Tag: cessation

Paper Highlights Adaptive Cessation Methods
Adaptive smoking cessation approaches can help individuals who struggle with traditional methods, according to a new study led by Gal Cohen, head of scientific affairs at Rose Research Center in North Carolina, USA, and conducted in collaboration with researchers from the Center of Excellence for the acceleration of Harm Reduction (CoEHAR) at the University of Catania in Italy.
Nearly 40 years after the U.S. Food and Drug Administration approved the first smoking-cessation products, the effectiveness of most methods remains low, with smokers requiring an average of 30 attempts for each successful cessation outcome.
In their paper “Personalized and Adaptive Interventions for Smoking Cessation: Emerging Trends and Determinants of Efficacy,” Cohen and his team analyze the limitations and prospects of the most commonly used smoking cessation methods, and conclude that adaptive smoking cessation approaches can represent a better solution for individuals who struggle with traditional methods.
The study highlights the complexities of cigarette addiction and innovations in cessation products. By focusing on individual determinants of efficacy—such as sensory preferences and nicotine tolerability—the article offers fresh insights into smoking cessation and advocates for personalized, adaptive treatment plans. It also highlights how emerging approaches, like cytisine and combustion-free nicotine delivery systems, provide new avenues to reduce smoking-related morbidity.
“Quitting smoking is hard; you are trying to extinguish the complex interplay of nicotine delivery, sensorial experience and use ritual that cigarettes provide to people who smoke” said Cohen in a statement. “However, the emerging array of pharmaceutical cessation therapies and nicotine substitution products offer the opportunity to personalize the off-ramp from smoking.”
According to CoEHAR founder Riccardo Polosa, nicotine replacement therapies provide neither the bolus nicotine delivery nor the sensory stimuli and behavioral rituals associated with smoking. Conversely, electronic nicotine delivery systems represent the most prevalent nicotine substitution products and were used every day or some days by 11-17 million U.S. adults.
In a survey of adult vapers in the U.S., U.K. and Canada, 73 percent of respondents said they used e-cigarettes because they wanted quit smoking.
October 23, 2024
WHO Releases Guideline for Cessation

Image: Tobacco Reporter archive
The World Health Organization has released a comprehensive set of tobacco cessation interventions, including behavioral support delivered by healthcare providers, digital cessation interventions and pharmacological treatments, in its first guideline on tobacco cessation.
The guideline focuses on helping tobacco users who want to quit all forms of tobacco. The recommendations are relevant for all adults seeking to quit various tobacco products, including cigarettes, water pipes, smokeless tobacco products, cigars, roll-your-own tobacco and heated-tobacco products.
“This guideline marks a crucial milestone in our global battle against these dangerous products,” said Tedros Adhanom Ghebreyesus, WHO director-general. “It empowers countries with the essential tools to effectively support individuals in quitting tobacco and alleviate the global burden of tobacco-related diseases.”
“The immense struggle that people face when trying to quit smoking cannot be overstated,” said Ruediger Krech, director of health promotion at the WHO. “We need to deeply appreciate the strength it takes and the suffering endured by individuals and their loved ones to overcome this addiction. These guidelines are designed to help communities and governments provide the best possible support and assistance for those on this challenging journey.”
July 2, 2024
Disappointing Quit Rates in Philippine Program

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Only one-fifth of individuals enrolled in the Philippine government’s cessation program in 2023 were able to fully quit smoking or vaping, reports the Inquirer, citing a doctor from the Lung Center of the Philippines (LCP).
Of the 144 participants in 2023, only 29 successfully quit, according to Jessica Catalan-Legarda, a doctor in the LCP’s pulmonology department,
Those who did not continue with the program voluntarily dropped out, to which the LCP responded with contact tracing and follow-up calls.
“These voluntary quitters usually go back to smoking and vaping, and based on studies, it takes around seven to eight attempts to successfully quit smoking or vaping,” Catalan-Legarda was quoted as saying.
Successful quitters tended to be between 22 and 44 years of age and have a comparatively high educational background, according to Catalan-Legarda.
June 17, 2024
Vapers Now More Likely to Quit Cigarettes

