Quitting smoking
The USPSTF recommends that clinicians ask every adult about tobacco, advise those who smoke to stop, and offer behavioral support and FDA-approved medicines (grade A, 2021). Using both works better than medicines alone. (USPSTF, 2021)
Free help: call 1-800-QUIT-NOW (1-800-784-8669) to reach your state's quitline and talk with a trained counselor. In Spanish: 1-855-DÉJELO-YA (1-855-335-3569). (Smokefree.gov) Your doctor can help you choose medicines.
- USPSTF grade
- A (adults); A and I (pregnancy)
- Who
- Adults who smoke
- Ages
- 18 and older
- Free help
- 1-800-QUIT-NOW
What the USPSTF recommends, by group
| Who | What | USPSTF grade |
|---|---|---|
| Adults who are not pregnant | Behavioral support plus FDA-approved medicines | A |
| Pregnant people | Behavioral counseling | A |
| Pregnant people | Medicines to quit | I (evidence insufficient) |
| All adults, including pregnant people | E-cigarettes to quit | I (evidence insufficient); use proven methods instead |
Behavioral support that works includes advice from a doctor or nurse, counseling with a quit specialist, group programs, telephone counseling and text-message programs. (USPSTF, 2021)
The FDA-approved medicines are nicotine replacement (patch, gum, lozenge, inhaler or nasal spray), bupropion SR and varenicline. All three types raise quit rates. Combining a long-acting and a short-acting nicotine product works better than one alone, and varenicline appears more effective than nicotine replacement or bupropion. Doses are for your doctor or pharmacist. (USPSTF, 2021)
Quitting in pregnancy
Any counseling helps pregnant people quit, and more intensive counseling works better. Quitting at any point helps, and quitting early in pregnancy helps the baby most. (USPSTF, 2021)
For medicines in pregnancy the evidence is insufficient. As summarized by the USPSTF, the American College of Obstetricians and Gynecologists says nicotine replacement should be considered only after a detailed talk about the risks of smoking and of the medicine, with close supervision. Talk to your doctor. (USPSTF, 2021)
Smoking history and lung cancer screening
If you smoke now or quit within the past 15 years, your pack-years decide whether yearly lung cancer screening applies to you. Read more: pack-year calculator.
Questions people ask
What is the best way to quit smoking?
The USPSTF says combining behavioral support with an FDA-approved medicine raises quit rates more than brief advice or medicines alone. Most combined programs in the studies included at least 4 counseling sessions. (USPSTF, 2021)
Can I use nicotine replacement while pregnant?
The USPSTF found the evidence insufficient on quit-smoking medicines in pregnancy (I statement), and recommends counseling for every pregnant person who smokes (grade A). Ask your doctor before using any medicine. (USPSTF, 2021)
Do e-cigarettes help you quit?
The USPSTF found the evidence insufficient to weigh e-cigarettes as a way to quit (I statement), and advises clinicians to point people to methods with proven effectiveness and established safety. (USPSTF, 2021)
Is there free help to quit?
Yes. 1-800-QUIT-NOW (1-800-784-8669) connects you to your state quitline, where a trained counselor can help you make a plan. Hours and services vary by state. (Smokefree.gov)
This page explains what the guidelines say. It cannot tell you what is right for you: talk to your doctor.