One of the most effective lifestyle measures for preventing a heart attack is quitting smoking.

Smoking cigarettes is a difficult habit to break because of the powerful physical and psychological addiction to nicotine. In fact, only about 5 to 10 percent of people successfully quit on their own, without any kind of aid or reinforcement. Fortunately, there are several options that can increase your chances of quitting. They include nicotine replacement therapy, drug therapy, and counseling.

Nicotine replacement therapy comes in many forms: gums, skin patches, nasal sprays, inhalers, and lozenges. Some are available over the counter; others require a prescription from your doctor. These products release small amounts of nicotine into the bloodstream to help reduce withdrawal symptoms and control cravings. The dose is slowly lowered over time, and several months later the therapy is stopped altogether.

Another quitting aid is the prescription antidepressant bupropion (Zyban). This drug also helps reduce cravings and withdrawal symptoms, but it works by disrupting the pleasurable feelings that cigarette smoking produces. People usually begin taking Zyban one to two weeks before their quit date and continue taking it for two to three months, either in combination with nicotine replacement therapy or by itself.

A newer option is varenicline (Chantix), a prescription medication that acts on nicotine receptors in the brain, reducing cravings and withdrawal symptoms and making smoking less pleasurable. Users begin taking Chantix one week before their quit date and continue taking it for the next eight to 12 weeks. Some people have experienced anxiety, nervousness, tension, depressed mood, and suicidal thoughts or actions while using Chantix. Thus, the drug should not be taken by individuals with a history of psychiatric illness.

Counseling sessions—either in a group or one-on-one with a therapist —can be helpful. At these sessions, people learn coping skills, relapse prevention, and stress management and receive social support and encouragement.

Publication Review By: Roger S. Blumenthal, M.D. and Simeon Margolis, M.D., Ph.D.

Published: 10 Mar 2011

Last Modified: 15 Jan 2015