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Smokers who switch to e-cigarettes are now more likely to stop smoking regular cigarettes, according to a new paper published by Oxford University Press in Nicotine & Tobacco Research. In the past, smokers who began vaping mostly continued smoking.
Electronic nicotine delivery systems first emerged on the U.S. market in 2007. The first e-cigarettes resembled conventional cigarettes (in appearance) and used fixed low-voltage batteries. Beginning in 2016, manufacturers introduced e-liquids containing nicotine salt formulations. These new e-cigarettes became widely available. These nicotine salts are lower in pH than freebase formulations, which allow manufacturers to increase nicotine concentration while avoiding harshness and bitterness.
Past population-level research provided conflicting findings on whether vaping helps people who smoke combustible cigarettes to quit smoking. Some research suggests improved cigarette quitting-related outcomes with e-cigarette use, while other research suggests the opposite. Inconsistent findings may be due to differences in the samples and measures considered, differences in the analytic approaches of researchers used, the rapidly changing product environment, or policy contexts.

While our study doesn’t give the answers as to why vaping is associated with cigarette quitting in the population today when it wasn’t associated with quitting years ago, design changes leading to e-cigarettes that deliver nicotine more effectively should be investigated.
Karin Kasza, assistant professor of oncology, Department of Health Behavior at Roswell Park Comprehensive Cancer Center
The researchers here examined differences in real-world trends in population-level cigarette discontinuation rates from 2013 to 2021, comparing U.S. adults who smoked combustible cigarettes and used e-cigarettes with U.S. adults who smoked combustible cigarettes and did not use e-cigarettes.
Using data from among adults (ages 21+) in the Population Assessment of Tobacco and Health (PATH) Study, a national longitudinal study of tobacco use from people from all over the United States, the researchers found that between 2013 and 2016, rates of discontinuing cigarette smoking among adults in the U.S. population were statistically indistinguishable between those who used e-cigarettes and those who did not. Cigarette discontinuation rates were 15.5 percent for those who used e-cigarettes and 15.6 percent for those who did not.
But the quit rates changed in subsequent years; the researchers here found that between 2018 and 2021 only 20 percent of smokers who did not use e-cigarettes stopped smoking combustible cigarettes, but some 30.9 percent of smokers who used e-cigarettes stopped smoking combustible cigarettes.
The paper notes that the full study period spanned a time in the United States when the e-cigarette marketplace was expanding; salt-based nicotine formulations gained market share in 2016 and vaping products became available with increased nicotine yields over time. This was also a period in which state and federal governments restricted tobacco in various ways, including increasing the tobacco-purchase age to 21 and restricting flavored e-cigarettes.
“Our findings here suggest that the times have changed when it comes to vaping and smoking cessation for adults in the U.S.,” said study first author, Karin Kasza, an assistant professor of oncology in the Department of Health Behavior at Roswell Park Comprehensive Cancer Center in Buffalo, New York, in a statement.
“While our study doesn’t give the answers as to why vaping is associated with cigarette quitting in the population today when it wasn’t associated with quitting years ago, design changes leading to e-cigarettes that deliver nicotine more effectively should be investigated. This work underscores the importance of using the most recent data to inform public health decisions.”
April 3, 2024
‘States Shortchange Tobacco Prevention’
Photo: Tobacco Reporter archive
Most U.S states continue to shortchange programs to prevent kids from using tobacco products and help tobacco users quit despite over $1.1 billion in legal settlement payments from Juul, according to a new report.
Maine is the only state to fully fund tobacco prevention and cessation programs at Centers for Disease Control and Prevention (CDC)-recommended levels. Eight other states provide at least 50 percent of the CDC’s recommended funding, and 31 states and the District of Columbia are spending less than a quarter of the CDC’s recommendation.
The report, Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement, was released by the Campaign for Tobacco-Free Kids, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, Americans for Nonsmokers’ Rights and Truth Initiative. These organizations have issued annual reports since the November 1998 Master Settlement Agreement.
This year, states have additional revenues that could be dedicated to tobacco prevention programs because of more than $1.1 billion in recent legal settlements with Juul for its deceptive marketing practices and its role in the youth e-cigarette epidemic.
Key findings of the report include:
Even without counting the Juul settlement funds, the states this year (fiscal year 2024) will collect $25.9 billion from the tobacco settlements and tobacco taxes. But they will spend just 2.8 percent—$728.6 million—on tobacco prevention and cessation programs, down from $733.1 million in fiscal year 2023. This funding amounts to less than a quarter (22 percent) of the total funding recommended by the CDC.
The amount states are spending on tobacco prevention pales in comparison to the $8.6 billion a year tobacco companies spend to market cigarettes and smokeless tobacco products in the United States. This means tobacco companies spend nearly $12 to market their products for every $1 the states spend to fight tobacco use.
“We know what works to win the fight against tobacco, and states have plenty of resources from tobacco settlements and taxes to invest in programs that can accelerate progress. Unfortunately, most states are falling short in funding these lifesaving programs,” said Yolonda C. Richardson, president of the Campaign for Tobacco-Free Kids, in a statement. “The tobacco industry continues to do everything it can to target our kids, Black communities and other vulnerable communities, especially with flavored products like menthol cigarettes and flavored e-cigarettes. We know their playbook, and policymakers should be using every tool available to protect our kids and help those already addicted.”
January 11, 2024
E-cigs More Effective Than NRTs: Study

