Your personal stop smoking plan
While some smokers successfully quit by going cold turkey, most people do better with a tailored plan to keep themselves on track. A good quit plan addresses both the short-term challenge of stopping smoking and the long-term challenge of preventing relapse. It should also be tailored to your specific needs and smoking habits.
Questions to ask yourself
Take the time to think of what kind of smoker you are, which moments of your life call for a cigarette, and why. This will help you to identify which tips, techniques or therapies may be most beneficial for you.
Are you a very heavy smoker (more than a pack a day)? Or are you more of a social smoker? Would a simple nicotine patch do the job?
Are there certain activities, places, or people you associate with smoking? Do you feel the need to smoke after every meal or whenever you break for coffee?
Do you reach for cigarettes when you're feeling stressed or down? Or is your cigarette smoking linked to other addictions, such as alcohol or gambling?
Start your stop smoking plan with START
S = Set a quit date.
Choose a date within the next two weeks, so you have enough time to prepare without losing your motivation to quit. If you mainly smoke at work, quit on the weekend, so you have a few days to adjust to the change.
T = Tell family, friends, and co-workers that you plan to quit.
Let your friends and family in on your plan to quit smoking and tell them you need their support and encouragement to stop. Look for a quit buddy who wants to stop smoking as well. You can help each other get through the rough times.
A = Anticipate and plan for the challenges you'll face while quitting.
Most people who begin smoking again do so within the first three months. You can help yourself make it through by preparing ahead for common challenges, such as nicotine withdrawal and cigarette cravings.
R = Remove cigarettes and other tobacco products from your home, car, and work.
Throw away all of your cigarettes, lighters, ashtrays, and matches. Wash your clothes and freshen up anything that smells like smoke. Shampoo your car, clean your drapes and carpet, and steam your furniture.
T = Talk to your doctor about getting help to quit.
Your doctor can prescribe medication to help with withdrawal symptoms. If you can't see a doctor, you can get many products over the counter at your local pharmacy, including nicotine patches, lozenges, and gum.
Why is quitting so hard?
Smoking tobacco is both a physical addiction and a psychological habit. The nicotine from cigarettes provides a temporary—and addictive—high. Eliminating that regular fix of nicotine causes your body to experience physical withdrawal symptoms and cravings. Because of nicotine’s “feel good” effect on the brain, many of us smoke as a way of coping with stress, depression, anxiety, or even boredom. Quitting means finding different, healthier ways to cope with those feelings.
Smoking is also ingrained as a daily ritual. It may be an automatic response for you to smoke a cigarette with your morning coffee, while taking a break at work or school, or on your commute home at the end of a hectic day. Or maybe your friends, family, or colleagues smoke, and it’s become part of the way you relate with them.
To successfully stop smoking, you’ll need to address both the addiction and the habits and routines that go along with it. But it can be done. With the right support and quit plan, any smoker can kick the addiction—even if you've tried and failed multiple times before.
Identify your smoking triggers
One of the best things you can do to help yourself quit is to identify the things that make you want to smoke, including specific situations, activities, feelings, and people.
Keep a craving journal
A craving journal can help you zero in on your patterns and triggers. For a week or so leading up to your quit date, keep a log of your smoking. Note the moments in each day when you crave a cigarette:
- What time was it?
- How intense was the craving (on a scale of 1-10)?
- What were you doing?
- Who were you with?
- How were you feeling?
- How did you feel after smoking?
Do you smoke to relieve unpleasant feelings?
Many of us smoke to manage unpleasant feelings such as stress, depression, loneliness, and anxiety. When you have a bad day, it can seem like cigarettes are your only friend. As much comfort as cigarettes provide, though, it's important to remember that there are healthier and more effective ways to keep unpleasant feelings in check. These may include exercising, meditating, relaxation strategies, or simple breathing exercises.
For many people, an important aspect of giving up smoking is to find alternate ways to handle these difficult feelings without turning to cigarettes. Even when cigarettes are no longer a part of your life, the painful and unpleasant feelings that may have prompted you to smoke in the past will still remain. So it’s worth spending some time thinking about the different ways you intend to deal with stressful situations and the daily irritations that would normally have you lighting up.
