only 6% succeed without help; discover methods that double your chances

Quitting smoking ranks high among the goals of the roughly 9.3% of Brazilian adults who still light up, according to the 2023 Vigitel survey from Brazil’s Ministry of Health. The reasons to stop are compelling, with tobacco use linked to a wide range of serious conditions, from various cancers to heart disease, diabetes, and reproductive issues. Yet, experts warn that relying solely on willpower is a rare path to success, often an exception rather than the rule. Research shows that interventions like behavioral therapy, nicotine replacement patches and gums, and medications can more than double the odds of kicking the habit, offering critical support to overcome chemical dependency and withdrawal symptoms. Maria Enedina Scuarcialupi, coordinator of the Scientific Tobacco Commission at the Brazilian Society of Pulmonology and Tisiology (SBPT), notes that only about 5% manage to quit on their own, while structured cessation programs boost that rate to around 50%. This stark difference underscores the value of professional help in tackling an addiction that impacts both body and mind, especially as the World Health Organization (WHO) estimates that 60% of the world’s 1.25 billion tobacco users—750 million people—want to quit. In Brazil, where smoking has dropped from 34.8% of adults in 1989 to today’s lower figures, the challenge persists for many without proper support.

The decline in smoking over decades reflects efforts like Brazil’s National Tobacco Control Program (PNCT), which provides free treatments through the public health system (SUS). Still, nicotine’s grip remains tough to break, reaching the brain in just nine seconds after inhalation, intensifying addiction and making withdrawal a formidable barrier without targeted strategies.

Globally, the push to quit smoking is urgent, and evidence-based methods are proving essential. Combining therapies offers a practical lifeline for those determined to leave tobacco behind, whether it’s traditional cigarettes or alternatives like e-cigarettes and hookahs.

Chemical dependency fuels the challenge

Nicotine’s addictive power stems from its rapid effect on brain receptors, which multiply dramatically with regular smoking. Elnara Negri, a pulmonologist at São Paulo’s Sírio-Libanês Hospital, explains that while everyone is born with a baseline number of these receptors, smoking causes them to surge exponentially, locking users into a cycle of constant need. When smoking stops, severe withdrawal symptoms kick in—irritability, anxiety, and intense cravings—making it tough to quit without assistance.

A recent study from University College London, published in January in JAMA Network Open, tracked 25,000 British smokers and found that those attempting to quit unaided had about a third fewer chances of success compared to those using support, whether pharmacological or behavioral.

Another comprehensive review by researchers from the Universities of Oxford and Leicester analyzed 319 clinical trials involving 157,200 participants. Published in Cochrane in 2023, it revealed that only 6 out of 100 people succeed in quitting without help, while nicotine replacement therapies double that to 12, and medications like bupropion or varenicline push it to 14.

Proven methods take the spotlight

Combining behavioral and pharmacological interventions stands out as the most effective way to quit smoking. In July last year, the WHO released its first clinical guideline on tobacco cessation, endorsing this approach for all forms of tobacco use, including cigarettes, e-cigarettes, hookahs, and cigars. The guideline highlights options like Nicotine Replacement Therapy (NRT)—patches, gums, and lozenges—alongside medications such as bupropion, varenicline, and cytisine.

In Brazil, the SUS offers free access to NRT patches and gums, as well as bupropion, paired with cognitive-behavioral therapy (CBT) sessions. These strategies ease withdrawal symptoms and help unravel the psychological triggers behind smoking, providing vital support in the early smoke-free months.

Mariana Pinho, coordinator of the Tobacco Project at ACT Health Promotion, stresses that CBT is key to pinpointing dependency’s roots and sustaining abstinence, becoming even more powerful when combined with medications for those with heavy reliance.

How available treatments work

The battle against smoking benefits from methods tackling both physical and mental dependency. Bupropion, for instance, boosts well-being in the brain, curbing the urge to smoke by softening the blow of nicotine withdrawal. Varenicline and cytisine, meanwhile, bind to nicotine receptors, reducing cravings and the pleasure tied to smoking. A JAMA study found that 32.6% of participants using cytisine stayed smoke-free after three months, compared to just 7% in the placebo group, showcasing its promise—though it’s not yet approved in Brazil.

Nicotine Replacement Therapy delivers controlled doses to ease withdrawal, with patches providing steady release through the skin and gums or lozenges tackling sudden cravings. In the SUS, these are paired with CBT sessions that teach coping strategies for triggers like stress or social habits.

While varenicline faces availability issues in Brazil due to manufacturing challenges and a lack of generics, the SBPT advocates for its inclusion in the SUS, citing its proven efficacy and cheaper generic versions abroad. The group also aims to push for cytisine’s approval, seen as a fresh option after two decades without major pharmacological breakthroughs.

E-cigarettes fall short as a solution

Unlike approaches in countries like the UK and Sweden, e-cigarettes aren’t a reliable way to quit smoking. The WHO and Brazilian experts dismiss them, noting that many users revert to traditional cigarettes or dual-use, failing to break nicotine dependency. Mariana Pinho points out that the fast nicotine absorption in e-cigarettes may even heighten addiction, hooking a new generation of smokers.

Elnara Negri adds that e-cigarettes sustain chemical dependency and pose health risks, including respiratory and cardiovascular issues, due to toxic substances in their vapor, debunking the myth of harmlessness. This makes them an ill-advised choice for cessation.

Why professional help pays off

Seeking structured treatment sharply boosts success rates. While only 6% quit without aid, NRT doubles that figure, and medications can triple it, per the Cochrane review. In Brazil, the SUS’s free offerings level the playing field, with CBT reshaping behaviors and drugs easing withdrawal.

The numbers speak volumes: cessation programs hit success rates of up to 50%, versus 5% for solo attempts, says Maria Enedina Scuarcialupi. This support is critical during the initial days without cigarettes, when cravings peak, and for maintaining long-term abstinence.

Steps to quit smoking effectively

Smokers aiming to quit can take practical steps to improve their odds:

• Consult a pulmonologist or SUS professional for a tailored plan.
• Join cognitive-behavioral therapy sessions to spot triggers.
• Use nicotine patches or gums to manage withdrawal.
• Try medications like bupropion, under medical guidance.
• Avoid smoking-linked situations, like coffee or drinking, early on.

These combined efforts help desensitize nicotine receptors and build a smoke-free life, with expert support making a huge difference.

Smoking’s decline in Brazil over time

Brazil’s smoking landscape has shifted dramatically. Key milestones include:

• 1989: 34.8% of adults smoked, per the PNSN.
• 2010: The Anti-Smoking Law bans cigarettes in enclosed spaces, cutting secondhand smoke.
• 2023: The rate drops to 9.3%, per Vigitel, thanks to public health policies.

This drop highlights the power of campaigns and accessible treatment, though the remaining 9.3% still face hurdles to quit.

A fight worth winning

Quitting smoking reshapes health and life quality, even for those with tobacco-related conditions. Within 20 minutes, blood pressure normalizes; after 8 hours, blood oxygen stabilizes; and in 10 years, lung cancer risk halves. These gains, paired with effective methods, make the effort worthwhile.

Elnara Negri stresses that dependency is a chemical process needing gradual intervention, not just willpower. Brazil’s SUS provides tools like bupropion and NRT, while the SBPT pushes for broader access to varenicline and cytisine, already successful elsewhere.

For the 750 million smokers worldwide eager to quit, professional support and proven strategies pave the way. In Brazil, where smoking fell from 34.8% to 9.3% over 35 years, the fight continues, demanding dedication and resources to reach those still struggling.