Quitting Smoking Advice
- The best health decision you will EVER make.
- It is NEVER too late to quit!
I strongly believe in smoking cessation, but understand how difficult it is for some people to kick the habit. Feel free to ask me about the use of buproprion HCl [Wellbutrin or Zyban], the new agent varenicline [Chantrix] and or nicotine patches or gum.
If you're a smoker, quitting smoking is the most important step you can take to protect your lungs. It is NEVER too late to quit.
Why should I quit smoking?
You've probably heard how smoking can be harmful to your health and the health of those around you. Here are some ways quitting can be helpful. If you quit, you will:
- Prolong your life.
- Improve your health. Smoking increases your risk of lung cancer, throat cancer, a lung disease called emphysema, heart disease, high blood pressure, ulcers, gum disease, and other conditions.
- Feel healthier. Smoking can cause coughing, poor athletic ability, and sore throats.
- Look better. Smoking can cause face wrinkles, stained teeth, and dull skin.
- Improve your sense of taste and smell.
- Save money.
How can I quit smoking?
There's no one-way to quit smoking that works for everyone. A smoking cessation program may be helpful to you. Ask your doctor about smoking cessation programs in your community.
Before you quit all at once ("cold turkey"), setting a plan will help:
- Pick a date to stop smoking, and then get ready for it.
- Record when and why you smoke. You will come to know what triggers you to smoke.
- Record what you do when you smoke. Try smoking at different times and different places to break the connections between smoking and certain activities.
- List your reasons for quitting. Read over the list before and after you quit.
- Find activities to replace smoking. Be ready to do something else when you want to smoke.
- Ask your doctor about using nicotine gum and patches. Some people find these aids are very helpful. Also ask about a nicotine-free prescription medication, like Zyban, that can help you quit smoking.
What do I do when I quit smoking?
On the day you pick to quit, start that morning without a cigarette. Then follow these helpful tips:
- Don't focus on what you are missing. Think about what you are gaining. (See the section below, "What Happens When You Quit.")
- Tell yourself you are a great person for quitting. Remind yourself of this when you want a smoke.
- When you get the urge to smoke, take a deep breath. Hold it for 10 seconds, and then release it slowly.
- Keep your hands busy. Doodle, play sports, knit, or work on a computer.
- Change activities that were connected to smoking. Take a walk or read a book instead of taking a cigarette break.
- Don't carry a lighter, matches, or cigarettes.
- Go to places that don't allow smoking, such as museums and libraries.
- Eat low-calorie, healthful foods when the urge to smoke strikes. Carrot and celery sticks, fresh fruits, and fat-free snacks are good choices.
- Drink a lot of fluids. Cut down on alcohol and caffeine. They can trigger you to smoke. Select water, herbal teas, caffeine-free soft drinks, and juices.
- Exercise. Exercising will help you relax.
- Hang out with non-smokers.
- Get support for quitting. Tell others about your milestones with pride.
What happens when I quit smoking?
After 20 minutes of not smoking:
- You stop polluting the air
- Your blood pressure and pulse decrease
- The temperature of your hands and feet increases
- The carbon monoxide level in your blood returns to normal
- Oxygen levels in your blood increase
- Your chance of heart attack decreases
- Your nerve endings adjust to the absence of nicotine
- Your ability to taste and smell begins to return
- Bronchial tubes relax
- Your circulation improves
- Your exercise tolerance improves
- Coughing, sinus congestion, fatigue, and shortness of breath decrease
- Cilia in the lungs regrow, increasing the ability of the lungs to handle mucus, clean the lungs, and reduce infection
- Your overall energy level increases
- Your risk of dying from heart disease decreases to half that of a lifelong smoker's risk
- Your risk of dying from lung cancer decreases to half that of a lifelong smoker's risk
- Your risk of dying from lung cancer drops to almost the same rate as a lifelong NON-smoker
- Your risk of other cancers -- of the mouth, larynx, esophagus, bladder, kidney, and pancreas -- decrease
- Crave cigarettes.
- Feel very hungry.
- Cough often.
- Get headaches.
- Have difficulty concentrating.
