Quitting smoking: Which methods actually help according to studies
Nicotine patches, varenicline, e-cigarettes, a quit-smoking hotline, or just going cold turkey? We read the major Cochrane reviews and show you what helps when quitting, how much it helps, what it costs, and where to get free support in Switzerland, Germany, and Austria.
You're standing in the pharmacy in front of the shelf with nicotine patches. Next to them: gum, lozenges, a mouth spray. Your colleague swears by her e-cigarette, your brother-in-law managed it with a pill from his doctor, and your father simply stopped one morning, with no help at all. And you're wondering: what actually works, and what's just a good story?
Personal stories are the problem with this question. Those who succeeded talk about it; those who didn't stay quiet. That's why the research here is especially valuable: for almost every method, there are dozens of comparison studies with tens of thousands of people, and the Cochrane Collaboration, an independent research network, regularly summarizes them according to fixed rules.
We read the current Cochrane reviews on nicotine replacement, medications, e-cigarettes, counseling, and telephone counseling, as well as the WHO's first treatment guideline and the available services in Switzerland, Germany, and Austria. By the end, you'll know which forms of support work, how well they work, which ones you can combine, and where to get free help. For the method that best fits your situation, it's worth talking to your doctor or pharmacist.
What works best for quitting smoking?
The combination of medication and counseling works best. In a Cochrane analysis of 52 studies with 19,488 people, success rates were 83 percent higher than with brief counseling or usual care. Since 2024, the WHO recommends varenicline, nicotine replacement, bupropion, and cytisine, ideally each combined with counseling.
In July 2024, the WHO published its first treatment guideline for smoking cessation in adults. It recommends four medications: varenicline, nicotine replacement, bupropion, and cytisine. In addition, health professionals should routinely offer brief advice — 30 seconds to 3 minutes — and those who want more should receive more intensive support individually, in a group, or by phone.
How much the combination helps is shown by the Cochrane review by Stead et al. (2016): people who took a medication and received multiple counseling sessions were significantly more likely to be smoke-free after at least six months. The relative risk was 1.83. This means the chance of succeeding was 1.83 times as high — in other words, 83 percent higher than in the comparison group.
The table gives you an overview of the most important methods. All figures refer to smoke-free status after at least six months. They tell you how much a method increases the odds compared to a control group — not how many people succeed overall. That depends heavily on how much someone smokes and how the study was designed.
| Method | compared to | Odds of quitting | Source |
|---|---|---|---|
| Medication plus counseling | brief counseling or usual care | 1.83 times as high | Stead 2016, 52 studies |
| Varenicline | placebo | 2.32 times as high | Livingstone-Banks 2023, 41 studies |
| Cytisine | placebo | 1.30 times as high | Livingstone-Banks 2023, 4 studies |
| Nicotine replacement (any form) | placebo or no nicotine replacement | 1.55 times as high | Hartmann-Boyce 2018, 133 studies |
| Patch plus fast-acting form | single form only | 1.27 times as high | Theodoulou 2023, 16 studies |
| Nicotine e-cigarette | Nicotine replacement | 1.59 times as high | Lindson 2025, 7 studies |
| Individual counselling | minimal support | 1.57 times as high | Lancaster 2017, 27 studies |
| multiple counselling calls after calling a quit-smoking line | information materials or a brief call | 1.38 times as high | Matkin 2019, 14 studies |
Smoke-free status was measured at a minimum of six months in each case. The values show how much a method increased the odds compared to the control group. The studies differ in design and participants, so the figures should only be compared with caution.
How well does it work to quit smoking entirely on your own?
Rarely. A 2004 review by Hughes and colleagues found that after an unaided quit attempt, only 3 to 5 percent of people remain smoke-free for 6 to 12 months. Most relapses happen within the first eight days. That doesn't mean quitting alone is impossible, but support improves the odds considerably.
