The thought of giving up smoking can be daunting for smokers, especially those who have tried before and failed. Here Patricia Ryan looks at what works and what doesn't

Cutting out smoking for good is extremely hard to do. In the last two years 51% of Irish smokers have tried to quit without success. 29% of the Irish adult population smokes. 14% of the population are ex-smokers. While equal numbers of men and women smoke, men are heavier smokers with 53% of male smokers smoking over 15 cigarettes a day versus 44% of female smokers. People more likely to smoke are under 50 and people in lower socio-economic groups. Here we look at available techniques to help you find the best way to make this new century a smoke-free zone ... NICOTINE REPLACEMENT THERAPY Don't dismiss nicotine replacement therapy (NRT) a way of providing nicotine without tobacco via patches, nasal sprays or gum. If you've tried it before you may not have given it a chance to work properly. There is indisputable evidence that it doubles people's chances of stopping smoking successfully. It's not a magic cure, however, and needs to be used in combination with other non-drug strategies for it to work. The biggest problem is people often don't use it for long enough and tend to relapse quickly when they stop using it too soon. Nicotine gum Nicotine gum comes in two strengths (2mg or 4mg). Heavier smokers should use the 4mg gum and lighter smokers should be fine with the 2mg variety. The gum can't help with cravings unless you give it a chance to build up the amount of nicotine in your bloodstream. If you want to succeed, you've got to use around ten to 15 pieces a day in the first few weeks after stopping. For the best absorption, chew it a bit then rest it against your cheek for a few minutes before having another go. Pros: It's easy to control your dose to suit your level of addiction. Cons: Your chewing technique must be right for it to work properly. Nicotine patches These come in three different strengths, 5mg, 10mg and 15mg. Some are intended for use around the clock and others (16-hour patches) are for daytime use only. They all have the advantage that they deliver a steady dose of nicotine into the blood through the skin and are easy to use. Pros: 24-hour patches may help with anxieties about early morning cravings. Cons: A few people may get a bad skin reaction when using patches. Nicotine nasal spray This is the most powerful kind of NRT and available only on private prescription. It delivers a shot of nicotine very rapidly through the lining of the nose and can help with cravings quickly. It is recommended for heavy smokers who have tried everything else. Pros: Fast-acting and can help heavily addicted smokers. Cons: A bit more difficult to get hold of in some areas and causes nasal irritation at first. Nicotine inhaler This is a newcomer which is about as strong as 2mg gum. To use, you simply suck on the inhaler and nicotine vapour, mixed with menthol, passes into your mouth and throat where it is absorbed into your body. Pros: Helps if you can't think what to do with your hands. Cons: A bit similar to the action of smoking and may remind you of what you're missing. Microtab Another newcomer which you allow to dissolve on your tongue (it takes about 20-30 minutes to do so) and will give the same relief from cravings as you'd expect from 2mg gum. If you smoke 20 cigarettes a day, then you'll need to use one Microtab every hour but you can increase this to two if you need more help. Pros: Early trials have shown that Microtab has few side-effects. Cons: You might not use enough for maximum benefit. * Extracted by Lucy Shakeshaft from Stop! No Smoking Programme by Nicola Willis, to be published by Vermilion on January 6 at stg£6.99. ONES TO AVOID Herbal capsules (Nicobrevin) This product is unlikely to help you stop smoking. It's intended to improve your respiratory abilities and control withdrawal symptoms but there's no good evidence to show that it does anything helpful for smokers. Silver Acetate gum and mouthwash (Giv-Up) The idea is that after using this, cigarettes will taste unpleasant. Again, there's no evidence they work and you get the effect only when you actually light up. They also give some people indigestion and nausea. Dummy cigarettes (Flowers, Crave-away, Everlasting Cigarettes) These plastic replicas of cigarettes are supposed to simulate the hand-to-mouth feel of a real cigarette and give you something to fiddle with. But they may even trigger cravings by reminding you of the very thing you're trying not to do. Herbal cigarettes Even though herbal cigarettes don't contain nicotine, smoking them will hurt you by putting tar and carbon monoxide into your body. Even if you persist with them, you'll still be hooked on the whole idea of smoking. Graduated filters These products are designed to fit over the end of your cigarette and filter out some of the tar and nicotine that passes into your body. Your best option is to stop smoking completely, so don't be beguiled by the idea that they will let you carry on. Tobacco-flavoured chewing gum: Chewing this when you have a craving won't do you any harm, but there's no evidence it'll help. So you might as well use nicotine gum for help with cravings or regular gum if you just want something to do with your mouth. Scented inhalers (Logado) These are meant to be sniffed when you have a craving and, in some ways, help with withdrawal. Carry one around if you wish, but don't expect it to help much.

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