- Have constipation.
- Feel very tired.
- Have a sore throat.
- Have difficulty sleeping.
Although withdrawal symptoms will be the strongest when you first quit, they should go away within a few weeks.
I've tried quitting before, but it didn't work. Why not?
To quit smoking, you must be ready emotionally and mentally. Some people are more ready to quit than others. Look at these five stages of change that people go through to successfully quit smoking.
Stage One:
Pre-contemplation. You don't want to quit smoking, but you may try to quit because you feel pressured to quit.
Stage Two:
Contemplation. You want to quit someday. You haven't taken steps to quit, but you want to quit.
Stage Three:
Preparation. You take small steps to quit such as cutting back on smoking or switching to a lighter brand.
Stage Four:
Action. You put a plan for quitting into action. You make changes in your actions and environment to help cope with urges to smoke. You cope with urges to smoke by following the plan and remain smoke-free for six months.
Stage Five:
Maintenance. You have not smoked for one year.
Remember: Smoking again (relapse) is common. In fact, 75% of those who quit will smoke again. Most smokers try to quit three times before being successful.
Taming that Overwhelming Urge to Smoke
By Martin Downs NY Times Article : May 9, 2008
In Brief:
The brain of an addicted smoker treats nicotine as if it is essential for survival.
Genetic traits may predispose some smokers to stronger addiction.
Most smokers try to quit unaided, resulting in a high failure rate.
If you smoke, no one needs to tell you how bad it is. So why haven’t you quit? Why hasn’t everyone?
Because smoking feels good. It stimulates and focuses the mind at the same time that it soothes and satisfies. The concentrated dose of nicotine in a drag off a cigarette triggers an immediate flood of dopamine and other neurochemicals that wash over the brain’s pleasure centers. Inhaling tobacco smoke is the quickest, most efficient way to get nicotine to the brain.
“I completely understand why you wouldn’t want to give it up,” said Dr. David Abrams, an addiction researcher at the National Institutes of Health. “It’s more difficult to get off nicotine than heroin or cocaine.”
Smoking “hijacks” the reward systems in the brain that drive you to seek food, water and sex, Dr. Abrams explained, driving you to seek nicotine with the same urgency. “Your brain thinks that this has to do with survival of the species,” he said.
Nicotine isn’t equally addictive for everyone. A lot of people do not smoke because they never liked it to begin with. Then there are “chippers,” who smoke occasionally but never seem to get hooked. But most people who smoke will eventually do it all day, every day.
New discoveries in genetics may explain why certain people take to smoking with such gusto and end up so addicted. Some people, for instance, produce a gene-encoded enzyme that clears nicotine from their bloodstreams rapidly, so they tend to smoke more and develop stronger addictions. Others possess special receptors in the brain that bond extra tightly with nicotine, giving them an especially intense high that makes it harder to quit.
Drug makers are exploiting the science of addiction to create novel treatments to help smokers quit. The newest stop-smoking medication, the first to be approved in 10 years, is called Chantix. Available by prescription, Chantix masquerades as nicotine well enough to occupy the brain’s nicotine receptors, where it may lessen cravings. Real nicotine, when it comes along, cannot find enough free receptors to do its thing.
Chantix seems to have a higher success rate than Zyban, an antidepressant that helps to balance dopamine levels. And recently released federal guidelines to doctors for helping smokers quit reported that the drug, combined with the nicotine replacement patch and use of nicotine nasal spray or gum as needed, produced higher long-term abstinence than the patch alone.
Doctors have written millions of prescriptions for Chantix, though enthusiasm for the drug was tempered by reports of suicide and bizarre behaviors in people taking it. The reports prompted the Food and Drug Administration to issue a safety warning about Chantix early in 2008.
“That’s something that needs to be taken very seriously, but it needs to be put in the context of what happens if you don’t quit smoking,” said Dr. Michael Fiore, a smoking cessation specialist at the University of Wisconsin and chairman of the government panel that issued the new guidelines. Dr. Fiore used to consult for Pfizer, the maker of Chantix, but said he cut those ties in 2005. He still prescribes the drug but now takes care to discuss the safety warning with patients.
