Researchers from Iceland have found that combined methods of nicotine replacement therapy are more effective than using just one.

Dr Thorsteinn Blondal and colleagues from National University Hospital in Iceland, along with researchers from Sweden, found that patients combining the use of nicotine patches with nicotine nasal sprays were twice as likely to still be abstaining from smoking after five years than those who had only used patches.

The British Medical Journal reports that the researchers monitored 237 smokers aged 22 to 66 over a six-year period.

Volunteers were split into groups and given either a patch and a nasal spray, or a patch and a dummy placebo spray to help them stop smoking.

They found the most effective way to stop smoking was to use a nicotine patch for five months in conjunction with a nicotine nasal spray and then continue to use the spray only for a further seven months.

The scientists believe that this is because the patches release nicotine slowly, with the nasal spray delivering nicotine more rapidly, as and when the smoker needs to respond to any smoking urges.

Complex craving

Clive Bates, director of Action on Smoking and Health, said: "The two methods together seem to help to deal with the complex pattern of craving that smokers experience.

"The nicotine patches give a steady, measured dose, while the sprays give a potent hit."

Mr Bates said 4m smokers tried to quit the habit every year in the UK alone, but only about 150,000 succeeded permanently.

He said people wanting to give up should seek advice from their GP or local pharmacist.

"There are many products available now to help people give up, but you still need a lavish amount of willpower, and to be psychologically ready to give up," he said.

Mr Bates said it was a good idea to plan a strategy for giving up well in advance. For instance, it was wise to develop an exercise regime to guard against putting on weight.