The story of the father who simply quit one morning is true — it's just the exception. Hughes, Keely and Naud analysed data in the journal Addiction from people who wanted to quit without treatment. The result: only 3 to 5 percent managed a prolonged smoke-free period of 6 to 12 months after a given attempt.
At the same time, a great many people want to quit. The WHO estimates that of 1.25 billion people who use tobacco worldwide, more than 750 million want to stop. According to the WHO, around 70 percent of them have no access to effective support.
In Switzerland, Germany and Austria, this access is available and often free of charge. If you've tried on your own before and it didn't work out, that's not a sign of weakness — it's the most common outcome. A new attempt with support has significantly better prospects.
How well do nicotine patches, gum and other nicotine replacement products work?
Nicotine replacement increases the chance of a lasting quit by around 55 percent. That's what a Cochrane review of 133 studies and 64,640 people shows. Even better is combining a patch with a fast-acting form such as gum or lozenge: this raised the success rate by a further 27 percent compared to using just one form.
Nicotine replacement gives your body nicotine without the smoke — that is, without tar and carbon monoxide. This reduces cravings and withdrawal while you break the smoking habit. There are patches that work steadily throughout the day, and fast-acting forms such as gum, lozenges, mouth spray or inhaler that you use when cravings strike.
The large Cochrane review by Hartmann-Boyce and colleagues (2018) covers 133 studies with 64,640 participants. With nicotine replacement, the chance of being smoke-free after at least six months was 1.55 times as high as without.
The follow-up work by Theodoulou and colleagues (2023) with 68 studies and 43,327 people compared the different forms with each other. Patches alone and fast-acting forms alone worked about equally well. The combination of a patch plus a fast-acting form, however, produced more smoke-free people with high certainty: 1.27 times as many as with one form alone. Gum at 4 mg worked better than at 2 mg. With moderate certainty, it also helped to start using nicotine replacement before the quit day.
Your pharmacist can advise you on which form and strength suits your level of use. If you have heart disease, are pregnant or are taking other medications, speak with your doctor first.
What is varenicline and how well does it help with quitting smoking?
Varenicline is a prescription medication that binds to the same receptors in the brain as nicotine. In 41 studies with 17,395 people, the chance of a lasting quit was 2.32 times as high with varenicline as with a placebo. It worked better than a single nicotine replacement product and about as well as two combined.
Varenicline binds to the nicotine receptors in the brain — the sites where nicotine normally acts. This reduces withdrawal and at the same time makes a cigarette less satisfying. According to stopsmoking.ch, treatment normally lasts three months.
The Cochrane review by Livingstone-Banks and colleagues (2023) covers 75 studies with 45,049 people. With varenicline, the chance of being smoke-free after at least six months was 2.32 times as high as with a placebo (high certainty). Compared to a single nicotine replacement product it was 1.25 times as high, and compared to bupropion 1.36 times as high. No clear difference was found compared to two combined nicotine replacement products.
According to stopsmoking.ch, the most common side effects include nausea, vivid dreams, headaches and sleep disturbances. In the Cochrane analysis, people taking varenicline reported serious adverse events slightly more often than those on placebo (relative risk 1.23, moderate certainty). For serious psychiatric side effects, the analysis found no clear difference. Whether varenicline is right for you is a decision for your doctor; stopsmoking.ch notes that Swissmedic advises against it during pregnancy and breastfeeding.
What is cytisine and where can you get it?
Cytisine is a plant-derived compound from the laburnum plant that works similarly to varenicline. In four studies with 4,623 people, the chance of quitting was 1.30 times as high as with a placebo. It is available as a medication in Germany and Austria, but is not approved in Switzerland.
Cytisine has been used as a smoking cessation aid since the 1960s, particularly in Eastern Europe. According to stopsmoking.ch, treatment normally lasts 25 days, with a tablet count that decreases according to a fixed schedule.
In the 2023 Cochrane review, cytisine increased the chance of being smoke-free compared to placebo by 30 percent (moderate certainty). In a direct comparison with varenicline across two studies with 2,131 people, no clear difference was found. For serious adverse events compared to placebo, no clear difference was found either, though the certainty for this is low.