Dr. Nancy Rigotti was involved in Chantix studies conducted at Massachusetts General Hospital in Boston, where she directs the Tobacco Research and Treatment Unit. “Those trials mostly enrolled people who were pretty healthy,” she said. “They did not include people with depression or much of a history of depression.”
Dr. Rigotti said it was possible that varenicline, the generic name for Chantix, “might have more psychiatric side effects in certain groups of people.”
Continued research should help to resolve lingering concerns about the safety of Chantix. Meanwhile, experts continue to recommend the old standbys: nicotine replacement gums, patches, nasal sprays, inhalers and lozenges, which have been proved to be safe.
Nicotine by itself does not cause cancer, heart disease or other major health problems linked to smoking; other chemicals in tobacco smoke are to blame. Nicotine replacement can be used alone or with prescription medications or, for best results, combined with counseling. Recent evidence suggests that using two forms simultaneously, like the patch and gum together, works better than either alone.
Although nicotine replacement products do not require a prescription, the F.D.A. limits where and how they are sold. They are also expensive.
“It’s so much easier to go down to the corner store and get a pack of cigarettes than it is to get access to evidence-based treatment,” Dr. Fiore said.
This year, the New York State health commission petitioned the F.D.A. to revise its rules so that nicotine gum, patches and lozenges could be sold anyplace that sells cigarettes, and at prices comparable to a cigarette pack. The agency is currently reviewing the petition.
Still, no treatment works for everyone. And even with the most successful treatments, only about 30 percent of attempts to quit last more than six months. Compared with willpower alone, however, that’s a huge improvement. Fewer than one in 10 smokers who go it alone manages to go six months without a cigarette. Most do not make it past a week.
When longtime smokers finally do quit, they soon realize that not smoking doesn’t necessarily make them nonsmokers. That’s what counseling is for — learning to function without nicotine and to cope with the cues that trigger smoking urges.
Most important, former smokers have to rediscover that it is possible to enjoy life without cigarettes, although the yearning may never die completely.
“I’m an ex-smoker,” Dr. Abrams said, “and I still miss it.” said.
Question and Answer session with Dr. David B. Abrams, executive director of the Steven A. Schroeder National Institute for Tobacco Research and Policy Studies at the American Legacy Foundation, a nonprofit group dedicated to reducing tobacco use. He was formerly director of the Office of Behavioral and Social Sciences Research at the National Institutes of Health. As a researcher and a clinical psychologist, he has studied and treated nicotine addiction for 25 years. He co-wrote an Institute of Medicine report, “Ending the Tobacco Problem: A Blueprint for the Nation,” published in 2007.Q: Do you think it’s much easier to quit smoking now than it was 5 or 10 years ago? A: Yes. There are now a variety of good treatments available that can be tailored to individual smokers. There are good cognitive behavioral treatments for the part of addiction that has to do with needing to unlearn the habit. There have also been some breakthroughs in pharmacologic treatments, from the introduction of the first nicotine replacement therapies to the very recent new drug, Chantix, that’s tailored to nicotine receptors in the brain.
Q: The Food and Drug Administration recently warned about suicidal behavior with Chantix. Are people more wary of trying it now because of that?
A: As with other new drugs, there are a few people that have some untoward reactions. In some of them, frankly, it’s not clear that it’s directly related to the drug itself. They may have other predisposing factors that coincidentally happen around the same time. So I hope there isn’t an overreaction to that. I think it continues to be a very safe and effective drug.
Q: In addition to new medicines, have counseling methods improved?
A: Right. I think one of the biggest breakthroughs was taking the best components of behavioral treatments and boiling them down so they could be distributed widely through different channels, like telephone quit lines and primary care practices, where physicians or nurses can be trained to deliver a brief treatment.
Q: What about changes in social norms? Does less tolerance of smoking in public support the clinical side of treating the addiction?
