Smoking Cessation

Options include nicotine replacement in combination, prescription treatments where appropriate, and a structured plan around a quit date.

Book if

• You want to stop and want it to work this time
• You have tried before and it did not stick
• You are using vapes and want to come off nicotine altogether

Previous attempts are not failures

Most people who stop successfully have several attempts behind them. Each one teaches you where the difficulty is. Starting again is not going backwards.

Please also know

Free NHS stop smoking services are genuinely excellent, and in many areas provide both medication and structured behavioural support at no cost. If that is available and suits you, take it — we will say so.

What we offer is speed and an appointment outside working hours.

1. Set a quit date

Two to three weeks ahead. Long enough to prepare, short enough not to lose momentum.

2. Combine treatments

A long-acting patch for background craving, plus a fast-acting form — gum, lozenge, spray or inhalator — for breakthrough urges. Combination works considerably better than either alone, and is the step most people skip.

3. Plan for the triggers

The first cigarette of the day, alcohol, driving, breaks at work. These are predictable, which means they can be planned for.

4. Follow-up

Support plus medication roughly triples the success rate compared with willpower alone. Follow-up is the support half.

Follow-up is half the treatment

Medication plus behavioural support roughly triples the success rate compared with willpower alone. Follow-up is the support half, and skipping it wastes most of the benefit of the medication.

• Around the quit date — checking the plan and the nicotine replacement combination
• Week 1 and week 2 — the hardest fortnight, and when most attempts end
• Week 4, then 12 — four weeks smoke-free is the recognised marker of a successful quit

What to expect, and when it ends

• Cravings peak in the first three days and are mostly gone by three to four weeks. Individual cravings last only a few minutes, however overwhelming they feel
• Irritability, poor concentration and low mood — usually settling within two to four weeks
• Coughing more for a few weeks, which is the lungs clearing and is a good sign rather than a bad one
• Mouth ulcers, oddly common and temporary

Medication doses often need changing

Under-dosing nicotine replacement is the commonest reason it appears not to work. If you are still craving badly, the answer is usually more, not less.

Use the patch plus a fast-acting form — gum, lozenge, spray or inhalator. The combination is considerably more effective than either alone, and it is the step most people skip.

Two medical points worth knowing

• Stopping smoking changes how some medicines are handled by the body — notably clozapine, olanzapine, theophylline and warfarin. Doses may need adjusting, so tell us what you take
• Asthma and COPD often improve within weeks, and inhaler doses may need reviewing

A slip is not a failure

One cigarette does not undo a quit — treating it as total failure does. Come back, work out what the trigger was, and carry on.

Most people who stop successfully have several attempts behind them. Each one teaches you where the difficulty is, and starting again is not going backwards.

Mood

Low mood in the first weeks is common and usually settles. If it does not, or if you have thoughts of harming yourself, say so — that needs addressing rather than enduring.

Free NHS stop smoking services are excellent — start there

We would rather say this plainly. Local NHS services provide structured behavioural support and, in many areas, free medication and nicotine replacement. They have the best success rates of anything available, and they cost nothing.

You can self-refer. What we offer is speed and appointments outside working hours — which matters if you cannot get to a weekday clinic.

Nicotine replacement — use it properly

Combination is the point: a 16- or 24-hour patch for background craving plus a fast-acting form — gum, lozenge, mouth spray, inhalator or nasal spray — for breakthrough urges.

• All of it is available over the counter, and much of it free through NHS services
• Chew gum slowly and park it against the cheek; chewing it like ordinary gum causes hiccups and does not deliver nicotine properly
• Under-dosing is the commonest error. Nicotine replacement is far safer than smoking, and using too little is what makes people conclude it does not work

Prescription options

Bupropion, and other prescription treatments where appropriate — not suitable with a history of seizures or eating disorders, and requiring discussion of mood effects before starting.

Vaping, honestly

Substantially less harmful than smoking and among the more effective quitting aids — the evidence on that is reasonably clear. Not harmless, and the long-term picture is not yet known.

• If it gets you off cigarettes, it is a gain — the comparison is with smoking, not with nothing
• Aim to come off nicotine eventually, reducing strength gradually
• Never start vaping if you do not smoke, and keep it away from young people

What else helps

• Behavioural support, in any form — group, one-to-one, telephone or app. It is the component with the strongest evidence after medication
• Planning for predictable triggers: the first cigarette of the day, alcohol, driving, breaks at work
• Telling people you are stopping, and removing every ashtray and lighter

What does not work

Cutting down without a quit date — people compensate by inhaling more deeply, and most never actually stop. Hypnotherapy, acupuncture and laser "therapy" — no good evidence, and often expensive. Heated tobacco, which is still tobacco.

