Cessation interventions

Tobacco cessation interventions are effective and cost-effective. They include:

Mass communication campaigns to encourage quitting. These can refer people to cessation services and telephone quitlines.

Tobacco telephone quitlines to provide information, support and advice on quitting. They allow better access to people who live in rural areas and can operate outside normal business hours. Trained quitline staff can introduce tobacco users to different treatment options and therapies, and refer to cessation services such as counselling. For best effect, quitlines should be free, adequately staffed and widely publicised. Their numbers can be included on tobacco product packaging. Internet-based support and mobile telephone text messaging can also be effective cessation tools.

Tobacco cessation advice integrated into health care services. Tobacco users can be reminded at every visit that tobacco harms their health and the health of those around them. Health care workers should be trained to ask about tobacco use, record it in patient notes and give brief advice, including referral to cessation services and products where appropriate.

Pharmacological interventions through the use of medications. This includes nicotine replacement therapy (NRT), in which low levels of nicotine are delivered to the body through skin patches, chewing gum, lozenges, tablets, nasal sprays and inhalers. NRT increases a smoker’s chances of quitting by 1.5 to 2 times. Also antidepressant medications, such as brupropion and nortryptiline, can reduce withdrawal symptoms and double the chances of quitting. In addition, varenicline tablets reduce the need to smoke and make cigarettes less satisfying, increasing the chance of quitting three-fold.

Behavioural interventions by specialized tobacco dependence treatment services. This includes structured support by trained specialists such as group or individual counselling. This can be provided in a variety of settings and by different types of health care workers, including doctors, nurses, midwives, psychologists and pharmacists. It can also be tailored to different groups of people, through men and women-only groups or groups for pregnant women or young people. It can be combined with pharmacological interventions for best effect.