If you’ve been a smoker for some time, you know how hard it can be to quit. You probably also know how damaging smoking is to your health. Smoking is the single largest preventable cause of disease, disability, and premature death in the U.S. The good news is that it’s never too late to work on quitting.
Nicotine: a powerful addiction
Quitting smoking is hard because nicotine is a very addictive drug. For some people, it can be as addictive as heroin or cocaine. (Addiction can be described as compulsive drug-seeking and use, even in the face of negative health consequences.) The discomfort of withdrawal from nicotine upon quitting is the primary reason that people resume smoking. In fact, more people in the U.S. are addicted to nicotine than any to any other chemical.
People usually don’t realize that the cigarette is a very powerful drug-delivery system. By inhaling, the smoker can get nicotine to the brain very rapidly. A smoker may take 10 puffs on a cigarette over a period of five minutes during which the cigarette is lit. Thus a person who smokes about 30 cigarettes a day gets 300 “hits” of nicotine to the brain each day. This contributes greatly to nicotine’s highly addictive nature. In addition to nicotine, tobacco contains more than 19 known cancer-causing chemicals (most are collectively known as "tar") and more than 4,000 other chemicals. Smoking is clearly a dangerous habit.
Good reasons for quitting smoking
Each time you try to quit, you can learn about what helps and what hurts. When you quit smoking:
- You will live longer and live better.
- You will lower your chance of having a heart attack, stroke, or cancer.
- If you are pregnant, quitting smoking will improve your chances of having a healthy baby.
- The people you live with, especially your children, will be healthier.
- You will have extra money to spend on things other than cigarettes.
Five keys to quitting
Studies have shown that the following five steps will help you quit and quit for good. You have the best chances of quitting if you use them together. No single method works for everyone; a combination of therapies often works best.
1. Get ready.
- Set a firm quit date.
- Change your environment.
- Get rid of all cigarettes and ashtrays in your home, car, and place of work.
- Don't let people smoke in your home.
- Review your past attempts to quit. Think about what worked and what did not.
- Once you quit, don't smoke—not even a puff.
2. Get family and medical support. Studies have shown that you have a better chance of being successful if you have help. You can get support in many ways:
- Share your plan. Tell your family, friends, and co-workers that you are going to quit and you want their support. Ask them not to smoke around you or leave cigarettes out.
- Talk to your health care provider (for example, a doctor, dentist, nurse, pharmacist, psychologist, or smoking counselor).
- Get individual, group, or telephone counseling. The more counseling you have, the better your chances are of quitting. Programs are provided at local hospitals and health centers. Call your local health department for information about programs in your area.
3. Learn new skills and behaviors.
- Try to distract yourself from urges to smoke. Plan an activity during a typical “smoking trigger” time: talk to someone, go for a walk, or get busy with a task.
- When you first try to quit, change your routine. Use a different route to work. Drink tea instead of coffee. Eat breakfast in a different place.
- Keep healthy snacks, such as carrot sticks, nearby to munch on (if it helps, you can even handle them as you used to handle cigarettes).
- Do something to reduce your stress. Take a hot bath, exercise, or read a book.
- Plan something enjoyable to do every day.
- Drink a lot of water and other fluids.
- Eat a well-balanced diet and get enough sleep.
4. Get medication and use it correctly. Medications can help you stop smoking and lessen the urge to smoke. The U.S. Food and Drug Administration (FDA) has approved a number of medications to help you quit smoking.
Nicotine replacement therapy
Smoking cessation products known as nicotine replacement are designed to wean your body off cigarettes. They supply nicotine in controlled amounts without all the other harmful components found in cigarette smoke.
Over the counter (OTC) nicotine replacement products are sold under brand names and private labels, and as generic products. They are approved for sale to people 18 years of age and older. OTC nicotine replacement products include:
- Skin patches available as generics known as transdermal nicotine patches, as private-label products, and under the brand names Habitrol and Nicoderm. These patches are affixed to the skin, similar to how you would apply an adhesive bandage.
- Chewing gum available as a generic product known as nicotine gum, as private-label products, and under the brand name Nicorette.
- Lozenges available as generics known as nicotine lozenges, as private-label products, and under the brand name Commit.
Prescription-only nicotine replacement products are available only under the brand name Nicotrol and are available both as a nasal spray and an oral inhaler.
Products not containing nicotine
Two medicines that do not contain nicotine have FDA's approval as smoking cessation products. They are Chantix (varenicline tartrate) and Zyban (buproprion). Both are available in tablet form on a prescription-only basis. Ask your health care provider for advice and carefully read the information on the package. All of these medications will more or less double your chances of quitting and quitting for good. Everyone who is trying to quit may benefit from using a medication. If you are pregnant or trying to become pregnant, nursing, under age 18, smoking fewer than 10 cigarettes per day, or have a medical condition, talk to your doctor or other health care provider before taking medications.
5. Be prepared for relapse or difficult situations. Most relapses (resuming smoking) occur within the first three months after quitting. Don't be discouraged if you start smoking again. Remember, most people try several times before they finally quit. Here are some difficult situations to watch for:
- Alcohol. Avoid drinking alcohol. Drinking lowers your chances of success.
- Other smokers. Being around smoking can make you want to smoke.
- Weight gain. Many smokers will gain weight when they quit, usually less than 10 pounds. Eat a healthy diet and stay active. Don't let weight gain distract you from your main goal: quitting smoking. Some quit-smoking medications may help delay weight gain.
- Bad mood or depression. There are a lot of ways to improve your mood other than smoking.
- Other triggers. Try to identify what triggers – physical activities, locations and circumstances – you associate with lighting up. One of your most important tasks will be to avoid as many triggers as you can. Common triggers for smokers include waking up in the morning; ending a meal; drinking coffee or alcohol; studying; relaxing in a particular place; and feeling stressed. Dealing with triggers effectively is especially important during the first three weeks, when your urge to smoke is the greatest.
If you are having problems with any of these situations, talk to your doctor or other health care provider about ways to cope.
Special situations where quitting is key
Studies suggest that everyone can quit smoking. Your situation or condition can give you a special reason to quit.
- Pregnant women/new mothers. By quitting, you protect your baby's health and your own.
- Hospitalized patients. By quitting, you reduce health problems and help healing.
- Heart attack patients. By quitting, you reduce your risk of a second heart attack.
- Lung, head, and neck cancer patients. By quitting, you reduce your chance of a second cancer.
- Parents of children and adolescents. By quitting, you protect your children and adolescents from illnesses caused by second-hand smoke.
Sources: U.S. Food and Drug Administration, U.S. Centers for Disease Control and Prevention
This article is information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Blue Shield of California does not endorse other resources that may be mentioned here.