There are as many reasons to quit smoking  as there are cigarettes in a pack.

It increases your risk of cardiovascular disease. Respiratory disease.

Cancer. Diabetes … Actually, it might be easier to list  the diseases that smoking doesn’t cause. So quitting is a smart thing to do.

But it’s far from an easy thing to do, as  anyone who has ever tried can tell you. Most people who try to quit nicotine are  not successful on their first attempt. But there are a number of tools  that increase your odds of success,   and scientists are working on others  that may sound a little bizarre.

So here’s what the research  says about seven popular ways   to kick a nicotine habit … including a  vaccine that could change everything. [♪ INTRO] You probably know that nicotine  is the compound in cigarettes   and vaping products that keeps people addicted. When you smoke, nicotine makes its  way into the brain, where it binds   to the receptors that trigger the  release of chemicals like dopamine. Dopamine can make you feel good and give smoking   that rewarding feeling that  easily turns it into a habit.

And the more you smoke, the more nicotine changes  your brain so that if you try to go without it,   you get withdrawal symptoms like increased  appetite, anxiety, and trouble sleeping. All of that is famously tough to get through. But, as they say, mind over matter, right?

If you just buckle down and stick to your  goal, maybe you can quit cold turkey? A study published in 2023 found that this   was the most common method among  vapers who were trying to quit. 78.4% of them reported trying  to quit without any assistance. So if you’ve tried to break your nicotine  habit without help, you’re not alone.

You might have set a day where you  officially plan to stop smoking. Like, “Enough is enough. On January  1, my body is a nicotine free zone.” Or, maybe when that didn’t work, you tried winding  down in the weeks leading up to a new deadline.

Like,” By February 1, I’ll go from  five cigarettes a day to four a day. Then by March, I’ll cut down to three. I’ll be totally free by the summer!” It’s not completely clear  whether quitting cold-turkey   versus that gradual approach makes a difference.

There have been some well-publicized  studies that suggested quitting nicotine   cold-turkey might be better  than cutting back gradually. But a meta-analysis of 51 studies including more  than 22,000 people in total didn’t find strong   evidence that either gradual quitting or abruptly  quitting were better for long-term success. On the whole, they concluded that  just 12% of people who tried to   quit using these methods were not  smoking at a six month follow up.

So most smokers who try to quit  nicotine are not successful at first. But they may have better luck  quitting with social support. And one way to get that is  probably in your hands right now.

There are research and nonprofit groups that   send supporting messages and  reference material via text. For example, the organization Truth Initiative   launched a program a few years ago  to help young people quit smoking. You’d send them a text message to sign up,  stating when you wanted to quit nicotine.

Then, you received text messages from the service   the week before you intended  to quit and for 30 days after. These messages were geared around cheering you  on and helping you build coping strategies. For example, “Giving yourself a reason to quit   is a good motivator.’ Reply why  you’re thinking about quitting.” You’d respond with your motivator, which reminds  you of why you chose to do this hard thing.

And if you texted back certain keywords like  “stress” or “crave,” you’d get on-demand support. These services are pretty cheap and easy  to scale up to help a lot of people. Most importantly, it seems to  actually work for some people.

Almost 25% of users reported they  weren’t smoking 90 days after they quit,   which is significantly better  than the Cold Turkey number. But, while these text options are  better than having no support,   three quarters of people who wanted to  quit weren’t able to using this tool. So let’s look at some methods with better rates.

Nicotine is addictive, but it  doesn’t have quite the toxic   effects of the other chemicals in a cigarette. So one popular way to quit  smoking is to not quit nicotine. That’s where nicotine gum comes in.

In 1984, it was the first drug  to be approved by the Food and   Drug Administration to help people quit smoking. Soon after, we got nicotine  inhalers, patches, and nasal spray. These treatments are grouped together in the  category of nicotine replacement therapy.

They give you a low dose of  nicotine that helps ease the   symptoms of withdrawal and craving without  the other toxins you’d find in a cigarette. I know the goal for many is to quit  nicotine, and this method is, well, not that. But we couldn’t make a video  about trying to quit smoking   without talking about one of the  major ways a lot of people do that.

A meta-analysis of 136 studies concluded  that all approved nicotine replacement   therapies can increase the rate  of smoking cessation by up to 60%. And another study found that it’s even  more effective when you alternate among   multiple replacements, like mixing  and matching lozenges and the patch. That’s a pretty high success rate!

But it’s still nowhere near 100%. If you’ve tried this method and it didn’t work,   it’s possible that you raced to  the finish line a little too fast. One of the main challenges  people face with nicotine   replacement therapies is stopping them too soon.

You might have the goal to taper off your gum,   but rushing that taper can lead  you right back to cigarettes. Considering the side effects of replacement  therapies, like difficulty sleeping, headaches,   and nausea, I understand wanting to be  done with them sooner rather than later. But quitting is all about the long game.

And there’s another way that some people ease into  quitting without immediately giving up nicotine. E-cigarettes or vapes are often seen  as safer alternatives to cigarettes   because they don’t have as many toxic  chemicals in them …that we know of. But they still have risks.

