This review summarizes the effectiveness and safety of pharmacological interventions for smoking cessation. The study compared nicotine replacement therapy (NRT), bupropion, and varenicline with placebo and each other, as well as other treatments like cytisine, nortriptyline, clonidine, and others. The primary outcome was sustained abstinence from smoking for at least six months, while secondary outcomes included adverse events and serious adverse events. NRT and bupropion were both more effective than placebo in achieving long-term abstinence. Varenicline was more effective than both NRT and bupropion. Varenicline was more effective than single forms of NRT, but not more effective than combination NRT. Cytisine showed positive results with minimal adverse events. Nortriptyline also improved the chances of quitting. Bupropion had a known risk of seizures, but the rate in the studies was lower than expected. Varenicline showed no significant increase in neuropsychiatric or cardiovascular events. Clonidine helped with quitting but had side effects. Mecamylamine combined with NRT may help, but the evidence is inconclusive. Other treatments did not show significant benefit compared to placebo. The study found that NRT, bupropion, varenicline, and cytisine all improved the chances of quitting. Combination NRT and varenicline were equally effective as quitting aids. Nortriptyline also improved the chances of quitting with minimal harm. The study concluded that none of the treatments had an incidence of adverse events that would mitigate their use. Further research is needed into the safety of varenicline and the potential of cytisine as an effective and affordable treatment. The study also noted that further research into NRT versus placebo is unlikely to change current understanding. The review highlights the importance of balancing the potential benefits and harms of these treatments.This review summarizes the effectiveness and safety of pharmacological interventions for smoking cessation. The study compared nicotine replacement therapy (NRT), bupropion, and varenicline with placebo and each other, as well as other treatments like cytisine, nortriptyline, clonidine, and others. The primary outcome was sustained abstinence from smoking for at least six months, while secondary outcomes included adverse events and serious adverse events. NRT and bupropion were both more effective than placebo in achieving long-term abstinence. Varenicline was more effective than both NRT and bupropion. Varenicline was more effective than single forms of NRT, but not more effective than combination NRT. Cytisine showed positive results with minimal adverse events. Nortriptyline also improved the chances of quitting. Bupropion had a known risk of seizures, but the rate in the studies was lower than expected. Varenicline showed no significant increase in neuropsychiatric or cardiovascular events. Clonidine helped with quitting but had side effects. Mecamylamine combined with NRT may help, but the evidence is inconclusive. Other treatments did not show significant benefit compared to placebo. The study found that NRT, bupropion, varenicline, and cytisine all improved the chances of quitting. Combination NRT and varenicline were equally effective as quitting aids. Nortriptyline also improved the chances of quitting with minimal harm. The study concluded that none of the treatments had an incidence of adverse events that would mitigate their use. Further research is needed into the safety of varenicline and the potential of cytisine as an effective and affordable treatment. The study also noted that further research into NRT versus placebo is unlikely to change current understanding. The review highlights the importance of balancing the potential benefits and harms of these treatments.