Smokers Trying to Quit Often Do Not Use Effective Cessation Aids, UK Study Finds

04 April 2025

Vaping, which was used in 40.2% of quit attempts, was the most commonly used cessation aid and associated with the highest odds of success.

Many smokers trying to quit in the United Kingdom do not partake in the wide range of effective smoking cessation aids available, according to study findings published in JAMA Network Open.

Investigators characterized the prevalence of current smoking cessation aids in England and their association with quit-success. Self-reported success in quitting, from the start of the most recent quit attempt until time of the survey, was the primary outcome.

The current analyses, conducted July 2024 to November 2024, was based on data from monthly cross-sectional household surveys administered from 2006 to 2024 in England through the Smoking Toolkit Study. Overall, 25,094 participants (mean [SD] age, 38.7 [15.3] years; 51.5% men) were included in analyses.

The researchers found that the most frequently used smoking cessation aids in 2023 to 2024 were e-cigarettes/vaping (40.2%; 95% CI, 37.6%-42.8%) and over-the-counter nicotine replacement therapy (NRT; 17.3%; 95% CI, 15.3%-19.2%). Unaided quit attempts occurred in 40.8% of cases; 95% CI, 38.2%-43.4%. Participants self-reported success in quitting smoking (17.7%) from the start of their most recent attempt to survey time.

[W]hile a range of effective smoking cessation aids are available, many people tried to quit either using less effective forms of support or none at all. Quit success rates could be improved by encouraging people to use more effective methods.

After adjustment for use of other aids and covariates, vaping was associated with higher odds of quit success (odds ratio [OR], 1.95; 95% CI, 1.74-2.17), although use of over-the-counter NRT was not associated with greater quit success (OR, 1.03; 95% CI, 0.93-1.15).

The researchers also assessed the impact of other smoking cessation aids used by less than 5% of participants during the study period. Aids positively associated with quit success in 2023 to 2024 included websites (used by 4.6%; OR, 1.43; 95% CI, 1.03-1.98), prescription NRT (used by 4.5%; OR, 1.33; 95% CI, 1.12-1.58), varenicline (used by 1.1%; OR, 1.80; 95% CI, 1.50-2.18), and heated tobacco products (used by 0.7%; OR, 2.37; 95% CI, 1.24-4.51).

Among participants who were less socioeconomically advantaged, face-to-face behavioral support was used by 2.2% during the study period and was associated with higher odds of quit success (OR, 1.59; 95% CI, 1.19-2.14). However, no association was found between face-to-face behavioral support and quit success among participants who were more socioeconomically advantaged (OR, 0.91; 95% CI, 0.65-1.29).

No clear evidence of benefit was found with any other aid, including bupropion, telephone support, hypnotherapy, and written self-help materials as well as smartphone apps, Allen Carr’s Easyway method (a pharmacotherapy-free behavioral program), and newer noncombustible nicotine products. Some analyses were inconclusive.

Study limitations include the use of outcome data based on self-reported success occurring over an unspecified period of time. Additionally, the survey failed to regularly capture frequency, intensity, or dosage of aids used, and no distinction was made between various types of NRT.

“[W]hile a range of effective smoking cessation aids are available, many people tried to quit either using less effective forms of support or none at all,” the investigators concluded. “Quit success rates could be improved by encouraging people to use more effective methods.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.