Tips for avoiding common triggers
Alcohol. Many people smoke when they drink. Try switching to non-alcoholic drinks or drink only in places where smoking inside is prohibited. Alternatively, try snacking on nuts, chewing on a cocktail stick or sucking on a straw.
Other smokers. When friends, family, and co-workers smoke around you, it can be doubly difficult to give up or avoid relapse. Talk about your decision to quit so people know they won't be able to smoke when you're in the car with them or taking a coffee break together. In your workplace, find non-smokers to have your breaks with or find other things to do, such as taking a walk.
End of a meal. For some smokers, ending a meal means lighting up, and the prospect of giving that up may appear daunting. However, you can try replacing that moment after a meal with something else, such as a piece of fruit, a healthy dessert, a square of chocolate, or a stick of gum.
Coping with nicotine withdrawal symptoms
Once you stop smoking, you’;ll likely experience a number of physical symptoms as your body withdraws from nicotine. Nicotine withdrawal begins quickly, usually starting within an hour of the last cigarette and peaking two to three days later. Withdrawal symptoms can last for a few days to several weeks and differ from person to person.
Common nicotine withdrawal symptoms include:
- Cigarette cravings
- Irritability, frustration, or anger
- Anxiety or nervousness
- Difficulty concentrating
- Increased appetite
- Increased coughing
- Constipation or upset stomach
- Decreased heart rate
As unpleasant as these withdrawal symptoms may be, it’s important to remember that they are only temporary. They will get better in a few weeks as the toxins are flushed from your body. In the meantime, let your friends and family know that you won't be your usual self and ask for their understanding.
Manage cigarette cravings
While avoiding smoking triggers will help reduce your urge to smoke, you probably can't avoid cigarette cravings entirely. Fortunately, cravings don’t last long—typically, about 5 or 10 minutes. If you’re tempted to light up, remind yourself that the craving will soon pass and try to wait it out. It helps to be prepared in advance by having strategies to cope with cravings.
Distract yourself. Do the dishes, turn on the TV, take a shower, or call a friend. The activity doesn't matter as long as it gets your mind off smoking.
Remind yourself why you quit. Focus on your reasons for quitting, including the health benefits (lowering your risk for heart disease and lung cancer, for example), improved appearance, money you're saving, and enhanced self-esteem.
Get out of a tempting situation. Where you are or what you're doing may be triggering the craving. If so, a change of scenery can make all the difference.
Reward yourself. Reinforce your victories. Whenever you triumph over a craving, give yourself a reward to keep yourself motivated.
|Coping with Cigarette Cravings in the Moment|
Find an oral substitute - Keep other things around to pop in your mouth when cravings hit. Try mints, carrot or celery sticks, gum, or sunflower seeds. Or suck on a drinking straw.
Keep your mind busy - Read a book or magazine, listen to some music you love, do a crossword or Sudoku puzzle, or play an online game.
Keep your hands busy - Squeeze balls, pencils, or paper clips are good substitutes to satisfy that need for tactile stimulation.
Brush your teeth - The just-brushed, clean feeling can help banish cigarette cravings.
Drink water - Slowly drink a large glass of water. Not only will it help the craving pass, but staying hydrated helps minimize the symptoms of nicotine withdrawal.
Light something else - Instead of lighting a cigarette, light a candle or some incense.
Get active - Go for a walk, do some jumping jacks or pushups, try some yoga stretches, or run around the block.
Try to relax - Do something that calms you down, such as taking a warm bath, meditating, reading a book, or practicing deep breathing exercises.
Go somewhere smoking is not permitted - Step into a public building, store, mall, coffee shop, or movie theater, for example.
Preventing weight gain after you stop smoking
Smoking acts as an appetite suppressant, so gaining weight is a common concern for many of us when we decide to give up cigarettes. You may even be using it as a reason not to quit. While it's true that many smokers put on weight within six months of stopping smoking, the gain is usually small—about five pounds on average—and that initial gain decreases over time. It’s also important to remember that carrying a few extra pounds for a few months won’t hurt your heart as much as smoking does. However, gaining weight is NOT inevitable when you stop smoking.
