Smoking

At a glance

  • There are many good reasons to quit smoking.
  • Most people succeed with the right motivation. But it often takes a couple of attempts.
  • It helps to plan well. There is also lots of free support available.
  • Nicotine replacement therapies and certain medications can relieve the withdrawal symptoms and increase your chances of succeeding.
  • E-cigarettes are a less harmful alternative to tobacco for people who don’t want to or can't go without nicotine completely.

Introduction

Photo of man wearing sunglasses

Reaching for a cigarette after a meal, during a break or with a beer outside a bar is a habit many people enjoy. About 30% of people in Germany smoke tobacco. But most of them try to quit smoking at some point.

There are many good reasons to do so: Smoking increases the risk of various diseases and is an added expense. Tobacco smoke is also harmful to other people around you. For example, passive smoking at home can be damaging to a child’s health.

Because the nicotine in tobacco can become addictive after just a short time, most people find it difficult to quit smoking. And it takes motivation to give up old habits. But most people do eventually succeed. It often takes several attempts, though.

The good news is that there are many support options and treatments that can increase your chances of success.

Effects

Long-term smoking reduces life expectancy by several years and has lots of negative effects on your health. It increases the risk of many types of cancer, in particular lung cancer and malignant tumors in the mouth and throat. It also makes you more prone to infectious diseases like colds, flu, and pneumonia. Over time it can lead to a chronic cough and lung disease.

Smoking also reduces physical fitness and damages your cardiovascular system. That can cause follow-up diseases like heart attack and stroke. It affects your teeth and gums, too. For instance, smokers are more likely to have gum inflammations and periodontitis.

Wounds heal more slowly in people who smoke. They also have an increased risk of complications after an operation. And last but not least, smoking can make the skin age prematurely and impair fertility and potency.

In pregnant women, smoking can affect the unborn child’s development. The harmful substances from smoke can reduce oxygen supply. This is one of the reasons why miscarriages are more common in women who smoke. It also increases the risk of the baby being born prematurely, too small or underweight.

Good to know

By the way: Even people who only smoke a little or occasionally may already be doing damage to their health.

Treatment

Most people who smoke manage to quit at some point. It often takes several attempts. But there are lots of options for increasing the chances of successfully quitting smoking. They include:

  • Advice: For instance from addiction advice centers, support groups, your family doctor, your company physician, and some health authorities. The German Federal Centre for Health Education (BZgA) also offers free online and telephone advice.
  • Courses and programs for quitting smoking: These are usually group courses offered by various providers. If the courses are quality assured, health insurance providers cover the costs in part or in full. Many health insurance providers also offer their own programs for quitting smoking. There is also an app-based stopping smoking program that can be prescribed by doctors.
  • Nicotine replacement therapy: It can relieve physical withdrawal symptoms and so increase the chances of successfully quitting smoking. The nicotine from the tobacco is replaced with nicotine plasters or chewing gum, gradually weaning your body off the nicotine. Nicotine replacement products are available from pharmacies without a prescription.
  • Medication: Medication approved for quitting smoking also increases the chances of successfully stopping smoking. The active ingredients bupropion (Zyban), varenicline (Champix) and cytisine (Asmoken) are currently approved. They have to be prescribed by a doctor.

People who combine non-medicinal treatments like quitting smoking programs or regular telephone counseling with nicotine replacement therapy or medication have the best chances of success. And there is no reason to be disappointed if you do not succeed on your first attempt. That is entirely normal, but most people do succeed at some point.

There is no proof that other treatments like , herbal products like St. John’s wort, and hypnosis increase the chances of quitting smoking.

Not (yet) ready to quit smoking?

E-cigarettes can help you to give up tobacco. They are less harmful than tobacco smoke. E-cigarettes can be the lesser evil for people who are not (yet) ready to quit smoking. But they are not harmless: The vapor inhaled when smoking e-cigarettes also contains harmful substances and usually nicotine, too.

Many people who manage to quit smoking tobacco by using e-cigarettes continue to “vape” for a long time. That is why it's advisable for people who want to completely quit nicotine and replacements to choose other methods.

Tobacco heaters have also been available for a number of years. They heat the tobacco to lower temperatures instead of burning it. Experts suppose that tobacco heaters are more harmful than e-cigarettes but less harmful than cigarettes. They are not suitable for giving up nicotine or tobacco.

Everyday life

Quitting smoking also has a lot of advantages in daily life. You can already smell and taste better within a short time and your lung function also improves after just a few weeks. What is more, the often unpleasant smell for others also disappears.

Many people worry that they will put on weight if they quit smoking. Many people do actually put on a little weight, especially in the first year. The reason is not just that they eat or snack more – their metabolism also changes. Smoking also suppresses hunger.

But whether you put weight on or not is entirely individual. Some ex-smokers don't put on any weight at all or even lose weight, while others put on several pounds. Gaining a little weight is definitely better for your health than smoking – and your metabolism and weight might also return to normal over time.

Barnes J, McRobbie H, Dong CY et al. Hypnotherapy for smoking cessation. Cochrane Database Syst Rev 2019; (6): CD001008.

Batra A, Kiefer F, Andreas S et al. S3-Leitlinie „Rauchen und Tabakabhängigkeit: Screening, Diagnostik und Behandlung“. AWMF-Registernr.: 076-006. 2021.

Deutsches Krebsforschungszentrum (DKFZ). E-Zigaretten und Tabakerhitzer - ein Überblick. 2020.

Edwards SA, Bondy SJ, Callaghan RC et al. Prevalence of unassisted quit attempts in population-based studies: a systematic review of the literature. Addict Behav 2014; 39(3): 512-519.

Hartmann-Boyce J, McRobbie H, Lindson N et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev 2020; (10): CD010216.

United States Public Health Service Office of the Surgeon General, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Smoking Cessation: A Report of the Surgeon General. 2020.

White AR, Rampes H, Liu JP et al. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev 2014; (1): CD000009.

World Health Organization (WHO). WHO report on the global tobacco epidemic 2021: addressing new and emerging products. 2021.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

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Updated on September 7, 2022
Next planned update: 2025

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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