What are the most proven ways to quit smoking?

A. Kicking a smoking habit can be difficult - most people require more than one attempt before they’re successful - but there are many resources available to help those who want to quit through the process. The Department of Health and Human Services released clinical guidelines in 2008 that help physicians provide evidence-based recommendations to patients trying to quit smoking. The main message is that several kinds of treatment - even brief ones - are effective, and a little bit of help can make a difference.

Elyse Park, a clinical health psychologist at Massachusetts General Hospital and chief of behavioral health research at the Benson-Henry Institute for Mind Body Medicine, says that strategies should be tailored to a person’s smoking history, attempted quit history, and health status. Although both medications and counseling are effective, they are most helpful when used in combination. Seven medications are recommended for smoking cessation: five are nicotine replacement therapies in the form of a patch, gum, lozenge, inhaler, or nasal spray. The other two are bupropion SR (Zyban or Wellbutrin), and varenicline (Chantix); both work by reducing craving and withdrawal symptoms. Two other drugs, nortriptyline and clonidine, are not specifically approved for smoking cessation but are sometimes prescribed off-label. Some nicotine replacement products are available over the counter; insurance coverage for prescription medications varies.

Counseling, Park says, can include making calls to a quit line, participating in a Web-based quitting program, or seeing a health professional for extended therapy sessions - she recommends at least four sessions. The bottom line, she says, is that all of these can be effective and all are recommended.

What’s clear, she says, is that people need extra help around the time they’re quitting, since physical withdrawal symptoms can last up to two weeks. “It’s important to have a quit plan,’’ she says, and to seek support during that critical window. The first 24 hours are an important milestone, Park says, and “if you can quit for a week, that’s a very good sign that you’re going to be successful long-term.’’

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