Smoking dampens your sense of smell and taste, so after you quit food will often seem more appealing. You may also gain weight if you replace the oral gratification of smoking with eating unhealthy comfort foods. Therefore, it's important to find other, healthy ways to deal with unpleasant feelings such as stres, anxiety, or boredom rather than mindless, emotional eating.
Nurture yourself. Instead of turning to cigarettes or food when you feel stressed, anxious, or depressed, learn new ways to quickly soothe yourself. Listen to uplifting music, play with a pet, or sip a cup of hot tea, for example.
Eat healthy, varied meals. Eat plenty of fruit, vegetables, and healthy fats. Avoid sugary food, sodas, fried, and convenience food.
Learn to eat mindfully. Emotional eating tends to be automatic and virtually mindless. It’s easy to polish off a tub of ice cream while zoning out in front of the TV or staring at your phone. But by removing distractions when you eat, it’s easier to focus on how much you’re eating and tune into your body and how you’re really feeling. Are you really still hungry or eating for another reason?
Drink lots of water. Drinking at least six to eight 8 oz. glasses will help you feel full and keep you from eating when you're not hungry. Water will also help flush toxins from your body.
Take a walk. Not only will it help you burn calories and keep the weight off, but it will also help alleviate feelings of stress and frustration that accompany smoking withdrawal.
Snack on guilt-free foods. Good choices include sugar-free gum, carrot and celery sticks, or sliced bell peppers or jicama.
Medication and therapy to help you quit
There are many different methods that have successfully helped people to kick the smoking habit. While you may be successful with the first method you try, more likely you’ll have to try a number of different methods or a combination of treatments to find the ones that work best for you.
Smoking cessation medications can ease withdrawal symptoms and reduce cravings. They are most effective when used as part of a comprehensive stop smoking program monitored by your physician. Talk to your doctor about your options and whether an anti-smoking medication is right for you. The U.S. Food and Drug Administration (FDA) approved options are:
Nicotine replacement therapy. Nicotine replacement therapy involves "replacing" cigarettes with other nicotine substitutes, such as nicotine gum, patch, lozenge, inhaler, or nasal spray. It relieves some of the withdrawal symptoms by delivering small and steady doses of nicotine into your body without the tars and poisonous gases found in cigarettes. This type of treatment helps you focus on breaking your psychological addiction and makes it easier to concentrate on learning new behaviors and coping skills.
Non-nicotine medication. These medications help you stop smoking by reducing cravings and withdrawal symptoms without the use of nicotine. Medications such as bupropion (Zyban) and varenicline (Chantix, Champix) are intended for short-term use only.
What you need to know about e-cigarettes
Since it eliminates the tar and toxic gases found in cigarette smoke, smoking e-cigarettes (vaping) is almost certainly less dangerous than smoking conventional cigarettes. While different studies have conflicting results, e-cigarettes may also be helpful in kicking the habit. However, there are some downsides to vaping:
- The liquid used in e-cigarettes contains nicotine which has many negative health effects, including high blood pressure and diabetes.
- The nicotine from e-liquid is especially dangerous to the developing brains of children and teens.
- E-liquids may contain flavoring agents that can cause chronic lung disease.
- Some vaporizers can generate significant amounts of toxins such as formaldehyde.
Source: Harvard Health Publications
There are several things you can do to stop smoking that don’t involve nicotine replacement therapy, vaping, or prescription medications. These include:
Hypnosis – This is a popular option that has produced good results for many smokers struggling to quit. Forget anything you may have seen from stage hypnotists, hypnosis works by getting you into a deeply relaxed state where you are open to suggestions that strengthen your resolve to stop smoking and increase your negative feelings toward cigarettes.
Acupuncture – One of the oldest known medical techniques, acupuncture is believed to work by triggering the release of endorphins (natural pain relievers) that allow the body to relax. As a smoking cessation aid, acupuncture can be helpful in managing smoking withdrawal symptoms.
