Prevention

Alternatives include nicotine replacement therapy ^a - a combination works best ^a (e.g. patches/gum; patches/inhaler).

Why?

• Nicotine replacement therapy helps smokers quit ^a   
• No route is clearly more effective than another. ^b   
• Patches are cost-effective. ^a
• Smokers who take a combination are more likely to quit ^a , but more develop transient itching. ^a
• Offering support with nicotine replacement therapy increases quit rates. ^a

Nicotine replacement therapy helps smokers quit

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
smoker a	nicotine replacement therapy	control	stopped smoking at 6 months	10%	1.73 (1.62 to 1.85)	16 (14 to 19)
	4 mg gum	2 mg gum	stopped smoking at 6 months	19%	1.59 (1.16 to 2.20)	12 (7 to 42)
	nicotine replacement therapy + low-intensity support	nicotine replacement therapy alone	stopped smoking at 6 months	7.8%	1.75 (1.57 to 1.96)	20 (16 to 25)
	nicotine replacement therapy+ high-intensity support	nicotine replacement therapy alone	stopped smoking at 6 months	13%	1.68 (1.53 to 1.84)	14 (12 to 18)
	2 forms of replacement therapy	1 form of replacement therapy	stopped smoking at 6 months	12%	1.55 (1.17 to 2.05)	18 (10 to 57)

Combining nicotine replacement treatments increases transient itching

Patient	Treatment	Comparison	Outcome	CER	RRI (95% CI)	NNH (95% CI)
smokers wanting to quit a	nicotine patches and inhaler	nicotine inhaler and placebo	itching at 7 days	2.0%	250% (17% to 950%)	20 (11 to 100)