A: It is probably one of the most important drivers of helping people to quit. It’s not just that it motivates people to quit because it’s more inconvenient to smoke, or because they don’t want to damage the health of people around them. It’s also that there’s less smoking around them at bars or in restaurants, and therefore, they’re not as tempted. The way I like to say it is that once your brain has tasted “chocolate cake” — the powerful benefits of nicotine — it’s very hard to forget it. So every time you’re reminded of it when you see someone smoking, or you smell smoke, you have an instant reaction to want to smoke.
Q: Might smoking bans and high taxes make some smokers feel persecuted, and as a result more recalcitrant about their smoking? Or doesn’t that matter much?
A: I think it does matter. Sometimes when they dig their heels in, it’s because they really don’t feel that they can get the help they need to change. I think you need to be very supportive. But certainly, there will be a small group of people who say, “I have the freedom to smoke, and leave me alone.”
Q: What major obstacles remain for smokers trying to quit?
A: The general public is not as aware of the value of using evidence-based treatment as they should be. When we do surveys of current smokers, a fair number of them actually believe that nicotine replacement products could be as harmful to their health as smoking, which is absolutely not true. It’s the burnt carcinogens in tobacco, and not the nicotine, that’s the really harmful substance. Unfortunately, I think people are not using the best pharmacologic treatments and the best behavioral treatments. They still try to use willpower.
I think another barrier is that busy physicians, because of managed care and other things, have so much pressure to move patients through their offices that they aren’t able to take the time to do brief lifestyle counseling. I would love to see the reimbursement system change to allow physicians to bill for, say, 15 minutes of talk therapy, and allow them to do brief behavioral treatment, along with nicotine replacement or other drug therapies.
We need a system where you have comprehensive continuity of care until the smoker quits. You never give up on a diabetic if they go off their diet or stop taking their insulin. You still bring them back, and you remind them, and you have all sorts of support systems because it’s a lifetime commitment.
We’re talking about a stepped-care system. The idea is that you should give people a chance to use a low-level treatment on their own, but if it doesn’t work, then you need to step them up to a more specialized treatment. In fact, a third step may well be that if you’ve tried to quit with your primary care physician and failed, maybe you ought to be referred to a specialist in addiction treatment.
Q: What do you think about people continuing to use nicotine replacement for a long time after quitting cigarettes?
Q: Is there anything new on the horizon that could make it much easier for people to quit?
A: There are two things that I’m quite excited about. One is the talk with the F.D.A. about systematically reducing nicotine in tobacco over a 5- or a 10-year period. If they did reduce it significantly, there’s a lot of research suggesting that we could, in effect, wean the whole population off their nicotine addiction and get to the point where, gradually, smokers would be less and less addicted and may find it easier to quit. I think as a public health solution, that’s a very good one. I’m hoping that kind of legislation will be taken seriously.
The second thing is that we may be developing a nicotine vaccine — the NicVAX. There is some preliminary evidence that it’s promising. It’s not quite there yet, but it’s particularly useful, perhaps, to prevent relapse.
We’ve got a lot of people trying to quit smoking every year — millions, actually. What we have to do is figure out how to prevent them from relapsing after they quit. I think relapse prevention is the single biggest research challenge. The vaccine may help with that; getting nicotine out of cigarettes would certainly help with that.
Q: Do you think today’s young children will take up smoking the way their parents’ generation did?
A: Of course, my hope would be absolutely not. I hope within 5 to 10 years that the F.D.A. would have approved the reduction of nicotine content in tobacco; therefore, it wouldn’t even be an interesting thing to try, because there would be so little reward value in the small amount of nicotine left. I also hope that because so many fewer parents smoke, that kids would grow up smoke-free. The third thing is, there may well be a more significant vaccine. The real hope is that we could give pre-adolescent kids a vaccine, just like we do for childhood diseases.
If I were to wave a magic wand so that those three things happened, I think we may actually have very close to a smoke-free next generation, which would be my ideal.
Q: What do you say to your friends and family who still smoke?
A: I want to find a way to hold your hand and help you quit, not to be nasty to you and box you in a corner, but really be sympathetic and understand that this is something that you couldn’t help doing. When you were younger and you got hooked on nicotine, you had no idea that you would become a lifetime slave to this substance, because it changed the reward pathway in your brain. I want to help you get over that, and I know it’s extremely hard to do because nicotine is a very powerful addictive substance.