Behavioral Therapy – Nicotine addiction is related to the habitual behaviors or rituals involved in smoking. Behavior therapy focuses on learning new coping skills and breaking those habits.
Motivational Therapies – Self-help books and websites can provide a number of ways to motivate yourself to give up smoking. One well known example is calculating the monetary savings. Some people have been able to find the motivation to quit just by calculating how much money they will save. It may be enough to pay for a summer vacation.
Smokeless or spit tobacco is NOT a healthy alternative to smoking
Smokeless tobacco, otherwise known as spit or chewing tobacco, is not a safe alternative to smoking cigarettes. It contains the same addictive chemical, nicotine, contained in cigarettes. In fact, the amount of nicotine absorbed from smokeless tobacco can be 3 to 4 times the amount delivered by a cigarette.
What to do if you slip or relapse
Most people try to stop smoking several times before they kick the habit for good, so don’t beat yourself up if you slip up and smoke a cigarette. Instead, turn the relapse into a rebound by learning from your mistake. Analyze what happened right before you started smoking again, identify the triggers or trouble spots you ran into, and make a new stop-smoking plan that eliminates them.
It’s also important to emphasize the difference between a slip and a relapse. If you start smoking again, it doesn’t mean that you can’t get back on the wagon. You can choose to learn from the slip and let it motivate you to try harder or you can use it as an excuse to go back to your smoking habit. But the choice is yours. A slip doesn’t have to turn into a full-blown relapse.
You’re not a failure if you slip up. It doesn't mean you can't quit for good.
Don’t let a slip become a mudslide. Throw out the rest of the pack. It's important to get back on the non-smoking track as soon as possible.
Look back at your quit log and feel good about the time you went without smoking.
Find the trigger. Exactly what was it that made you smoke again? Decide how you will cope with that issue the next time it comes up.
Learn from your experience. What has been most helpful? What didn’t work?
Are you using a medicine to help you quit? Call your doctor if you start smoking again. Some medicines cannot be used if you’re smoking at the same time.
Helping a loved one to stop smoking
It’s important to remember that you cannot make a friend or loved one give up cigarettes; the decision has to be theirs. But if they do make the decision to stop smoking, you can offer support and encouragement and try to ease the stress of quitting. Investigate the different treatment options available and talk them through with the smoker; just be careful never to preach or judge. You can also help a smoker overcome cravings by pursuing other activities with them, and by keeping smoking substitutes, such as gum, on hand.
If a loved one slips or relapses, don’t make them feel guilty. Congratulate them on the time they went without cigarettes and encourage them to try again. Your support can make all the difference in helping your loved one eventually kick the habit for good.
Helping a teen to quit
Most smokers try their first cigarette around the age of 11, and many are addicted by the time they turn 14. This can be worrying for parents, but it’s important to appreciate the unique challenges and peer pressure teens face when it comes to quitting smoking. While the decision to give up has to come from the teen smoker him- or herself, there are still plenty of ways for you to help.
Tips for parents of teen smokers
- Try to avoid threats and ultimatums. Find out why your teen is smoking; they may want to be accepted by a peer group or want your attention. Talk about what changes can be made in their life to help them stop smoking.
- Be patient and supportive as your child goes through the quitting process.
- Set a good example for your kids by not smoking yourself. Parents who smoke are more likely to have children who smoke.
- Know if your children have friends that smoke. Talk with your kids about ways to refuse a cigarette.
- Explain the health dangers, as well as the unpleasant physical aspects of smoking (such as bad breath, discolored teeth and nails).
- Establish a smoke-free policy in your home. Don't allow anyone to smoke indoors at any time.
Source: American Lung Association
How to Quit Smoking - 8 Steps to Quitting For Good
You can quit smoking with a little help. If you’re anxious about quitting, this website will take you through the stages of quitting smoking step-by-step. You will learn how to get ready, how to quit, and how to make sure that you don’t relapse. You will also learn tips that make quitting easier.
