Tobacco use is the leading preventable cause of death in the United States, resulting in more than 480,000 deaths annually. Almost 70 percent of current smokers report wanting to quit smoking, but quitting can be hard and often takes multiple attempts. A variety of FDA-approved medications are available to help people successfully quit smoking. During a January 26, 2018 FDA public hearing focused on FDA’s approach to evaluating nicotine replacement therapies, we heard concerns about misperceptions around smoking cessation medications and we want to help separate fact from fiction.
The best way to quit is “cold turkey.”
There is no “right way” to quit smoking, but many smokers try to quit “cold turkey” and are not successful. The good news is that there are several proven methods to help you quit smoking. There are many ways to get help and there are multiple options proven to be safe and effective when trying to quit. Over-the-counter nicotine replacement therapy products and prescription medications can help minimize the withdrawal symptoms and cravings when trying to quit. Studies show that using cessation medicines can double your chances of successfully quitting, and behavioral support (such as counseling) can also increase your likelihood of success. In fact, according to several studies done by the National Institutes of Health, medication plus behavioral support is more effective than either alone. Your doctor can help you determine what approach is best for you and you can learn about different tools available to help you quit smoking by visiting http://smokefree.gov.
All smoking cessation medications are the same.
There are 3 different types of medications approved by the FDA to help you quit smoking — nicotine replacement therapies, bupropion, and varenicline. Nicotine replacement therapy medications are available in five different forms: inhaler, nasal spray, patch, gum, or lozenge (see this FDA Consumer Update for more information). The medications vary in how they affect the body, how they are used, and how long they should be used. Some are available over-the-counter, and others require a prescription from your doctor. Talk to your doctor to determine which option might be best for you.
E-cigarettes are not an approved method to help people quit smoking.
E-cigarettes are not approved by the FDA as an aid to quit smoking and may expose users to some of the same toxic chemicals found in combustible cigarette smoke. There are other proven, safe, and effective methods for quitting smoking. One way to start is to talk to your doctor to determine which option might be best for you. You can also visit http://smokefree.gov for more information, free tips and tools to help you quit smoking.
Nicotine is not the primary cause of cancer from most tobacco products.
Nicotine is the main addictive substance in cigarettes and other tobacco products, including most e-cigarettes. Nicotine is a naturally occurring addictive chemical that is found in tobacco and is what keeps people smoking. However, while nicotine has a number of toxic effects on the body, it is not the primary cause of cancer and other chronic smoking-related diseases. More than 7,000 chemicals are present in cigarette smoke, including more than 70 that can cause cancer. Examples of cancer causing chemical found in cigarettes include tobacco-specific nitrosamines, benzo-a-pyrene, benzene, arsenic, and more (see “Chemicals in Cigarettes: from plant to product to puff”).
It is dangerous to use more than one nicotine replacement therapy product at the same time.
Although each nicotine replacement therapy product was approved as an individual therapy (a standalone medication), two nicotine replacement therapy products can be used safely together when you are trying to quit (see Federal Register Notice Modifications To Labeling of Nicotine Replacement Therapy Products for Over-the-Counter Human Use). For example, some smokers combine products, using a nicotine replacement therapy patch for general relief of withdrawal symptoms, then a nicotine replacement therapy gum or inhaler for sudden urges to smoke. It may take multiple tries to find out what works best to help you quit.
Research shows that nicotine replacement therapy is safe and effective for almost all adults, but some people should not use nicotine replacement therapy. Pregnant women, teens, and people with serious health issues such as heart disease and stomach ulcers should talk to their doctor first before using nicotine replacement therapy. In addition, if considering combining nicotine replacement therapy products, talk to your doctor to help you decide if combination therapy is right for you.
Nicotine replacement therapy gum is different than regular gum.
Unlike regular chewing gum, nicotine replacement therapy gum is most effective when used as directed — that is placed ( “parked”) between cheek and gum. You should start by placing the nicotine replacement therapy gum in your mouth and chewing until there is a strong taste or tingling sensation, which indicates that the nicotine is being released. Then, stop chewing and place it between your cheek and gum. When the taste or tingling sensation decreases, repeat the chew and park process. This process helps your body absorb the nicotine.
Nicotine replacement therapy can be used only for the duration listed on the label.
Although the duration listed on the label may work for some smokers, it might not work for others. Talk to your doctor if you feel extending your use would help you stay smoke-free.
If you’ve tried nicotine replacement therapy in the past and it didn’t work, there is still reason to try it again.
Research shows most smokers have to make multiple attempts to quit before being able to quit for good, even when using a proven cessation medication, like nicotine replacement therapy. The best thing to do is try again. FDA’s public education campaign, Every Try Counts, was designed with this important message in mind and encourages adult cigarette smokers to quit through messages of support that underscore the health benefits of quitting. The campaign aims to change attitudes and beliefs about what it means to quit smoking; increase motivation to try quitting again; and encourage smokers to practice the quit, because each attempt to quit makes quitting for good more likely.
By knowing the facts and using proven methods to quit smoking, you can improve your chances of success. But, if you don’t succeed on the first try, remember that every try counts.
This post was originally published on the Food and Drug Administration website on March 28, 2019.