subject of much debate.

These battery powered devices heat a small cartridge of a liquid which is either propylene glycol or glycerine, both of which contain nicotine. Flavourings can also be added.

As the liquid heats up, it produces a vapour which is inhaled by the user. The vapour contains nicotine but not the carcinogenic chemicals or harmful carbon monoxide, along with the toxic tar residue it leaves behind.

E-cigarettes are not currently available by prescription but are widely available on the highstreet and online. Safety regulations for e-cigarettes and their refill containers were introduced in the United Kingdom in 2016.

What research is there?

A 2015 report from the British government found e-cigarettes to be 95% safer than regular cigarettes. The same report estimated that 5% of the British adult population were e-cigarette users, between two and three million people.

A report by the Cochrane Review in 2014 combining the results of two studies found e-cigarette use effective in giving up smoking, though it maintained that more research was needed, and was already underway.

The NHS reports that two out of three smokers who used e-cigarettes in conjunction with their Stop Smoking service were successful in giving up smoking in the year to April 2015.