The biggest problem with nicotine is that, actually, your brain works better on nicotine. It improves reaction time, it improves memory, it improves concentration, it helps you get through a frustrating workday. There are reasons why people hang on to nicotine. It’s almost the perfect drug.
I’m an ex-smoker, and I still miss it. I think I might actually have been more productive as a researcher if I’d continued to smoke, because I know it made my brain work better. It’s very, very hard to give up, and I’m very sympathetic.
What to Ask About Quitting
By Martin Downs
Here are some questions you may not think to ask, along with notes on why they’re important.
What do I need to do to prepare to quit?
Maybe you are ready today, but your doctor may suggest that you plan for a quit date in the near future. Ask about steps you can take before quitting to be better prepared.
Should I use nicotine replacement?
Though you do not need a prescription to buy nicotine gum, patches or lozenges, it’s a good idea to discuss their use with your doctor. Contrary to popular belief, many people can safely use more than one type of nicotine product at the same time. Studies show that using two forms of nicotine replacement simultaneously, like the patch with the gum, works better than using only one.
Is the nicotine in nicotine replacement products harmful?
No. The really harmful substances are the burnt carcinogens in tobacco, not the nicotine. Many people use nicotine replacement for a year or more after quitting. Experts think that for most people there is no harm in long-term use. It’s better to use nicotine replacement forever than to start smoking again.
Should I try a prescription drug?
Research shows that these drugs help people stay smoke-free longer. Doctors have written millions of prescriptions for Chantix, for example, though enthusiasm for the drug has been tempered by recent concerns about side effects like suicidal thoughts and erratic behaviors.
Who else can I talk to?
Most doctors do not have time to stay in close contact with you to find out how you’re doing. But counseling is known to be one of the most effective aids to quitting. The more frequent your contact with a counselor, the better. Ask your doctor for a referral to a trained counselor. Many states offer telephone quitlines that can aid smokers.
Are there alternative quitting aids that you recommend?
The scientific evidence for treatments like hypnosis, herbs and acupuncture is not convincing enough to merit an official recommendation for them. But you and your doctor may want to discuss ideas about complementary treatments to support your effort.
Do I have any factors that might make it harder for me to quit?
Personal circumstances can make quitting easier or harder. Depression or anxiety, for example, may make it harder to quit. Living with nonsmokers may ease the effort. (The Centers for Disease Control and Prevention reports that 75 percent of American homes are now smoke free.) Different smokers may also be more or less addicted to nicotine, and those with stronger addictions may need more help quitting.
Will I gain weight?
Most people put on weight when they quit smoking. Usually it is less than 10 pounds, but about 10 percent of quitters gain up to 30 pounds. Your doctor may be able to refer you to a nutritionist or counselor who can help you make changes to prevent weight gain.
If I quit now, how might my health improve?
For smokers who are still relatively healthy, quitting cigarettes may remove the final barrier to achieving optimal health. But smoking has been linked to all kinds of health ills besides lung cancer or heart disease, including erection problems, arthritis and macular degeneration.
How will quitting smoking affect the health care I’m receiving?
Ask your doctor to re-evaluate you after you have not smoked for a while. Your doctor may, for example, lower your doses for cholesterol or blood pressure medications after you stop smoking.
What if I fail?
Most smokers relapse. Ask your doctor to help you come up with a Plan B in case your first strategy does not succeed.
Have I already done irreparable harm by smoking?
It’s never too late to quit. Discuss your disease risks based upon your smoking history.
Should I be screened for lung cancer?
Most doctors don’t recommend it. On the one hand, a chest X-ray could potentially catch tumors early, and maybe offer better treatment odds. On the other hand, screening may pick up something that looks like cancer but actually isn’t. Having an operation to check out a suspicious spot on the lung may therefore subject you to unnecessary risk, pain and expense.
Will I ever feel good again after quitting?
