Use smoking-cessation medicine rather than relying on willpower alone
Most people do not succeed by endurance alone. Varenicline more than doubles the quit rate compared with placebo. Nicotine patches, gum and similar replacement products improve success by about 50%; combining a patch with gum improves it by another 20% or more.
What it takes
In China, nicotine patches and gum are available over the counter. An 8–12-week course costs several hundred to over RMB 1,000. Varenicline and bupropion require prescriptions from a cessation clinic or respiratory department. Savings on cigarettes roughly offset the expense.
What you may gain
Across 41 randomized trials with 17,395 participants, varenicline increased cessation relative to placebo by a factor of 2.32 (RR 2.32, 95% CI 2.15–2.51; high-certainty evidence). It also outperformed bupropion (RR 1.36) and a single nicotine-replacement product (RR 1.25). Across 133 trials with 64,640 participants, nicotine replacement improved success by about 55% versus no medication (RR 1.55, 95% CI 1.49–1.61). Combining a patch with a fast-acting product such as gum or lozenges improved success by 27% versus one product alone (RR 1.27, 95% CI 1.17–1.37; 16 trials, 12,169 participants; high-certainty evidence).
Context & considerations
These are the three medicine categories described as available in China, and only nicotine replacement is nonprescription. Common varenicline effects include nausea, vivid dreams and sleep difficulties; tell the clinician about any psychiatric history. Nicotine replacement usually lasts 8–12 weeks; follow the clinician's tapering instructions instead of stopping abruptly on your own. Medicine eases withdrawal but does not remove situational cravings. Combine it with setting a quit date and cessation support.
Research & references
Livingstone-Banks J, Fanshawe TR, Thomas KH, et al. (2023). Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews, 5, CD006103. https://doi.org/10.1002/14651858.CD006103.pub8 ; Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T (2018). Nicotine replacement therapy versus control for smoking cessation. Cochrane Database of Systematic Reviews, 5, CD000146. https://doi.org/10.1002/14651858.CD000146.pub5 ; Theodoulou A, Chepkin SC, Ye W, et al. (2023). Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews, 6, CD013308. https://doi.org/10.1002/14651858.CD013308.pub2 ; Shanghai Municipal Health Commission (2021). Choosing medication to make quitting easier. It lists nicotine replacement, bupropion and varenicline; only nicotine replacement is OTC, while the other two require a physician's prescription and pharmacist dispensing after a cessation-clinic or respiratory visit. https://wsjkw.sh.gov.cn/jtyx/20211119/df50681e01ba49f896d54f771d8176ae.html