Smoking Cessation

This document explains the best ways for you to quit smoking and new treatments to help. It lists new medicines that can double or triple your chances of quitting and quitting for good. It also considers ways to avoid relapses and concerns you may have about quitting, including weight gain.

NICOTINE: A POWERFUL ADDICTION

If you have tried to quit smoking, you know how hard it can be. It is hard because nicotine is a very addictive drug. For some people, it can be as addictive as heroin or cocaine. Usually, people make 2 or 3 tries, or more, before finally being able to quit. Each time you try to quit, you can learn about what helps and what hurts. Quitting takes hard work and a lot of effort, but you can quit smoking.

QUITTING SMOKING IS ONE OF THE MOST IMPORTANT THINGS YOU WILL EVER DO.

  • You will live longer, feel better, and live better.

  • The impact on your body of quitting smoking is felt almost immediately:

  • Within 20 minutes, blood pressure decreases. Pulse returns to its normal level.

  • After 8 hours, carbon monoxide levels in the blood return to normal. Oxygen level increases.

  • After 24 hours, chance of heart attack starts to decrease. Breath, hair, and body stop smelling like smoke.

  • After 48 hours, damaged nerve endings begin to recover. Sense of taste and smell improve.

  • After 72 hours, the body is virtually free of nicotine. Bronchial tubes relax and breathing becomes easier.

  • After 2 to 12 weeks, lungs can hold more air. Exercise becomes easier and circulation improves.

  • Quitting will reduce your risk of having a heart attack, stroke, cancer, or lung disease:

  • After 1 year, the risk of coronary heart disease is cut in half.

  • After 5 years, the risk of stroke falls to the same as a nonsmoker.

  • After 10 years, the risk of lung cancer is cut in half and the risk of other cancers decreases significantly.

  • After 15 years, the risk of coronary heart disease drops, usually to the level of a nonsmoker.

  • 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 these 5 steps will help you quit smoking and quit for good. You have the best chances of quitting if you use them together:

  1. Get ready.

  2. Get support and encouragement.

  3. Learn new skills and behaviors.

  4. Get medicine to reduce your nicotine addiction and use it correctly.

  5. Be prepared for relapse or difficult situations. Be determined to continue trying to quit, even if you do not succeed at first.

1. GET READY

  • Set a quit date.

  • Change your environment.

  • Get rid of ALL cigarettes, ashtrays, matches, and lighters in your home, car, and place of work.

  • Do not let people smoke in your home.

  • Review your past attempts to quit. Think about what worked and what did not.

  • Once you quit, do not smoke. NOT EVEN A PUFF!

2. GET SUPPORT AND ENCOURAGEMENT

Studies have shown that you have a better chance of being successful if you have help. You can get support in many ways.

  • Tell your family, friends, and coworkers that you are going to quit and need their support. Ask them not to smoke around you.

  • Talk to your caregivers (doctor, dentist, nurse, pharmacist, psychologist, and/or smoking counselor).

  • Get individual, group, or telephone counseling and support. The more counseling you have, the better your chances are of quitting. Programs are available at local hospitals and health centers. Call your local health department for information about programs in your area.

  • Spiritual beliefs and practices may help some smokers quit.

  • Quit meters are small computer programs online or downloadable that keep track of quit statistics, such as amount of "quit-time," cigarettes not smoked, and money saved.

  • Many smokers find one or more of the many self-help books available useful in helping them quit and stay off tobacco.

3. LEARN NEW SKILLS AND BEHAVIORS

  • Try to distract yourself from urges to smoke. Talk to someone, go for a walk, or occupy your time with a task.

  • When you first try to quit, change your routine. Take a different route to work. Drink tea instead of coffee. Eat breakfast in a different place.

  • Do something to reduce your stress. Take a hot bath, exercise, or read a book.

  • Plan something enjoyable to do every day. Reward yourself for not smoking.

  • Explore interactive web-based programs that specialize in helping you quit.

4. GET MEDICINE AND USE IT CORRECTLY

Medicines can help you stop smoking and decrease the urge to smoke. Combining medicine with the above behavioral methods and support can quadruple your chances of successfully quitting smoking.