In Switzerland, cytisine is not approved as a medication according to stopsmoking.ch. With a doctor's prescription, pharmacies can source it from abroad; basic health insurance does not cover it. The platform advises against purchasing it online.
Does the e-cigarette help with quitting?
In studies, yes: in the Cochrane review from January 2025, 1.59 times as many people quit smoking with nicotine e-cigarettes compared to nicotine replacement — about 4 additional smoke-free people per 100 (high certainty). However, long-term safety data are still lacking, and the WHO does not include e-cigarettes among its recommended aids.
The e-cigarette is the most debated method, so it's worth taking a closer look. The Cochrane review by Lindson and colleagues is a so-called living review that is continuously updated. The January 2025 version covers 90 studies with 29,044 people.
In a direct comparison with nicotine replacement across 7 studies with 2,544 people, 1.59 times as many were smoke-free with nicotine e-cigarettes. Compared to e-cigarettes without nicotine the figure was 1.46 times as many (moderate certainty), and compared to counselling alone or no support it was 1.96 times as many — though only with low certainty.
For side effects, the researchers found probably no difference compared to nicotine replacement. The most common were irritation in the mouth and throat, headaches, coughing and nausea, which diminished over time. They found no evidence of serious harm, but emphasise that longer and larger studies are needed. The findings apply only to regulated nicotine products, not to illegal products or those containing other substances such as THC.
The WHO's 2024 guideline lists varenicline, nicotine replacement, bupropion and cytisine as recommended medications — e-cigarettes are not included. If you want to use an e-cigarette to quit, one goal is important: to fully replace smoking and eventually get off nicotine altogether, not to combine both permanently.
Does smoking cessation counselling really make a difference?
Yes. In a Cochrane review, individual counselling without medication increased the chance of a lasting quit by 57 percent, across 27 studies with 11,100 people. Even when all participants also received nicotine replacement, counselling added a further 24 percent.
Counselling sounds less tangible than a patch, but it has a measurable effect. Lancaster and Stead summarised 49 studies with around 19,000 people for Cochrane in 2017. This refers to support from trained professionals, usually over several sessions, helping you recognise your smoking situations, make a plan for your quit day and work through setbacks.
Without medication, the chance of being smoke-free with individual counselling was 1.57 times as high as with minimal support. In the 6 studies where everyone received nicotine replacement, adding counselling still raised it 1.24 times. Counselling and medication therefore complement each other rather than substituting for each other.
The easiest way to access counselling in all three countries is by phone — free of charge and without a clinic appointment.
What do quit-smoking lines in Switzerland, Germany and Austria offer?
Quit-smoking lines are free telephone counselling services. According to a Cochrane review of 14 studies and 32,484 people, multiple counselling calls for people who had themselves called such a line increased the success rate by 38 percent. The numbers: Switzerland 0848 000 181, Germany 0800 8 31 31 31, Austria 0800 810 013.
Matkin and colleagues reviewed telephone counselling for Cochrane in 2019. For people who called a quit-smoking line themselves, the chance of a lasting quit with multiple callbacks was 1.38 times as high as with information materials or a single brief conversation. Even for people who were called by professionals without having dialled the line themselves, it was 1.25 times as high.
In Switzerland, you can reach the stopsmoking telephone counselling service at 0848 000 181, Monday to Friday from 11 am to 7 pm, in German, French, Italian and English. The counselling is free and anonymous; for additional languages such as Albanian, Portuguese, Spanish, Turkish or Ukrainian there are dedicated numbers. The clinical content of the platform is the responsibility of the Swiss Cancer League.
In Germany, the Federal Institute for Public Health (BIÖG) operates the portal rauchfrei-info.de with the telephone counselling line 0800 8 31 31 31, a free three-week quit programme and a chat service. In Austria, you can reach the Rauchfrei Telefon of the Austrian Health Insurance Fund at 0800 810 013, Monday to Friday from 10 am to 6 pm, also free of charge.