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Nicotine e-cigarettes are more effective quit-smoking products than conventional nicotine-replacement therapies (NRTs), reports University of Massachusetts Amherst, citing the latest Cochrane review.
The review found high certainty evidence that e-cigarettes lead to better chances of quitting smoking than using patches, gums, lozenges or other traditional NRTs.
“In England, quite different from the rest of the world, e-cigarettes have been embraced by public health agencies as a tool to help people reduce the harm from smoking,” said Jamie Hartmann-Boyce, assistant professor of health policy and promotion in the School of Public Health and Health Sciences at the University of Massachusetts Amherst.
“Most of the adults in the U.S. who smoke want to quit, but many find it really difficult to do so,” said Hartmann-Boyce, who conducted research at the University of Oxford in England before joining the University of Massachusetts Amherst earlier this year and is the senior author of the review and a Cochrane editor. “We need a range of evidence-based options for people to use to quit smoking, as some people will try many different ways of quitting before finding one that works for them.”
The review included 88 studies and more than 27,235 participants, with most of the studies taking place in the U.S., the U.K. or Italy.
“We have very clear evidence that, though not risk-free, nicotine e-cigarettes are substantially less harmful than smoking,” Hartmann-Boyce said. “Some people who haven’t had success in the past with other quit aids have found e-cigarettes have helped them.”
For every 100 people using nicotine e-cigarettes to quit smoking, eight to 10 are expected to successfully quit compared to six of 100 people using traditional NRTs and four of 100 trying to quit without support or with only behavioral support, according to the review.
“Not everything is either entirely harmful or beneficial,” Hartmann-Boyce said. “Different things can have different impacts on different populations. Evidence shows that nicotine e-cigarettes can help people quit smoking and that people who don’t smoke shouldn’t use e-cigarettes.”
Hartmann-Boyce compared tobacco smoking versus e-cigarette use to the treatment for substance use disorders involving opioids. “We’re not going to prescribe methadone to people who aren’t addicted to opioids,” she said. “But for people addicted to opioids, we recognize that methadone is a helpful thing.”
The U.S. Food and Drug Administration has not approved any e-cigarettes as medications to help adults quit smoking. “While certain e-cigarettes may help adult smokers transition completely away from, or significantly reduce their use of, more harmful combusted cigarettes, the law’s public health standard balances that potential with the known and substantial risk with regard to youth appeal, uptake and use of these highly addictive products,” said Robert Califf, FDA commissioner.
January 9, 2024
Cytisine More Effective than NRT: Study

