Around 23% of people in Luxembourg aged 16 and over smoke. Tobacco use remains particularly widespread among young adults, yet many want to quit: in 2024, 46% of smokers stated that they were aiming to quit, whilst a third had already tried to do so in the past year.
Among 16- to 24-year-olds, as many as 62% would like a smoke-free life. And one in two has already tried to quit – mostly without professional help.
But people wanting to quit smoking often hit a wall. Physical and psychological dependence on nicotine makes it difficult to quit, and withdrawal symptoms such as irritability, sleep disturbances or a depressed mood make it even harder to give up.
Those who wish to quit for the long term should try a combination of behavioural therapy and medication. Studies show that the chances of success increase when psychological counselling is combined with nicotine replacement therapy or prescription medication.
Why nicotine replacement helps
In nicotine replacement therapy, the body continues to receive the nicotine it craves, but without the harmful substances found in tobacco smoke.
Products such as patches, chewing gum, lozenges, inhalers or sprays release pure nicotine in controlled doses. This reduces the craving for a cigarette, and withdrawal symptoms become less severe.
Treatment can begin even before you actually stop smoking and usually lasts for several weeks to months. Patches are suitable for people who smoke heavily – for example, a packet of cigarettes or more per day – because they maintain a steady level of nicotine in the blood.
Chewing gum or sprays work more quickly but for a shorter duration. Heavy smokers can combine patches with a more short-acting solution.
Nicotine replacement products are generally considered well tolerated. Possible side effects include irritation of the skin or oral mucosa, and occasionally stomach discomfort. Serious complications are rare. It is important to use the products regularly and correctly to avoid sudden fluctuations in nicotine levels.
Medicines for quitting smoking
Where the level of dependence is severe, doctors may prescribe medicines that intervene more deeply in the brain’s metabolism. They aim to reduce the craving for nicotine and alleviate withdrawal symptoms.
The most common active ingredients are varenicline, bupropion and cytisine. All three affect the nicotinic receptors in the brain to which nicotine normally binds. This weakens the reactions that lead to “feelings of reward” when a cigarette is smoked.
Varenicline blocks the effects of nicotine whilst also alleviating withdrawal symptoms. Studies show that it improves the chances of successfully quitting smoking more effectively than other medications. However, nausea, sleep disturbances or headaches may occur.
Bupropion was originally developed to treat depression. It also acts on the neurotransmitters in the brain that are partly responsible for nicotine cravings. Side effects such as dizziness or sleep problems are possible. In rare cases, bupropion can trigger seizures, which is why its use should be strictly monitored by a doctor.
Cytisine has a similar effect to varenicline, is of plant origin and is taken in tablet form. It reduces the urge to smoke, but may cause dizziness or changes in appetite. Medical supervision is also required here.
Costs and reimbursement
In Luxembourg, the Caisse Nationale de Santé (CNS) national health insurance fund, in collaboration with the Ministry of Health, supports people wishing to quit smoking through the national “Programme d’aide au sevrage tabagique” stop smoking programme. The costs of medical support and withdrawal medications are partially or fully reimbursed.
Medical consultations under the programme are covered at the standard reimbursement rate of 88%. The first consultation (code E40) and the final consultation (code E45) are fully reimbursed by the health insurance fund.
When it comes to withdrawal medication, the CNS covers 50% of the costs, up to a maximum of €100. This is subject to the condition that participants are insured with the CNS and are taking part in a supervised cessation programme.
Combined approaches show the greatest success
A combination of psychological support, behavioural change and nicotine replacement or medication is usually the most promising approach. The use of preparations or apps alone is often insufficient to prevent relapses. A coordinated therapy that takes into account motivation, habits and physical dependence is crucial.
Experts recommend choosing a method based on the individual’s situation. Previous attempts to quit, potential side effects and personal preferences all play a role. A medical consultation helps to find the right approach and avoid risks.