An oral<unk>  spray Nasa spray Nicorette Inhalator, a<unk>  vapour inhalator with disposable cartridges.<unk> , in the form of gum, patches, nasal spray, inhaler and lozenges all improve the ability of people trying to quit tobacco products.<unk>  is as effective as medications, such as bupropion, in helping people quit smoking for at least six months. All forms of<unk> , including<unk>  gum, patches, nasal spray, inhalers, and lozenges, have similar success rates in terms of helping people stop smoking. However, the likelihood that someone will stick to a certain treatment varies, with compliance being the highest with<unk>  patches, followed by<unk>  gum, inhalers, and nasal sprays. Using a few different<unk><unk>  methods in combination may improve success rates in stopping tobacco use. Additionally, using<unk><unk>  with counseling has been proven to improve tobacco abstinence rates. These other strategies include: creating a plan to quit and utilizing quit programs, a quit phone line, or app that provides tips and inspiration to help quit. Using<unk>  to quit smoking should be considered for people who are severely dependent on<unk> . People who are severely dependent include those who smoke: more than one pack per day, within five minutes of awakening, while ill, when they wake up in the middle of the night, to ease withdrawal signs and symptoms.<unk><unk>  products are most beneficial for heavy smokers who smoke more than 15 cigarettes per day. There are not enough studies to show whether<unk>  helps those who smoke fewer than 10 cigarettes per day. Effectiveness Evaluation of<unk>  in real-world studies produces more modest outcomes than efficacy studies conducted by industry-funded trials. The National Health Service (NHS) in England has a smoking cessation service based on pharmacotherapy in combination with counseling support. An Action on Smoking and Health (UK) (ASH) report claims that the average cost per life-year gained for every smoker successfully treated by these services is less than £1,000 (below the NICE guidelines of £20,000 per QALY (quality-adjusted life year). However, the investment in NHS stop smoking services is relatively low. A comparison with treatment costs for illicit drug users shows that £585 million is committed for 350,000 problem drug users compared to £56 million for 9 million users of tobacco. This is £6.20 for each smoker, compared to £1,670 per illegal drug user. The claims for high efficacy and cost-effectiveness of<unk>  have not been substantiated in real-world effectiveness studies. Pierce and Gilpin (2002) stated their conclusion as follows: “Since becoming available over the counter,<unk>  appears no longer effective in increasing long-term successful cessation” (p. 1260). Efficacy studies, which are conducted using randomized controlled trials, do not transfer very well to real-world effectiveness. Bauld, Bell, McCullough, Richardson and Greaves (2009) reviewed 20 studies on the effectiveness of intensive NHS treatments for smoking cessation published between 1990 and 2007. Quit rates showed a dramatic decrease between 4-weeks and one year. A quit rate of 53% at four weeks fell to only 15% at one year. Younger smokers, females, pregnant smokers and more deprived smokers had lower quit rates than other groups. The efficacy for each of the formulations alone (lozenges, nasal spray, gum, and transdermal patch) to aid in smoking cessation is equal. Efficacy increases 15% to 36% with combining treatments such as gum and lozenges. Higher doses increase the chance of stopping smoking for a period of six months and more. For patches, the most efficient doses were 25 mg worn over 16 hours or 21 mg worn over 24 hours. The evidence suggests that 4 mg<unk>  gum leads to higher quit rates compared with 2 mg in heavy smokers. E-cigarettes are twice as effective as<unk>  in helping people quit smoking. Pregnancy<unk>  is not safe to use in any amount during pregnancy.<unk>  crosses the placenta and is found in the breast milk of mothers who smoke as well as mothers who inhale passive smoke. There are possible harms to the baby if<unk>  is used during pregnancy. Thus, pregnant women and those who are breastfeeding should also consult a physician before initiating<unk> . The gum, lozenge, and nasal spray are pregnancy category C. The transdermal patch is pregnancy category D. The transdermal patch is considered less safe for the fetus because it delivers continuous<unk>  exposure, as opposed to the gum or lozenge, which delivers intermittent and thus lower<unk>  exposure. Strong evidence suggests that<unk>  cannot be regarded as a safe substance of cigarette use.<unk>  itself could be at least partly responsible for many of the adverse after birth health results related to cigarette use while the mother was pregnant. There is evidence that<unk>  negatively affects fetal brain development and pregnancy outcomes. There is also risk of stillbirth and pre-term birth.<unk>  use will probably harm fetal neurological development. Risks to the child later in life from<unk>  exposure during pregnancy include type 2 diabetes, obesity, hypertension, neurobehavioral defects, respiratory dysfunction, and infertility.<unk>  exposure during pregnancy can result in attention deficit hyperactivity disorder (ADHD) and learning disabilities in the child. It also puts the child at increased risk for<unk>  addiction in the future. Pregnant women should consider behavioral therapy before<unk>  is considered. Youth In people under the age of eighteen, a physician is often consulted before starting<unk> . The evidence suggests that exposure to<unk>  between the ages of 10 and 25 years causes lasting harm to the brain and cognitive ability. Evidence is unclear whether adolescents gain benefit from cognitive-behavioral therapy or smoking cessation over the long-term as of 2017. Most tobacco users are under-eighteens when they start, and almost no-one over the age of 25 starts using. Cardiovascular conditions While there is no evidence that<unk>  can increase the risk of heart attacks, individuals with pre-existing cardiovascular conditions or recent heart attacks should consult a physician before initiating<unk> . Smoking is known to cause cardiovascular diseases such as coronary heart disease, hypertension, heart attack, stroke, and peripheral artery disease. Cigarette smoking is the cause of 20% of all cardiovascular deaths in the United States, which is the leading cause of mortality. Other conditions<unk> es should be used cautiously in individuals with the following conditions: severe reactive airway diseases (for nasal spray), chronic nasal disorders such as sinusitis, polyps, rhinitis, or allergy (for nasal spray), diabetes (insulin-dependent), gastrointestinal diseases such as esophagitis, active gastric or peptic ulcer disease, liver problems, hyperthyroidism,pheochromocytoma, phenylketonuria (for lozenges), renal problems, and skin conditions such as psoriasis or dermatitis (for the transdermal patch).
Nicotine replacement therapy
Stuttering therapy
Psychedelic therapy
Smoking cessation
Stamina therapy
Cognitive behavioral therapy for insomnia
Helminthic therapy
Cobalt therapy