Researchers have been looking for years at results from nicotine patches and gum, classes, buddies, medicines and behavioral techniques. Here's what works and what doesn't.
Smoking often gets left out of conversations about trimming daily expenses and sticking to a budget. Apart from all the other great reasons to quit, smokers stand to save considerable cash by dropping the habit — a couple thousand dollars a year or more if you smoke a pack a day.
Figure your savings
Your potential savings depend on where you live and how many cigarettes you use a day. The Awl, a news, politics and culture site, surveys prices for a pack of Marlboro Reds, including tax, around the country. Its 2013 survey, the latest, found prices highest in New York state, at $14.50 a pack. They were lowest — $4.96 – in Kentucky.
The big differences are largely due to variations in state cigarette excise taxes. See them with International Business Times’ interactive map of cigarette taxes state by state.
Your costs might be less. Maybe your brand is cheaper, or you roll your own. But buying smokes at $5 a pack and smoking a pack a day costs $1,826 a year. I got that number using the American Cancer Society’s smoking cost calculator. You can try it with your own numbers.
Of course it’s hard: It’s an addiction
Plenty of smokers have trouble quitting. Or they quit and relapse. Nicotine, the drug in tobacco products, is really hard to kick. “Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol,” says the U.S. Centers for Disease Control and Prevention.
Although 68 percent of adult smokers in the U.S. say they want to quit, most go at it without first learning what works, says the CDC.
Researchers have been looking for years at results from nicotine patches and gum, classes, buddies, medicines and behavioral techniques. They’ve learned a lot about what doesn’t work and what does.
Their main conclusion: So far, there’s no magic bullet.
But some methods are definitely more effective than others. “Use of effective treatments can almost double to triple rates of successful smoking cessation,” the CDC says.
Least effective of all? Stopping cold turkey, and doing it without help. You may tell yourself, “I got into this by myself and I can get out of it.” But that fails to take into account how powerful a nicotine habit can be.
About 90 percent of smokers who try to quit have tried going cold turkey and just 10 percent succeed, WebMD says.
Ditto — so far, at least — for über trendy e-cigarettes. “Researchers followed nearly 1,000 smokers for a year and found that those who used e-cigarettes were no more likely to quit smoking or reduce their dependence on tobacco cigarettes than those who weren’t using the products at the beginning of the study,” writes The Boston Globe.
Approach quitting with a flexible attitude, advises Bill Blatt, national director of tobacco programs at the American Lung Association.
“There’s no single technique most effective for everyone,” he told me in a phone interview. Use trial and error to find what’s most effective for you.
Your chances of success increase if you use medications, experts find. Three medications are licensed for use for smoking cessation in the U.S. Alone, any of them beats placebos for effectiveness, says Time magazine.
Here’s a breakdown of the four approaches research shows are most effective:
Varenicline (trade name Chantix) is a prescription drug. It’s one of the most effective treatments, doubling or tripling the chance of success, according to WebMD.
Costs of varenicline and the antidepressant drug bupropion (see below), also used to help quitting, vary a great deal, depending on your pharmacy, on whether you have insurance and whether the medication is included in that policy’s coverage.
Varenicline gets better results than nicotine replacement therapy (patches, gum and inhalers) or bupropion, according to a review of 267 studies on tobacco cessation by the Cochrane Tobacco Addiction Group at the University of Oxford Department of Primary Health Care in England. For every 10 quitters who succeeded with a placebo, about 28 succeeded with varenicline.
Bupropion (trade names Zyban or Wellbutrin) is a prescription antidepressant. It’s not as effective for smoking cessation as varenicline. It works about as well as a single nicotine replacement therapy, WebMD says. It does make a difference, though. The Cochrane research compares bupropion with a placebo: For every 10 people who quit with a placebo, about 18 were successful with bupropion.
3. Nicotine replacement therapy
No prescription is needed for nicotine replacement therapy — including nicotine patches, gum and inhalers, making them the least costly of the medications. They are available in stores and online. You can find nicotine gum, for example, for $31 for a pack with 170 pieces of gum.
On their own, nicotine replacement therapies are less effective than varenicline and about equivalent to bupropion.
It doesn’t seem to matter whether you choose gum, a patch or an inhaler. All types work about the same, research shows. WebMD’s review says:
Your chances of quitting are best when you combine nicotine replacement therapy with a complete smoking cessation program that includes setting a quit date, having a plan in place for dealing with smoking triggers, and getting support from a doctor, counselor, or support group.
4. Doubling up
Some experts make the case that combining a couple medicines can up your odds of success. For example, although nicotine replacement therapies aren’t terrific on their own, using two simultaneously — a nicotine patch and gum, for example — produces results equal to varenicline, the Cochrane researchers say.
Another effective combo is varenicline used with nicotine gum or a patch, Time reports.
Consult a doctor if you want to go this route. WebMD says:
Using a combination of treatment methods can increase your chances of quitting. For example, using both a nicotine patch and gum may be better than a patch alone. Other proven combination treatments include behavioral therapy and nicotine replacement therapy, prescription medication with a nicotine patch, and nicotine patch and nicotine spray.
Not everyone agrees that doubling up is effective, though. Blatt, with the American Lung Association, resists the idea that using more than one medicine at once is useful. Better to try one approach after the other until you hit on the ones that work best for you, he says.
Getting some form of support boosts your odds of successfully quitting, Blatt says.
Here are a few of the many free resources for smokers who are ready to quit:
- BecomeAnEx.org links quitters with a virtual live support group.
- QuitNet, founded by the Boston University School of Public Health, offers 24/7 support from a virtual group as well as chat, buddies, forums, clubs and personal guidance from counselors. Some features are free, others require a premium membership.
- Nicotine Anonymous applies the 12-step approach of Alcoholics Anonymous to smoking.
SmokeFree.gov, the federal government’s support service for quitting, has numerous options, including:
- Instant chat with a National Cancer Institute smoking cessation counselor (English only, weekdays 8 a.m. to 11 p.m. Eastern).
- Phone support (English or Spanish) from trained counselors, weekdays 8 a.m. to 8 p.m. Eastern at (877) 448-7848.
- Text messages of support and advice delivered 24/7. Sign up here.
- State quit lines. Call (800) 784-8669 (800-QUIT-NOW) to connect by phone with trained smoking cessation coaches in your state.
- American Lung Association’s Freedom from Smoking program. This effective program has helped lots of people quit. I joined a terrific group decades ago, quit successfully and have been able to stay smoke-free since. Follow the course online or in person with a local group (find your local lung association for information), or get help from phone counselors at the Lung HelpLine (800-LUNG-USA).
How much money would you be able to save by quitting smoking? Have you already quit? What did you do with the extra cash? Tell us by posting a comment below or on our Facebook page.