Quitting smoking is one of the hardest things many people will ever do. The World Health Organisation (WHO) recently introduced its first-ever clinical treatment guideline to help adults quit tobacco.
This comprehensive guide includes support from healthcare providers, digital tools and medications to help the 750 million tobacco users who want to quit.
But why is quitting smoking so tough?
Nicotine, the addictive substance in tobacco, hooks users quickly. It stimulates the release of dopamine, a “feel-good” chemical in the brain, making you feel pleasure and relaxation.
Over time, your brain starts to crave nicotine to keep those good feelings coming, creating a cycle that’s hard to break.
When you try to quit smoking, your body reacts to the absence of nicotine with withdrawal symptoms.
These can include:
- Irritability and mood swings:
- Cravings: A strong desire to smoke.
- Anxiety and depression: Feeling worried or down.
- Difficulty concentrating: Finding it hard to focus.
- Increased appetite: Eating more than usual.
These symptoms can be very uncomfortable, making it tough to stick to your decision to quit.
Additionally, many smokers associate smoking with certain activities or emotions. For example, you might smoke with your morning coffee, during work breaks or when you're feeling stressed.
These routines and habits make it harder to quit because smoking becomes intertwined with your daily life.
Social settings can also influence smoking habits. If your friends, family, or co-workers smoke, you might feel tempted to join them. Plus for many people, smoking is a way to cope with stress, anxiety or boredom.
Without a cigarette, they might feel unsure about how to handle these feelings, making it difficult to quit.
“This guideline marks a crucial milestone in our global battle against these dangerous products. It empowers countries with the essential tools to effectively support individuals in quitting tobacco and alleviate the global burden of tobacco-related diseases,” WHO director-general, Dr Tedros Adhanom Ghebreyesus, said in a statement earlier this month.
Why is this a game-changer?
The WHO guideline is significant because it addresses a massive gap in the availability of services to help people stop smoking.
Despite the desire of over 60% of the world’s 1.25 billion tobacco users to quit, 70% of them lack access to effective quitting services due to various challenges faced by health systems, especially in resource-limited settings.
Dr Rüdiger Krech, director of health promotion at WHO, highlighted the struggle individuals face when trying to quit smoking.
"The immense struggle that people face when trying to quit smoking cannot be overstated. We need to deeply appreciate the strength it takes and the suffering endured by individuals and their loved ones to overcome this addiction,” he said.
”These guidelines are designed to help communities and governments provide the best possible support and assistance for those on this challenging journey.”
The WHO guideline recommends a mix of behavioural support, digital interventions, and pharmacological treatments to assist individuals in quitting tobacco.
Here are some key components:
Behavioural support:
Health worker counselling: Brief counselling sessions ranging from 30 seconds to 3 minutes, are offered routinely in healthcare settings.
Intensive support: More in-depth individual, group, or phone counselling, for those interested.
Digital interventions: Tools such as text messaging, smartphone apps and internet programmes can support self-management and supplement other treatments.
Pharmacological treatments
Recommended medications: Varenicline, nicotine replacement therapy (NRT), bupropion and cytisine have been proven effective.
In 2023, WHO began a prequalification procedure for medicinal products to improve global access. Kenvue’s nicotine gum and patch became the first WHO-prequalified NRT products in April 2024.
Before the WHO’s guidelines, several products aimed to help people quit tobacco, with varying degrees of success:
Nicotine patches and gum are widely used but often underutilised due to cost and accessibility issues.
E-cigarettes are controversial and less effective, with growing evidence of potential health risks.
Herbal remedies are popular in some cultures but lack robust scientific backing.
Prescription medications such as varenicline and bupropion have been effective, but are not always available in all regions.
The WHO’s new guidelines provide a structured and evidence-based approach to stopping smoking, offering hope to millions of people struggling with tobacco addiction.
By combining behavioural support with pharmacological treatments and digital interventions, these guidelines aim to make finding information on stopping smoking more accessible and effective globally.
Healthcare providers, policy-makers, and stakeholders are encouraged to adopt and implement these guidelines to improve the health of millions worldwide, marking a significant step forward in the fight against tobacco-related diseases.