Smoking – treatments for quitting smoking



Key points about treatments for quitting smoking

  • Quitting smoking can be incredibly difficult, but there are many treatments that can help you do it.
  • Some people rely on their own willpower to get them through the cravings and withdrawal symptoms (called going ‘cold turkey’). This method may be successful but does not work for all smokers.
  • There are many treatment options to help beat your addiction and reduce withdrawal cravings.
Broken cigarette to quit smoking
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People who smoke cigarettes become addicted to nicotine but it is the other components of cigarette smoke that damage your health.

  • Nicotine activates an important group of nerve and brain receptors, producing many effects. Smokers say it gives them stress relief, improved mood and the ability to think or concentrate better. Because nicotine is rapidly absorbed from cigarette smoke, it gives instant effects.
  • The addictiveness of nicotine is as strong as some ‘hard drugs’, it's just that the immediate effects are less extreme. About 4 out of every 5 smokers are addicted to nicotine. Smoking your first cigarette within 30 minutes of getting up in the morning is a sign of a high level of addiction to nicotine.

For regular smokers, the downside is that without nicotine, the opposite sensations (withdrawal effects) are experienced. These can start a few hours after the last cigarette and include:

  • cravings for a cigarette
  • feeling irritable, anxious or depressed
  • difficulty concentrating
  • difficulty sleeping
  • a temporary increase in appetite, and weight gain.

The main treatment options are:

Quit smoking treatments can be effective in helping you give up smoking, but they only deal with the physical dependence. To get the most benefit, you’ll need other methods that help with the psychological (emotional and mental) part of quitting, such as a smoking quit program.

The best treatment for you will depend on your personal choice, your age, whether you're pregnant or breastfeeding and any medical conditions you have. Talk to your healthcare provider or stop smoking adviser about what is best for you.

NRT provides a safe, controlled way of administering nicotine without all the other harmful chemicals contained in cigarette smoke. It is shown to double your chances of quitting successfully over going cold turkey. 

NRT is easily available and you do not need a prescription to get it. Subsidised (low cost) or free gum, lozenges and some strengths of the patches are available from Quitline (0800 778 778), local quit smoking providers, your doctor or your pharmacist.

  • The nicotine skin patch is applied once a day and is designed to deliver a background level of nicotine over 16 or 24 hours of the day.
  • Nicotine chewing gum, lozenges, inhalators and mouth sprays deliver nicotine more quickly and can be used when you get a sudden urge for a cigarette.
  • There's no evidence that any single type of NRT is more effective than another. But there is good evidence to show that using a combination of NRT is more effective than using a single product.
  • Often the best way to use NRT is to combine a patch with a faster acting form such as gum, inhalator or nasal spray.
  • Treatment with NRT usually lasts 8-12 weeks, before you gradually reduce the dose and eventually stop.

Read more about nicotine replacement products.


You can use nicotine replacement therapy (NRT) during pregnancy if it will help you stop smoking and you're unable to stop without it. When using NRT, you and your baby are still exposed to nicotine, but the nicotine is delivered at lower levels than smoking, without all the other harmful chemicals contained in cigarette smoke. Talk to your healthcare provider or stop smoking adviser about this.

  • Avoid liquorice flavoured NRT products as liquorice root can cause negative effects.  
  • If you have pregnancy-related nausea and vomiting, patches may be a better solution. Patches should be used for a maximum of 16 hours per day.
  • Read about quitting smoking when pregnant.

Prescription medicines such as bupropion, varenicline and nortriptyline treatments reduce the negative sensations of nicotine withdrawal so you do not miss having a cigarette so badly. It also blocks the pleasant sensations of smoking so having a cigarette is less enjoyable.

These medicines are not suitable for everybody, so talk to your doctor or health professional to find out whether they're right for you.

The best thing you can do for your health is be smokefree and vape free. If you don’t smoke, don’t vape.

Although vaping can help some people quit smoking it is not harm free. Read more about vaping and vaping and pregnancy.(external link)

Quitting smoking is like giving yourself a pay rise. Click on the calculator tool below to see just how much you could be saving once you go smokefree.

(external link)

Also see the cost of cigarettes compared to groceries(external link)

Clinical resources

The New Zealand guidelines for helping people to stop smoking update(external link) Ministry of Health, NZ, 2021
Smokefree Aotearoa 2025 Action Plan – Auahi Kore Aotearoa Mahere Rautaki 2025(external link) Ministry of Health, NZ, 2021
ASH NZ – Action on Smoking and Health(external link) NZ

Antidepressants for smoking cessation(external link) Cochrane Database of Systematic Reviews, 2020
Effective stop smoking conversations with pregnant women(external link) LearnOnline, NZ (requires login)
Smoking cessation – helping patients stick with it, until they quit(external link) BPAC, NZ, 2015
Smokefree pharmacotherapy – table comparing funded options to support smoking cessation(external link) SafeRx, NZ, 2016 
Smokefree environments(external link) National Public Health Service – Northern Region

Continuing professional development

1. Video: PHARMAC seminar: Smokefree 2025, 1 of 6. Engaging and motivating smokers to quit (22 minutes) – Dr John McMenamin

2. Video: PHARMAC seminar: Smokefree 2025, 2 of 6. Developing QUIT Plans, part 1 – Optimising NRT (28 minutes) – Dr John McMenamin

3. PHARMAC seminar: Smokefree 2025, 3 of 6. Developing QUIT plans, part 2 - Prescribing – (37 minutes) – Rosie McMenamin

For more videos in the same series, visit PHARMAC seminars.(external link)

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Credits: Healthify Pharmacists. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Sandra Ponen, BPharm, MPH, Auckland

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