Nicotine Anonymous (NicA) is a twelve-step program for people desiring to quit smoking and live nicotine free. As of May 2008, there are 600 meetings in thirty-eight countries worldwide with the overwhelming majority of these meetings occurring in the United States, followed by Canada, Brazil, Australia and the UK, respectively. NicA maintains that total abstinence from nicotine is necessary for recovery. NicA defines abstinence as "a state that begins when all use of nicotine ceases."