Smoking is a serious addiction, not just a bad habit. The worst withdrawal symptoms last one to three weeks, but some people crave cigarettes long afterward. You may feel a sense of loss or emptiness after quitting. Ask your doctor to explain the process of nicotine addiction and withdrawal. It’s important to know what is happening in your brain and body to understand how you feel.
Five things to know about quitting smoking:
Dr. Richard H. Carmona, who was surgeon general of the United States from 2002 to 2006, is a distinguished professor at the Mel and Enid Zuckerman College of Public Health at the University of Arizona and president of the nonprofit Canyon Ranch Institute in Tucson. His advice to smokers: “Stop now. It will improve the quality and quantity of your life, no question.” He says that smokers should know these five things about quitting.
1. It’s never too late.
No matter how long you have smoked, you will benefit from quitting. The health benefits start immediately as your body begins to recover from the continual assault of noxious chemicals in tobacco smoke.
The earlier you quit, the less likely you are to get cancer or other smoking-related ills. If you quit before age 53, your disease risk 10 years later would be the same as those of someone who never smoked. But even people who quit in their 60s and 70s have a lower disease risk. If you have a smoking-related illness already, your condition can improve, or at least not worsen, if you quit.
2. Few people kick cigarettes on the first try.
As many as four relapses are common during the first year. Too often people think one or more failed attempts mean they are incapable of quitting. Not so. If you keep falling down, it means you need to try a different approach.
3. Get help.
There are many stop-smoking aids available, including nicotine patches and gums, prescription medicines and counseling. There is strong evidence these things really do help. Try one, or try them all together, to ease the transition and improve your chances of quitting.
4. Cutting down doesn’t cut it.
It can help as a way to prime yourself for quitting, but only if you intend go all the way. In the long run, smoking less often or smoking “light” cigarettes is not safe. For most people, cutting down is not sustainable. If you don’t break the addiction, you are likely to slip back into smoking as much as — or even more than — you did before.
5. America’s smoking days are over.
It’s only going to become more difficult to be a smoker anywhere in the United States. Smoking bans are taking effect in more places nationwide, and this trend is unlikely to stall or reverse. As the smoking population dwindles and as people are less willing to be exposed to tobacco smoke, cigarettes have become less socially acceptable. Increasingly, smokers are strangers in a smoke-free land. Certain people may well need some kind of pharmacologic treatment to correct their brain imbalance, just like some people need long-term medication for serious mental illness. I’d rather see them on long-term nicotine therapy than go back to smoking.
Plan to Become an Ex-Smoker for Good
By Jane E. Brody : NY Times : November 12, 2012
Few smokers would claim that it's easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.
Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.
Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.
Now, however, as we approach the American Cancer Society's 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.
Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.
People ages 18 to 25 now have the nation's highest smoking rate: 40 percent. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?
Challenging, yes, but by no means impossible. on the Web you can download a "Guide to Quitting Smoking," with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.
Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he's helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book's provocative title are "Can't Quit? You Can Stop Smoking.")
"There is no magic pill or formula for beating back nicotine addiction," Dr. Brunswick said. "However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes."
Addiction and Withdrawal
Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.
Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.
Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.
To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.
If you've failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.
Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don't assume you've failed and give up. Just go right back to not smoking.
Aids for Quitting
Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.
All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.
Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.
More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.
Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.
Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.
The cancer society suggests picking a "quit day"; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.
On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.
By Jane E. Brody : NY Times : November 12, 2012
Few smokers would claim that it's easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.
Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.
Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.
Now, however, as we approach the American Cancer Society's 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.
Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.
People ages 18 to 25 now have the nation's highest smoking rate: 40 percent. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?
Challenging, yes, but by no means impossible. on the Web you can download a "Guide to Quitting Smoking," with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.
Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he's helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book's provocative title are "Can't Quit? You Can Stop Smoking.")
"There is no magic pill or formula for beating back nicotine addiction," Dr. Brunswick said. "However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes."
Addiction and Withdrawal
Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.
Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.
Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.
To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.
If you've failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.
Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don't assume you've failed and give up. Just go right back to not smoking.
Aids for Quitting
Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.
All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.
Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.
More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.
Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.
Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.
The cancer society suggests picking a "quit day"; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.
On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.
