Varenicline is not as effective as which nicotine replacement therapy strategy?

• A. Monotherapy NRT
• B. Combination NRT
• C. Vaping therapy
• D. No therapy

Answer: (B)

Using more than one nicotine replacement approach together—combination NRT—often yields higher quit rates than using varenicline. The patch provides a steady background level of nicotine to prevent withdrawal, while a fast-acting form (like gum or lozenge) tackles craving as it hits, giving immediate relief when cravings spike. This combo addresses both ongoing withdrawal and acute triggers more comprehensively than varenicline alone, which works by partially stimulating nicotine receptors to reduce withdrawal and block reward but doesn’t deliver nicotine itself. In head-to-head comparisons, combination NRT has produced higher abstinence outcomes than varenicline in several trials, so it can be the more effective choice for quitting. Monotherapy NRT lacks the rapid relief component, no therapy obviously won’t help, and vaping therapy has mixed evidence and isn’t consistently superior to combination NRT across populations.