One advantage of telephone counselling: you don't need a clinic appointment and can simply request a callback — for example the day before your quit day or after a slip.
| Country | Service | Number | Available |
|---|---|---|---|
| Switzerland | stopsmoking phone counselling | 0848 000 181 | Mon–Fri 11 am–7 pm, DE/FR/IT/EN |
| Germany | BIÖG, rauchfrei-info.de | 0800 8 31 31 31 | Hours at rauchfrei-info.de |
| Austria | Smoke-free helpline (ÖGK) | 0800 810 013 | Mon–Fri 10 am–6 pm |
Information as of 2 November 2026, verified on the providers' websites. The service in Switzerland and Austria is free of charge; rauchfrei-info.de also lists its services as free.
Quitting cold turkey or cutting down gradually — what works better?
In a study of 697 smokers from English general practices, 22 percent of those who quit abruptly were smoke-free after six months, compared with 15.5 percent of those who gradually reduced over two weeks. The abrupt approach was more successful, but the gradual route also led to the goal.
Lindson-Hawley and colleagues randomly assigned 697 people to two groups in the Annals of Internal Medicine in 2016. One group quit on a fixed day; the other gradually reduced their consumption by 75 percent over the preceding two weeks. Both groups received counselling from nurses and used nicotine replacement before and after the quit day. After four weeks, 49 percent in the abrupt group were smoke-free compared with 39.2 percent in the gradual group; after six months, the figures were 22 and 15.5 percent.
The researchers also found that people who personally preferred the gradual approach were less likely to be smoke-free after four weeks than those who preferred the abrupt approach: 38.3 versus 52.2 percent. Their conclusion: quitting abruptly is more likely to lead to lasting smoke-freedom, even among people who would actually prefer to cut down.
If quitting abruptly feels impossible right now, the gradual approach is still better than no attempt at all. What matters is that there is a date at the end from which you stop smoking entirely.
Who pays for smoking cessation medication?
In Germany, people with statutory health insurance and severe tobacco dependence can receive nicotine replacement or varenicline on a prescription covered by their insurer if they take part in an approved cessation programme; the Federal Joint Committee decided this in May 2025. In Switzerland, the basic insurance does not currently cover varenicline in general, according to stopsmoking.ch. In Austria, it is best to ask your health insurer.
The Federal Joint Committee (G-BA), the highest self-governing body in the German healthcare system, decided on 15 May 2025 that medications containing nicotine or varenicline may be prescribed for severe tobacco dependence. Dependence is considered severe, for example, from 6 points on the Fagerström Test, a short questionnaire on nicotine dependence. The combination of both active substances is not covered by statutory insurance, nor are bupropion or cytisine. After a relapse, a new entitlement arises at the earliest after three years.
In Switzerland, according to stopsmoking.ch, a generic version of varenicline has been available since February 2026. It is currently not reimbursable; in certain individual cases, health insurers cover the costs. Nicotine replacement is generally paid for out of pocket.
A simple calculation puts this in perspective: someone who smokes 15 cigarettes a day and pays CHF 9.50 for 20 spends around CHF 217 a month, or around CHF 2,600 a year. You can find out what a treatment costs at your pharmacy; according to stopsmoking.ch, a pack of cytisine in Switzerland costs around CHF 90 for the entire course.
How the YUTHI app helps you
In the YUTHI app you choose your approach in the Smoking Cessation section: quitting cold turkey with a quit day, or step by step. For the gradual approach, the app builds a ladder from your own starting value, with steps at 100, 70, 50, 30 and 10 percent; if you smoke 20 or more a day, a gentler first step at 85 percent is added at the front. You stay on each step for as long as you like. The evidence from this article is stated honestly in the app: the abrupt approach was more successful in the study, and the choice is yours.
Under "Help & Counselling" you will find the free contact points for your country: in Switzerland the smoking cessation line 0848 000 181, in Germany the smoke-free helpline 0800 831 31 31, and in Austria the smoke-free helpline 0800 810 013. If you smoke a lot, this note appears higher up on the page.
