Effectiveness of smoking cessation aids varies between different types of smokers, a survey-based UK study has found.

The Smoking Toolkit Study is an ongoing monthly survey that provides information about smoking prevalence and cessation in England at a population level.

Targeted sampling is used to select a new group of approximately 1,700 individuals aged 16 years and over each month. Each participant provides self-reported data via a face-to-face computer-assisted survey with a trained interviewer. Data from the start of the survey in November 2006 up to July 2018 were included.

The study population comprised 18,929 respondents (52% women) who had reported a quit attempt in the previous 12 months. Of these, 15,949 were current smokers and 2,980 had stopped smoking at the time of the survey.

Overall, 10,581 respondents had used smoking cessation aids during their latest quit attempt, most had used just one method. More than a quarter (27.5%) had bought over the counter (OTC) nicotine replacement therapy (NRT); 12.7% had used e-cigarettes; 8.5% prescription NRT; 5.5% varenicline and 4.6% face-to-face behavioural support. Other aids had been used by < 2%.

Users of e-cigarettes adjusted odds ratio (OR) 1.95 (95% CI: 1.69-2.24) and varenicline OR 1.82 (95% CI: 1.51-2.21) had significantly higher rates of reported abstinence from smoking than those who did not use these aids. There was a stronger association with quitting with the use of e-cigarettes in men compared with women.

The use of prescription NRT was associated with increased abstinence in older smokers (≥ 45 years); OR 1.58 (95% CI: 1.25-2.00) but not younger smokers (< 45 years); OR 1.09 (95% CI: 0.85-1.42).

The use of websites was associated with increased abstinence rates in smokers from lower socioeconomic groups, OR 2.20 (95% CI: 1.22-3.98), but not from other groups, OR 0.74 (95% CI: 0.40-1.38), and for younger rather than older smokers.

Telephone support was less effective in increasing quit rates for those from lower compared with higher socioeconomic groups.

Use of telephone support and websites was associated with higher quit rates among smokers who were more addicted compared with those with lower levels of dependence.

Overall, use of OTC NRT, bupropion, face-to-face behavioural support, telephone support, written self-help materials and hypnotherapy were not significantly associated with achieving abstinence.

The data presented in this large, representative sample may provide useful information for GPs and other treatment providers in tailoring quit smoking advice to individual patients.

Dr Jez Thompson