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Cytisine, a low-cost, generic stop-smoking aid that has been used in eastern Europe since the 1960s, increases the chances of successful smoking cessation by more than two-fold compared with placebo and may be more effective than nicotine replacement therapy, according to a new study published in Addiction. The cessation tool reportedly has a benign safety profile, with no evidence of serious safety concerns.
Cytisine is a plant-based compound that eases smoking withdrawal symptoms. It was first synthesized in Bulgaria in 1964 as Tabex and later spread to other countries in eastern Europe and Asia, where it is still marketed. In 2017, the Polish pharmaceutical company Aflofarm began selling it as Desmoxan, a prescription-only medicine, and Canada approved it as an over-the-counter natural health product, Cravv.
This study pooled the results of eight randomized controlled trials comparing cytisine with placebo, with nearly 6,000 patients. The combined results showed that cytisine increases the chances of successful smoking cessation by more than twofold compared with placebo.
The study also looked at two randomized controlled trials comparing cytisine with nicotine replacement therapy, with modest results in favor of cytisine, and three trials comparing cytisine with varenicline, without a clear benefit for cytisine.
“Our study adds to the evidence that cytisine is an effective and inexpensive stop-smoking aid,” said lead author Omar De Santi in a statement. “It could be very useful in reducing smoking in low- and middle-income countries where cost-effective smoking cessation drugs are urgently needed.”
Cytisine is currently not licensed or marketed in most countries outside of central and eastern Europe, making it unavailable in most of the world. At the end of January, cytisine pills are due to become available in the U.K., according to National World.
January 5, 2024
England Paves Way for E-Cig Prescriptions

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Doctors in England may soon be prescribing e-cigarettes to help people stop smoking tobacco, according to a news story published by the Department of Health Social Care and the Office for Health Improvement and Disparities. The Medicines and Healthcare products Regulatory Agency (MHRA) is publishing updated guidance that paves the way for medicinally licensed e-cigarette products to be prescribed for smoking cessation.
Manufacturers can approach the MHRA to submit their products to go through the same regulatory approvals process as other medicines available on the health service.
This could mean England becomes the first country in the world to prescribe e-cigarettes licensed as a medical product.
If a product receives MHRA approval, clinicians could then decide on a case-by-case basis whether it would be appropriate to prescribe an e-cigarette to NHS patients to help them quit smoking. It remains the case that non-smokers and children are strongly advised against using e-cigarettes.

This country continues to be a global leader on healthcare, whether it’s our Covid-19 vaccine rollout saving lives or our innovative public health measures reducing people’s risk of serious illness.
Sajid Javid, Health and Social Care Secretary
If a product receives MHRA approval, clinicians could then decide on a case-by-case basis whether it would be appropriate to prescribe an e-cigarette to NHS patients to help them quit smoking. It remains the case that non-smokers and children are strongly advised against using e-cigarettes.
E-cigarettes contain nicotine and are not risk free, but expert reviews from the U.K. and U.S. have been clear that the regulated e-cigarettes are less harmful than smoking. A medicinally licensed e-cigarette would have to pass even more rigorous safety checks.
Smoking remains the leading preventable cause of premature death and while rates are at record low levels in the U.K., there are still around 6.1 million smokers in England. There are also stark differences in rates across the country, with smoking rates in Blackpool (23.4 percent) and Kingston upon Hull (22.2 percent) poles apart from rates in wealthier areas such as Richmond upon Thames (8 percent).
E-cigarettes were the most popular aid used by smokers trying to quit in England in 2020, according to the Department of Health and Social Care. E-cigarettes have been shown to be highly effective in supporting those trying to quit, with 27.2 percent of smokers using them compared with 18.2 percent using nicotine replacement therapy products such as patches and gum.
Some of the highest success rates of those trying to quit smoking are among people using an e-cigarette to kick their addiction alongside local Stop Smoking services, with up to 68 percent successfully quitting in 2020 -2021.