What you pay us

• £40 for the consultation, building the plan around a quit date
• £40 for follow-up, which is the part that roughly doubles your chance of success

The free route is better — and we will say so

NHS stop smoking services provide structured behavioural support and, in many areas, free medication and nicotine replacement. They have the best success rates available, and they cost nothing. You can self-refer.

If that is accessible to you, take it. We offer speed and evening or weekend appointments, which matters for shift workers and people who cannot reach a weekday clinic — not a better treatment.

What you pay elsewhere

• Nicotine replacement is available over the counter, and often free through NHS services. Own-brand patches and gum are the same nicotine
• Prescription treatments are inexpensive generics. We earn nothing from what is prescribed

The arithmetic, which is worth doing

Twenty cigarettes a day costs several thousand pounds a year. Whatever you spend on stopping — appointments, patches, gum — is recovered within weeks, and it is the single most cost-effective health intervention there is.

If cost is the barrier to nicotine replacement, say so, because free routes exist and it is worth finding them rather than under-dosing.

Where not to spend money

• Hypnotherapy, acupuncture and laser "stop smoking" treatments — no good evidence, and often several hundred pounds
• Expensive branded nicotine products when own-brand is identical
• Heated tobacco products, which are marketed as safer and are still tobacco

The false economy

Under-dosing nicotine replacement to save money is why most attempts with it fail. Nicotine replacement is far safer than smoking, and using enough of it — patch plus a fast-acting form — is what makes it work.

What actually works?

Medication plus behavioural support, which roughly triples success compared with willpower alone.

Willpower alone works for a small minority. Combining a patch with a fast-acting nicotine product, plus follow-up, is what shifts the odds — and both halves matter.

Should I use the NHS service instead?

If you can, yes — and we will tell you so. NHS stop smoking services are free, structured, often provide free medication, and have the best success rates available. You can self-refer.

We offer speed and appointments outside working hours. That is the difference, not the quality of the treatment.

Is nicotine replacement safe?

Far safer than smoking, and the risk comparison is not close. Nicotine is what makes cigarettes addictive; the tar and combustion products are what cause the harm.

Under-dosing is the commonest mistake. If you are still craving badly, you probably need more, not less.

Patch or gum?

Both — that is the point. A patch for background craving, plus a fast-acting form for breakthrough urges. Combination is considerably more effective than either alone, and it is the step most people skip.

Chew gum slowly and park it against your cheek. Chewing it normally causes hiccups and delivers little nicotine.

Is vaping a reasonable way to stop?

Yes — it is substantially less harmful than smoking and among the more effective quitting aids. The evidence on that is reasonably clear.

It is not harmless, and the long-term picture is not yet known. Aim to come off nicotine eventually by reducing the strength gradually. And never start if you do not smoke.

How long do cravings last?

They peak in the first three days and are largely gone by three to four weeks.

An individual craving lasts only a few minutes, however permanent it feels. That fact is genuinely useful in the moment.

Will I put on weight?

Many people gain a few kilograms, mostly from appetite returning and from nicotine's effect on metabolism ending.

The health benefit of stopping vastly outweighs it — you would need to gain a great deal of weight to offset the gain from quitting. Nicotine replacement blunts it, and the weight can be addressed afterwards. Stopping first is the right order.

I have tried before and failed. Is there any point?

Yes — and previous attempts make success more likely, not less. Most people who stop permanently have several attempts behind them.

Each attempt teaches you where the difficulty is. Starting again is not going backwards.

I have slipped and had one. Have I ruined it?

No. One cigarette does not undo a quit — treating it as total failure does.

Work out what the trigger was, plan for it, and carry on from today.

Does stopping affect my other medication?

Yes, and it is worth knowing. Smoking affects how the body handles several medicines — notably clozapine, olanzapine, theophylline and warfarin — and doses may need adjusting when you stop.

Tell us everything you take.

How quickly do things improve?

Faster than people expect. Heart rate and blood pressure fall within a day; carbon monoxide clears within 48 hours; circulation and lung function improve over weeks to months.

Coughing more for a few weeks is the lungs clearing — a good sign rather than a setback.