The adverse health effects of smoking to both you and the people around you are by now well known - ranging from a slight cough to death from various cancers and heart disease.

Not only smokers but now also the health authorities and national governments have got the message. Smoking in public places - including pubs, clubs and offices will be banned in England and Wales from 1 July 2007. It is already banned in Scotland. Even without that incentive, the vast majority of smokers want to give up. But how? Let's be honest - giving up is hard. It has been said that nicotine is at least as addictive as heroin and is probably more difficult to give up.

The first few days and weeks are the worst as the body withdraws from its dependence on nicotine. You become irritable, aggressive, anxious, depressed, sleepless and nauseous.

And the easiest thing of all seems to be to light another cigarette. And then you're back to square one.

The good news is that giving up is easier than it was 30 years ago, thanks to a whole range of treatments - nicotine patches, various prescription drugs, counselling, group therapy, etc.

Researchers at the Cochrane Collaboration - an international network of researchers - recently updated their research into the various quit smoking treatments on offer.

Nicotine replacement therapy should be the first port of call for anyone who is a moderate to heavy smoker trying to give up.

Nicotine replacement therapy (NRT) first appeared in the 1980s as nicotine chewing gum and in the 1990s as patches. They're available without prescription from pharmacies (some are even available from supermarkets).

For people who smoke more than 10 cigarettes a day, nicotine replacement therapy boosts the odds of quitting by a factor of 1.5 to 2, say the Cochrane researchers.

It doesn't seem to matter what form you use (patches, gum etc). They all work equally well, but patches are simplest to use. If using patches, an eight-week course seems to be enough. Using them for longer doesn't improve the chances of quitting. Using patches for 16 hours is just as effective as using them 24 hours a day. If using gum, heavy smokers (more than 20 a day) should use the higher dose 4mg rather than 2 mg gum. Heavy smokers may need to use combinations - gum plus patches, for example.

People who've had heart trouble in the past, or who are pregnant or who are breastfeeding, should consult their doctors before using NRT.

However, for mild smokers, under 10 a day, they don't work. Why not? Because these people aren't smoking enough to have become addicted to nicotine.

Other signs of nicotine addiction are getting cravings, smoking within 30 minutes of waking, and getting withdrawal symptoms in previous quit attempts. People who don't have these symptoms may not benefit from NRT either.

Some people have side effects from NRT. The patches can cause skin irritation or rashes, and the gum can sometimes cause aches in the jaw or stomach problems. Inhalers can irritate the membranes inside the nose, particularly in those prone to sinusitis or a runny nose.

Counselling is an effective alternative for these people, say the researchers. But it has to be intensive and ongoing.

Both individual (one-on-one) and group programmes can double the chances of successfully giving up compared to no treatment. There's no evidence that group therapy is better than one-on-one counselling. But some smokers don't like attending groups and prefer one-on-one counselling. Telephone help lines are also effective. But there has to be follow-up; at least three or more phone counselling sessions are needed before quit rates improve compared to no treatment. The more phone counselling sessions, the higher the quit rate.

What about alternative treatments? Acupuncture is no better than placebo, say the researchers. As for hypnotherapy, there's not enough evidence to say yes or no.

What about those on NRT? Does counselling help them? This is less clear - but recent studies suggest that counselling will add to the effectiveness of NRT. The more intensive the counselling the better.

What about good old fashioned sheer will power? About half of the smokers who succeed in quitting manage to do so without any particular support program or treatment. (Cold turkey - sudden abrupt complete cessation - is more likely to be successful than gradually reducing the number of cigarettes down to zero).

Less effective is simple quit smoking advice from a doctor, which often takes place during a consultation for some other problem and tends to be brief and perfunctory. It's better than no advice or no treatment, but not by much. The same goes for self-help materials; they help those who are highly motivated to quit anyway, but don't help as much as intense counselling.

But it's harder. Without any help, the chances of successfully giving up are one in 10. Using a treatment like NRT and/or counselling can reduce this to about one in five.

If you persist you'll manage it. But with treatment, you'll probably get there a lot sooner.

The best news is that an effective, prescription-only medication is now available from Pfizer -
Champix (varenicline). This is the only precription medication authorised for use wthin the UK.

Click here for a FREE confidential Smoking Cessation consultation.

A range of other drugs are sometimes used - anti-anxiety drugs like benzodiazepines and antidepressants - but studies have shown they don't work, say the Cochrane researchers. Some antihypertensive medications work, but can have unpleasant side effects.

But many people don't like the idea of using any kind of medication to quit. They feel the whole idea is to get away from using drugs.