What are the most effective pharmacological interventions for smoking cessation in adults?

The most effective pharmacological interventions for smoking cessation in adults are varenicline, nicotine replacement therapy (NRT), bupropion, and cytisinicline, especially when combined with behavioural support ¹.

Varenicline is recommended as an option in NICE guidance for people who smoke and wish to quit, and it increases the chances of abstinence from smoking at 6 months by 2-3 times compared with placebo ¹.

All forms of NRT are effective, increasing the chance of stopping smoking by 50-60% compared with placebo, with no difference in efficacy between preparations ¹.

Combination of short-acting and long-acting NRT is more effective than single forms ¹.

Bupropion is as effective as NRT alone, but less effective than varenicline, and it increases the chances of stopping smoking by approximately 50% to 80% in the long-term ¹.

Cytisinicline, when combined with behavioural support, is also considered among the most effective options ¹.