12/15/2011 06:38 pm ET Updated Feb 14, 2012

The Best Medicine to Quit Smoking

Most smokers who want to quit smoking don't realize that if they combine two forms of nicotine replacement therapy (NRT), their chances for success are vastly increased. In fact, a combined NRT approach is the best of the medical options available for helping them. Under this treatment, one form of NRT, such as the patch, provides constant relief from nicotine withdrawal. Meanwhile, a second form, for example the gum, lozenge or inhaler, provides a new "ritual," a physical behavior for when an urge to smoke is triggered. The patch, gum and lozenge are all safe enough to be available over the counter at a drug store without a prescription.

Studies on quitting smoking show that combined NRT treatments lead to long-term success for more than one in three smokers who try it, compared with one in four using just one form of NRT. (Fewer than one in six quit successfully using a placebo, and the U.S public Health Service 2008 update cites just a 4-7 percent success rate for "unaided smoking cessation attempts.")

While NRT combination therapy is easing physical dependence on smoking, it also gives quitting smokers a big boost in confidence, a vital factor in long term quitting success. With the physical demands of quitting being addressed by the NRT, a mental shift in perceptions about smoking and quitting also needs to take place. Not surprisingly, we call this shift the "decision to quit." It has a deeper emotional aspect as well, and helps keep the smoker honest about, and committed to, doing what it takes to break free from the physical, mental and emotional dependency that smoking breeds.

Having the short-term support of combined NRT can make all the difference in long-term success at quitting. This approach is especially helpful in those moments, whether prompted by situations, emotions or physical urges to smoke, when you might otherwise find yourself reaching automatically for a cigarette.

Note: I accept no funding from the tobacco or pharmaceutical industries.

Video: "Is Nicotine Replacement Therapy Useful?"

Dr. Daniel Seidman is director of smoking cessation services at Columbia University Medical Center, and author of "Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit," with a foreward by Dr. Mehmet Oz (Simon & Schuster 2010). For more details about the book, go to