Ready to quit smoking? Here's what works best

Kim Painter, Special for USA TODAY
It’s always a good time to quit smoking. But if smoking cessation has a season, it’s about to begin.
Thursday is the American Cancer Society’s Great American Smokeout, a day on which all smokers will be encouraged to abstain or start making a plan to quit. In coming weeks, even more people will make resolutions to quit as New Year’s Day approaches.
Sadly – with smoking causing 480,000 deaths each year in the United States – most will not succeed, at least this time.
One reason: most people try to do it alone, and just 4% to 7% of those people manage to quit on any given attempt, according to the cancer society. Getting help can raise quitting rates to 25% or more, at least in studies, the society says.
But what kind of help?
“We have a gold standard, and it’s a combination of counseling and medication,” says Yvonne Hunt, a program director at the National Cancer Institute’s tobacco control research branch. But just 4% of potential quitters use such combinations, according to the federal Centers for Disease Control and Prevention.
There are several methods to choose among, Hunt says: “People can mix and match and find a combination that works best for them.”
Among the proven methods:
• Counseling. One way to start planning a quit attempt is to call 1-800-QUIT-NOW (1-800-784-8669) to reach counselors on your state’s quit line. In-person counseling is available through many clinics and hospitals. Increasingly, counseling also is available through text messages (such as the cancer institute’s SmokefreeTXT program). Some websites and apps offer advice too, but quality varies.
• Varenicline (Chantix). This prescription pill is the most effective smoking-cessation drug in studies. It can ease withdrawal symptoms and make smoking less satisfying by blocking the effects of nicotine. The pills carry warning labels – which a Food and Drug Administration panel recently voted to keep – saying they have been linked to mood swings, depression and suicidal thoughts. But those side effects are rare “and generally it’s accepted as a safe medication,” says Lee Westmaas, director of tobacco control research at the cancer society.
• Bupropion SR (Wellbutrin, Zyban). This is another prescription pill. It is best known as an antidepressant but it also can decrease cravings and withdrawal symptoms in those quitting smoking. Common side effects are dry mouth and difficulty sleeping.
• Nicotine-replacement therapies.
Nicotine from a patch, gum, spray, inhaler or lozenge can ease withdrawal symptoms and cravings in the first weeks and months without cigarettes. Some require a prescription and all are considered medications. They can be combined with non-nicotine medications. They have various side effects. For example, patches can cause skin irritation and nicotine gum can cause mouth sores.
Not on the list of proven methods: hypnosis, acupuncture and laser therapy. “You will certainly find people who swear by these methods, but they do not have a solid evidence base behind them,” Hunt says.
Some smokers also may be surprised that electronic cigarettes – e-cigarettes – are not listed as quit-smoking aids by groups such as the cancer society or the National Cancer Institute. The increasingly popular devices contain nicotine, but unlike nicotine-replacement therapies, they are not regulated and have not been thoroughly studied as quitting aids.
“The sale of e-cigarettes is going 100 miles an hour and the science is going five miles an hour,” says Jonathan Bricker, a psychologist specializing in smoking cessation at Fred Hutchinson Cancer Research Center, Seattle.
Bricker’s own research focuses on improving counseling methods. It is clear smokers need more and better help than is available now, he says: “We are not helping 65% to 75% who want to quit.”
But it’s also important for smokers who fail one — or many — quit attempts to keep trying, Westmaas says. “Each attempt gives them more information about what to do differently next time.”
More information on quitting is at the federal government’s smokefree.gov site and the cancer society’s cancer.org site.
Benefits of quitting:
For those who need reminders about why they should quit, here – according to the cancer society – are some benefits after:
20 minutes: heart rate and blood pressure drop
12 hours: carbon monoxide levels in blood drop to normal
2 weeks to 3 months: circulation and lung function improve
1 year: excess coronary heart disease risk cut in half
5 years: risk of mouth, throat and bladder cancer cut in half
10 years: risk of dying of lung cancer cut in half
15 years: risk of coronary heart disease same as non-smokers’
http://www.usatoday.com/story/news/nation/2014/11/16/quit-smoking-what-works/18812269/