OBJECTIVES: The Finnish Health For All 2000 target set in the mid-1980s (at least 80% non-smoking) was not realised. Actually, prevalence of smoking has remained rather constant during the 1990s even after introduction of over-the-counter nicotine replacement (NRT) options. Our intent was to model cost-effectiveness of six methods (willpower, physician advice, NRT [patch, gum, spray], bupropion) to quit smoking as applied in Finnish health care. METHODS: Data on efficacy (% successfully quit smoking during 12 months' observation period) were obtained from published meta-analyses and original articles. Cost data included only direct costs (physician visits, medications, adverse events [occurrence 1% in each treatment]). Costs were estimated using societal perspective (in year 2000 Euros). Decision-tree based average cost-effectiveness estimates (€/additional quitter) and incremental cost-effectiveness ratios (ICER) were derived by using Data 3.5 software. Two-way sensitivity analyses were performed. RESULTS: Efficacy of willpower (1%) and physician advice (3%) were the lowest, followed by NRT patch (13%) and NRT gum (18%) whereas higher for NRT spray (24%) and bupropion (30%). Costs of willpower were set to zero by definition. Cost per additional quitter of bupropion (€954) treatment was the lowest, and NRT spray (€2397) the highest. Bupropion dominated over NRT gum and spray. ICER of NRT patch vs. physician advice was €1495 (€804 for bupropion) whereas ICER of bupropion vs. NRT patch was €404. Sensitivity analyses showed results were robust. CONCLUSIONS: Short-term decision-tree analysis suggests that bupropion is a cost-effective option for physicians in order to help motivated smokers to quit smoking in Finnish health care settings.