The U.S. Food and Drug Administration (FDA) has approved 7 medicines to help you quit smoking. These medicines fall into 3 categories.

  • Nicotine replacement therapy (delivers nicotine to your body without the negative effects and risks of smoking):

  • Nicotine gum: Available over-the-counter.

  • Nicotine lozenges: Available over-the-counter.

  • Nicotine inhaler: Available by prescription.

  • Nicotine nasal spray: Available by prescription.

  • Nicotine skin patches (transdermal): Available by prescription and over-the-counter.

  • Antidepressant medicine (helps people abstain from smoking, but how this works is unknown):

  • Bupropion sustained-release (SR) tablets: Available by prescription.

  • Nicotinic receptor partial agonist (simulates the effect of nicotine in your brain):

  • Varenicline tartrate tablets: Available by prescription.

  • Ask your caregiver for advice about which medicines to use and how to use them. Carefully read the information on the package.

  • Everyone who is trying to quit may benefit from using a medicine. If you are pregnant or trying to become pregnant, nursing an infant, you are under age 18, or you smoke fewer than 10 cigarettes per day, talk to your caregiver before taking any nicotine replacement medicines.

  • You should stop using a nicotine replacement product and call your caregiver if you experience nausea, dizziness, weakness, vomiting, fast or irregular heartbeat, mouth problems with the lozenge or gum, or redness or swelling of the skin around the patch that does not go away.

  • Do not use any other product containing nicotine while using a nicotine replacement product.

  • Talk to your caregiver before using these products if you have diabetes, heart disease, asthma, stomach ulcers, you had a recent heart attack, you have high blood pressure that is not controlled with medicine, a history of irregular heartbeat, or you have been prescribed medicine to help you quit smoking.

5. BE PREPARED FOR RELAPSE OR DIFFICULT SITUATIONS

  • Most relapses occur within the first 3 months after quitting. Do not be discouraged if you start smoking again. Remember, most people try several times before they finally quit.

  • You may have symptoms of withdrawal because your body is used to nicotine. You may crave cigarettes, be irritable, feel very hungry, cough often, get headaches, or have difficulty concentrating.

  • The withdrawal symptoms are only temporary. They are strongest when you first quit, but they will go away within 10 to 14 days.

Here are some difficult situations to watch for:

  • Alcohol. Avoid drinking alcohol. Drinking lowers your chances of successfully quitting.

  • Caffeine. Try to reduce the amount of caffeine you consume. It also lowers your chances of successfully quitting.

  • Other smokers. Being around smoking can make you want to smoke. Avoid smokers.

  • Weight gain. Many smokers will gain weight when they quit, usually less than 10 pounds. Eat a healthy diet and stay active. Do not let weight gain distract you from your main goal, quitting smoking. Some medicines that help you quit smoking may also help delay weight gain. You can always lose the weight gained after you quit.

  • Bad mood or depression. There are a lot of ways to improve your mood other than smoking.

If you are having problems with any of these situations, talk to your caregiver.

SPECIAL SITUATIONS AND CONDITIONS

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 from illnesses caused by secondhand smoke.

QUESTIONS TO THINK ABOUT

Think about the following questions before you try to stop smoking. You may want to talk about your answers with your caregiver.

  • Why do you want to quit?

  • If you tried to quit in the past, what helped and what did not?

  • What will be the most difficult situations for you after you quit? How will you plan to handle them?

  • Who can help you through the tough times? Your family? Friends? Caregiver?

  • What pleasures do you get from smoking? What ways can you still get pleasure if you quit?

Here are some questions to ask your caregiver:

  • How can you help me to be successful at quitting?

  • What medicine do you think would be best for me and how should I take it?

  • What should I do if I need more help?

  • What is smoking withdrawal like? How can I get information on withdrawal?

Quitting takes hard work and a lot of effort, but you can quit smoking.

FOR MORE INFORMATION

Smokefree.gov (http://www.smokefree.gov) provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.