Cigarette smoking remains the commonest cause of preventable mortality in the UK, accounting for about 120, 000 deaths each year among people aged 35 years or more.1 In all, smoking-related disease costs a typical health authority around £15 million a year.2 It is notoriously difficult to stop smoking but success rates are increased if cigarettes are replaced by nicotine given as a medicine. When reviewing nicotine replacement in 1993, we recommended a "combined approach, using nicotine patches plus advice and support".3 Since then, other forms of nicotine replacement have become available. Here we discuss current evidence on the efficacy and safety of different forms of nicotine replacement and consider the place of such therapy.
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