When a craving strikes, tap "Craving": the app records the moment with a timestamp and shows you a four-minute exercise involving breathing, a glass of water and a brief change of location. After a few days you can see when your cravings typically occur. You enter cigarettes, roll-ups, heated tobacco products, e-cigarettes and cigars separately, each with their own price, and the app shows you how much you are saving.
What about you: have you ever called one of the smoking cessation lines, or would that be the step you want to do differently this time?
Frequently asked questions
What is the best method to quit smoking?
According to Cochrane, the combination of medication and counselling has the strongest effect. Among medications, varenicline increased the chances the most, roughly as effective as two combined nicotine replacement products. Which method suits you is best discussed with your doctor or pharmacist.
Can you use a nicotine patch and gum at the same time?
Yes, and it is actually more effective. In 16 studies with 12,169 people, the odds with a patch plus a fast-acting form were 1.27 times higher than with a single form. Ask your pharmacist about the right strength for you.
Is varenicline addictive?
According to stopsmoking.ch, whose content is managed by the Cancer League Switzerland, varenicline is not addictive. It requires a prescription, and the treatment normally lasts three months.
Is the e-cigarette harmless?
No. It contains nicotine, and long-term safety data are still lacking. In studies it helped people quit better than nicotine replacement, but the goal should be to eventually stop using nicotine altogether.
How long should you use nicotine replacement?
According to the 2023 Cochrane review, there is no fixed duration that has been shown to work better: it found no clear effect for the duration of patch use. It is best to discuss the plan for you with your pharmacist or doctor.
What does the smoking cessation phone counselling cost?
In Switzerland and Austria, the phone counselling is free of charge according to the providers; the German portal rauchfrei-info.de also lists its services as free. In Switzerland the counselling is also anonymous.
That was the snapshot. The app turns it into daily support.
Measure every day instead of calculating once: Vito or Vita puts your numbers in context, builds you a weekly plan and speaks up when something stands out.
From November 2026 — first for iPhone, Android follows. Notify me when it launches ↓
Sources
- Weltgesundheitsorganisation (WHO). WHO releases first-ever clinical treatment guideline for tobacco cessation in adults. Meldung, 2. Juli 2024.
- Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004;99(1):29–38.
- Hartmann-Boyce J, Chepkin SC, Ye W, et al. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev. 2018;5:CD000146.
- Theodoulou A, Chepkin SC, Ye W, et al. Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2023;6:CD013308.
- Livingstone-Banks J, Fanshawe TR, Thomas KH, et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2023;5:CD006103.
- Lindson N, Butler AR, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2025;1:CD010216.
- Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2017;3:CD001292.
- Matkin W, Ordóñez-Mena JM, Hartmann-Boyce J. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2019;5:CD002850.
- Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2016;3:CD008286.
- Lindson-Hawley N, Banting M, West R, et al. Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial. Ann Intern Med. 2016;164(9):585–592.
- stopsmoking.ch. Telefonberatung: 0848 000 181. Abgerufen am 2. November 2026.
- stopsmoking.ch (fachliche Inhalte: Krebsliga Schweiz). Vareniclin (Vareniclin Dalita, Champix, Chantix). Abgerufen am 2. November 2026.
- stopsmoking.ch (fachliche Inhalte: Krebsliga Schweiz). Cytisin (Tabex oder Asmoken). Abgerufen am 2. November 2026.
- Bundesinstitut für Öffentliche Gesundheit (BIÖG). rauchfrei-info.de: Telefonberatung 0800 8 31 31 31 und Ausstiegsprogramm.
- Österreichische Gesundheitskasse. Rauchfrei Telefon 0800 810 013.
- Gemeinsamer Bundesausschuss (G-BA). Tabakentwöhnung: Arzneimittel bei schwerer Tabakabhängigkeit künftig verordnungsfähig. Pressemitteilung, 15. Mai 2025.