Researchers from the University of Massachusetts have outlined three prominent strategies that help many people quit smoking. These include the prescription medication varenicline, a plant-derived compound called cytisine, and the use of nicotine-containing e-cigarettes. The study reporting these findings appeared in the journal Addiction.
To gauge how well different approaches work against nicotine dependence, the scientists analyzed 14 large-scale reviews conducted by the international research organization Cochrane. The overarching conclusion shows that replacing traditional cigarettes with nicotine-containing e-cigarettes reduces cravings and the urge to smoke, compared with continuing to smoke or using noncombustible nicotine products. Among the nicotine replacement options, patches, sprays, and gum were typically less effective than nicotine-containing e-cigarettes in helping individuals stay abstinent from smoking over time. These results align with a growing body of evidence that supports a harm-reduction path for many adults who struggle to quit using combustible tobacco products. (Cochrane, 2020; Addiction, 2024; Peer synthesis for Canada and the United States)
Varenicline has consistently shown promise as a quit aid. This prescription medication, originally developed by a major pharmaceutical company, works by moderating nicotine cravings and withdrawal symptoms. It acts on the brain’s reward pathways, helping to blunt the dopamine-driven reinforcement that makes smoking appealing. For many people, initiating varenicline alongside behavioral support increases the odds of staying smoke-free for longer periods compared with placebo or no pharmacological help. Clinicians in North America, including Canada and the United States, commonly prescribe varenicline as part of a structured quit plan that may also involve counseling or support services. (FDA labeling, Health Canada guidance, clinical reviews)
Another option gaining attention is cytisine, a plant-based alkaloid that mimics some actions of nicotine but tends to be far less toxic. Cytisine binds to nicotine receptors, providing the brain with a gentler signal that can ease cravings and withdrawal. Because of its wider therapeutic window, cytisine offers a potentially safer alternative for individuals seeking a non-pharmacological-NRT option or a product with a longer track record of use in certain regions. Ongoing reviews suggest cytisine can be effective in various populations, though availability and regulatory status vary by country. (Pharmacological reviews, regional health advisories)
Beyond these pharmacotherapies, the landscape of nicotine cessation includes behavioral support, counseling, and gradual reduction strategies. While some people prefer a complete switch to e-cigarettes, others choose non-nicotine substitutes or a combination approach tailored to their medical history, smoking patterns, and personal preferences. In Canada and the United States, physicians and public health professionals emphasize a comprehensive quit plan that blends medication with behavioral techniques, goal setting, and regular follow-up. The key is to have a plan that fits an individual’s lifestyle, reducing relapse risk and supporting long-term abstinence. (Canadian and US clinical guidelines; systematic reviews)
Historical observations have noted intriguing connections between smoking and certain health outcomes, including the rate at which neurodegenerative conditions may appear. While research into such associations continues, it remains clear that stopping smoking provides broad health benefits. The combination of pharmacotherapy with coaching or support services increases the likelihood of successful quitting and helps address the physical and psychological aspects of nicotine dependence. (Public health summaries; longitudinal studies)