We fully welcome the news that the NHS in England is exploring opportunities to prescribe vaping products to help people quit smoking.
Doug Mutter, director, VPZ
“This country continues to be a global leader on healthcare, whether it’s our Covid-19 vaccine rollout saving lives or our innovative public health measures reducing people’s risk of serious illness,” said Health and Social Care Secretary Sajid Javid.
“Opening the door to a licensed e-cigarette prescribed on the NHS has the potential to tackle the stark disparities in smoking rates across the country, helping people stop smoking wherever they live and whatever their background.”
Vapor industry representative welcomed the prospect of e-cigarettes on prescription.
“We fully welcome the news that the NHS in England is exploring opportunities to prescribe vaping products to help people quit smoking,” said Doug Mutter, director of VPZ, the U.K.’s largest vaping retailer with 157 stores throughout the country.
“The pandemic has triggered an increase in smoking rates and the public health problem has been compounded by funding cuts for NHS stop smoking services and local support groups.
“However this progressive and innovative approach being considered by the NHS in England has the potential to reverse this damage and bring new momentum to our ambitions of becoming a smoke free nation by 2030.”

The government deserves huge praise for taking this bold decision to look more closely at the use of vaping when it comes to smoking cessation and for taking an evidence-based, science-led approach.
John Dunne, director-general, UKVIA
“The government deserves huge praise for taking this bold decision to look more closely at the use of vaping when it comes to smoking cessation and for taking an evidence-based, science-led approach rather than the nonsensical anti-vaping, anti-harm reduction stance of some countries,” said John Dunne, Director General of the U.K. Vaping Industry Association.
“This announcement by the Department for Health is just the latest in a long line of breakthroughs for those of us who for years have advocated vaping as the best and most effective method for people looking to quit smoking.”
October 29, 2021
Pandemic Boosts Interest in Cessation

Photo: Hans Benn from Pixabay
Thousands of Australians are using the coronavirus shutdown to give up smoking.
Between January and May this year, the My Quitbuddy app was downloaded more than 24,000 times—a 310 percent increase over the same time last year.
“These figures are very encouraging, and I congratulate those who have taken the first step,” said Federal Health Minister Greg Hunt, adding that there is growing evidence that smokers are more likely to develop a severe case of Covid-19 if they contract the virus.
The Australian government aims to reduce smoking to less than 10 percent by 2025 through its 10-year National Preventive Health Strategy and has committed $31.6 million over four years to reduce smoking prevalence.
Meanwhile, health authorities in Israel have observed increased interest in quitting smoking during the pandemic.
A new study by the Israel Cancer Association found that 51 percent of Israelis between the ages of 18 and 24 who smoke considered quitting during the coronavirus crisis. Additionally, almost half (49.2 percent) reported smoking less.
However, the study also found that nearly a third of Arab Israelis said someone in their family began smoking during the coronavirus. Only 8 percent of Jewish respondents reported that someone started smoking.

June 2, 2020
Nicotine Gum Market Poised for Growth

The nicotine gum market is set to grow by $522 million between 2019 and 2023 with a CAGR of more than 5 percent during that period, according to a new report published by Technavio.
Technavio suggests three forecast scenarios (optimistic, probable and pessimistic) considering the impact of Covid-19.
British American Tobacco, GlaxoSmithKline, ITC Limited, Johnson & Johnson Services and Novartis are some of the major market participants.
April 10, 2020