Doctors are learning to become more persistent in encouraging patients. This is because half of smokers will quit eventually, although it may require many attempts to kick the habit. Medications and behavior therapy can help double quit rates. Recently, devices to deliver nicotine have caused the greatest increase in smoking cessation since the Surgeon General's report. One of these, the nicotine patch, is most responsible because it became available without a prescription.
Nicotine gum is used for times of craving along with the patch.
Earlier concerns about nicotine overdose or adverse cardiovascular problems caused by high nicotine exposure do not seem to be supported by studies of patients combining these delivery mechanisms in moderate levels. Smoking while wearing the patch seems to be relatively safe as well but patients with possible heart disease should consult their physician. Other devices available by prescription are the nicotine nasal spray and nicotine inhaler. These are effective but the long term effects are still being studied. This drug is usually started about a week before the planned quit date.