Evidence-based Cessation Treatment

Evidence-based Cessation Treatment

Quitting smoking has major and immediate health benefits for people of all ages. It dramatically reduces the risk of lung and other cancers caused by smoking, as well as the risk of coronary heart disease, stroke, and chronic obstructive pulmonary disease.

Cessation success is increased by the use of evidence-based treatment, including the use of behavioral counseling and medications. The combination of behavioral counseling and medication is especially effective. FDA-approved cessation medications include various forms of nicotine replacement therapy (NRT), and two medications that do not contain nicotine: bupropion (also known as Zyban), and varenicline (also known as Chantix). Behavioral support can be delivered in person, in group settings, over the phone (quitlines and telehealth sessions), and with other mobile technology tools and methods (i.e., mHealth). However, few people who smoke use evidence-based cessation treatments when attempting to quit, which decreases their likelihood of success.  

E-cigarettes (also known as vapes or Electronic Nicotine Delivery Systems) are battery-powered devices that convert a liquid (“e-liquid”) into an aerosol. E-liquids typically contain nicotine, flavorings, vegetable glycerin, propylene glycol and other chemicals. In addition to nicotine, e-cigarette aerosol may contain heavy metals, volatile organic compounds, and fine and ultrafine particles that can be inhaled deeply into the lungs by both users and bystanders. Many people who smoke report using e-cigarettes in an effort to quit smoking. However, the Surgeon General has concluded that there is presently inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation, and no e-cigarette has been approved by FDA as a therapeutic product for smoking cessation treatment.

The three measures presented here (“Any Cessation Treatment,” “Any Cessation Medication,” and “Any Cessation Counseling”) use a common denominator consisting of people who smoke at the time of interview and report a quit attempt during the past 12 months as well as people who formerly smoked but quit smoking within the past 12 months. The numerators for each measure consist of individuals reporting the following behaviors:

Any Cessation Medication Use: people who reported using any NRT(s) (patch, gum, lozenge, nasal spray or oral inhaler) and/or reported using any of the following medications: Bupropion (Zyban®) and/or Varenicline (Chantix®).

Any Cessation Counseling Use: people who reported using any of the following type(s) of behavioral counseling: from a quit-line; one-on-one with a clinician; at a clinic, class or support group; or from the internet (i.e., web-based), a smartphone app, or a texting program. (Note: The 2020 Surgeon General’s Report on Smoking Cessation concluded that evidence is inadequate to infer that smartphone apps for smoking cessation are independently effective in increasing smoking cessation.)

Any Cessation Treatment Use: people who reported using one or more of the cessation medications and/or cessation counseling types included in the above two measures.

The Tobacco Use Supplement to the Current Population Survey Harmonized Data, National Cancer Institute, 1992–2019.

US Department of Commerce, Census Bureau (2005, 2013, 2020). Tobacco Use Supplement to the Current Population Survey- National Cancer Institute sponsored in 2003 and 2010-11 and National Cancer Institute and Food and Drug Administration co-sponsored in 2018-19.

  • Healthy People 2030 includes a goal to increase the use of smoking cessation counseling and medication in adults who smoke (TU-13) which relies on National Health Interview Survey (NHIS) data. In 2015, 32.1 percent of adults who smoke and who tried to quit during the past year (and adults who formerly smoked and who quit during the past 2 years) reported using cessation counseling and/or medication as part of a quit attempt. The 2030 target for this goal is 43.8%. In contrast, the data presented in the Cancer Trends Progress Report are drawn from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS). Therefore, the data presented in this report cannot be directly compared to the HP2030 objective.

Healthy People 2030 is a set of goals set forth by the Department of Health and Human Services.

Smoking Cessation