Like, you can still injure  your lungs smoking e-cigs. But vapes can help you quit long-term. A 2024 study with over a thousand volunteers  compared the success of those who received   counseling and free e-cigarettes to a group that  received counseling without the e-cigarettes.

Six months later, 59.6% of the  people in the e-cigarette group   had stopped smoking compared  to 38.5% in the other group. Now, in that study, participants could choose   whether their e-cigarettes  had nicotine in them or not. And, since nicotine is so very  addictive, that makes a difference.

An analysis of 90 studies concluded that  e-cigarettes with nicotine in them lead   to higher rates of smoking cessation  than nicotine replacement therapy,   while e-cigarettes without nicotine  didn’t appear to be as successful. That means you can use e-cigs to stop  smoking and you can do it without nicotine. But more people make the transition  when nicotine is kept in the equation.

Sometimes, though, it takes something  a little stronger to kick the habit. Like pharmaceuticals. But before we go there, an ad.

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You get a full refund if you  aren’t happy with the service. Otherwise, you can keep their  protection for years to come. One common drug used to quit nicotine  is the antidepressant, Wellbutrin.

Yes, it’s an antidepressant,  and a nicotine cessation tool. Wellbutrin is the brand name for bupropion,  and that stuff does a lot of things for you. It increases your dopamine  and noradrenaline levels,   which are brain chemicals involved in  everything from motivation to anxiety.

If you recall, dopamine is what makes  nicotine so addictive in the first place. So researchers are still working out exactly  how bupropion helps you quit smoking. But they’re not surprised that  manipulating those chemicals   can reduce cravings and withdrawal symptoms.

In fact, in more than 100 studies comparing  bupropion to no medication, researchers found that   it’s as much as 72% more likely to help you stay  away from smoking six months after your quit date. Plus, given that depression  is a symptom of withdrawal,   an antidepressant is pretty well-poised  to help ease that particular issue. So the fact that it’s pretty broad-acting  might work to your advantage.

But Wellbutrin isn’t the only  nicotine cessation drug out there. Another one that you can use today  dates back to the 19th century. The seeds of the Cytisus laburnum shrub contain   a compound called cytisine that  was first written about in 1818.

And it’s shockingly similar to nicotine. Like, the molecule looks like the molecule  for nicotine, and produces a similar effect. Because these molecules are so similar,   cytisine can bind to the same receptors  in the brain that nicotine binds to.

So when nicotine floats by,  there’s no room to land. Its spot is already taken by cytisine. This has a few effects.

One: it can give you the feeling  you’re looking for from nicotine. During World War II, German  and Russian soldiers smoked   the leaves as a cheap alternative to tobacco. But also, when you take cytisine, nicotine  just doesn’t do it for you like it did before. Cytisine can interfere with  nicotine’s ability to put   more dopamine into your system,  making it much less desirable.

So cytisine generally works better than nicotine  replacement therapies when you’re trying to quit. So much so that in the 1960s, a Bulgarian  pharmaceutical company began selling   cytisine to help people quit smoking,  and it’s still sold in some countries. But the drug never ended up being approved for use   by the European Union or the  Food and Drug Administration.

They needed more data before approval. But they probably didn’t follow up with that  …because scientists made a better version of it. Varenicline is based on the structure of cytisine,   but does an even better job at binding to its  receptor, making it even more effective overall.

This drug, now known as Chantix, was already used   by around 3.5 million people in the US  alone just two years after FDA approval. Compared to placebos, nicotine patches, and  bupropion, varenicline works really well. According to a collection of 27 studies,   it’s more than two times more likely  than placebos to help you quit smoking.

So this method of getting in nicotine’s way when   it would usually bind to receptors in  the brain turns out to work pretty well. Which is why it’s also the mechanism  behind our last tool to quit smoking,   even though taking a pill is very  different from getting a shot. We get shots for everything from  measles to tetanus, so why not nicotine?

The theory is that it would get you to  make antibodies that attack nicotine. They’d bind to the nicotine molecule  and make it too big to pass through   the blood-brain barrier to get to those receptors. With less nicotine in your brain, you get  less dopamine, which could help you quit.

Which would be amazing! But in clinical trials, the  results have been mixed. While the vaccine did help some people  quit, that success was far from universal.

The determining factor seemed  to be how much of an antibody   response the vaccine generated in an individual. Participants with the highest antibody  levels were more likely to quit. So the idea can work, but the  hard part has been getting those   high levels of antibodies for  everyone who gets the vaccine.

To make that happen, scientists are  developing strategies to improve adjuvants,   which are molecules added to drugs and  vaccines to make them more effective. In this case, the adjuvants are made from proteins  that help your immune system fight infections. If scientists can reliably ramp up your  immune response, then ideally you’d make   more antibodies that target nicotine,  and you’d have a better shot at quitting.

So if you haven’t heard of the nicotine vaccine,  it’s because it doesn’t work well enough … yet. But scientists have some  good ideas for improving it. Which means there could still be  a nicotine vaccine in your future.

Until then, research shows that there are  already some very good ways to quit smoking. It could be a drug or a text  message or nicotine replacement. Here at SciShow, we’re not in the  business of telling you what to do.

But you know … if you’re trying to  quit, there’s no reason to wait. [♪ OUTRO]