Simultaneous use of multiple strategies is most effective: Establishment of a quit date Behavior modification techniques Group sessions Nicotine replacement therapy (by gum, transdermal patch, inhaler, lozenge, or nasal spray) Varenicline or bupropion Physician encouragement Quit rates > 50% at 1 year have not been demonstrated even with the most effective interventions, such as use of bupropion combined with nicotine replacement or use of varenicline alone.