You are probably at the stage where part of you wants to quit smoking, but part of you doesn’t. Maybe you’re worried about withdrawal, or afraid that you’ll fail. Put those thoughts aside for now. Focus on why you want to quit, and that will give you the motivation to succeed.
The good news about smoking is that it doesn't matter how much you’ve smoked, or how long you have smoked. If you quit now, your body will begin to repair itself and will take care of you even after years of neglect.
Table of Contents
Step By Step Quit Smoking Plan
Nicotine Replacement Therapy
Smoking Cessation Medication
Reasons To Quit Smoking
An average smoker gets about 200 hits of nicotine a day, and over 70,000 hits per year. Ten puffs per cigarette, times 20 cigarettes a day gives you about 200 hits of nicotine a day. That’s partly why smoking is so addictive. Your brain constantly waits for the next nicotine hit. Some studies have suggested that nicotine is as addictive as crack cocaine.
Nicotine Withdrawal Symptoms
- Irritability, Anxiety
- Difficulty concentrating
- Food cravings
- Cravings for cigarettes
What causes nicotine withdrawal? Smoking increases the number of nicotine receptors in your brain. When you stop smoking, those receptors continue to expect nicotine, and when they don’t get it, they begin to adjust. That adjustment process, is what causes cravings and withdrawal.
How Long Do Nicotine Withdrawal Symptoms Last?
Nicotine is out of your body 72 hours after you quit smoking. Nicotine withdrawal symptoms usually reach their peak 2 to 3 days after you quit, and are gone within 1 to 3 months.(1) It takes at least 3 months for your brain chemistry to return to normal after you quit smoking.(2) The last two symptoms to go usually are irritability and low energy.
Any effective smoking cessation program has to take into account this long adjustment period. It is why some doctors recommend weaning off nicotine slowly with nicotine replacement therapy.
In summary, most people start to feel better after 1 week, and the symptoms are usually gone within 3 months.
Quit Smoking Plan (Step-By-Step)
A step by step plan to help you quit smoking. You will find guidelines, best practices, facts and tips to help you successfully reach your goal. The basic steps of quitting are the following:
- Make the Decision to Quit
- Understand Your High-Risk Times
- Stock Up on Supplies
- Pick a Quit Date
- Let People Know
- Remove Smoking Reminders
- Your Quit Date and the First 2 Weeks
- Maintenance and Coping Strategies
Step 1: Make the Decision to Quit
Identify your reasons for quitting smoking. Quitting is challenging. You can rise to the challenge, but it helps if you have your goals in mind. Review your mental list as you approach your quit date.
If you have tried to quit smoking before and failed, don’t let that be an obstacle. The more times you try to quit, the greater your chance of success. Maybe you weren’t ready last time. Maybe you didn’t take the rights steps.
Step 2: Understand Your High-Risk Times
Smoking is more than just a physical addiction to nicotine. It is also a psychological addiction. Why do you smoke? Is it a break from your hectic day? Is it a moment of peace when you can be alone with your thoughts? Most people smoke for the same reasons alcoholics drink. It’s a chance to escape, relax, or reward yourself.
Anticipate your high-risk situations and plan for them. This will help you deal with them better. Here are some common triggers for smoking cravings:
- Drinking coffee
- Finishing a meal
- Driving your car
- Using the phone
- Stressful situations
- Drinking alcohol
- Social events
These are some strategies for dealing with your triggers:
- If you smoke with your morning coffee, plan to have your first coffee at work where you probably can’t smoke.
- If you smoke while driving, plan to take a different route. It will keep your mind occupied, so that you won’t be on autopilot.
- If you smoke after meals, plan to get up after a meal. Go for a walk, brush your teeth, do something.
- If you smoke when you’re on the phone, put one of those stress balls next to your phone to keep your hands occupied.
- Plan to keep yourself busy in the beginning. Too much unstructured time is not a good thing when it comes to smoking cessation.
What should you do if you slip? A slip is also a high risk time. You don’t need to slip. Many people have quit without a slip. But if you do, it’s good to have a plan.
- The most important thing you can do is avoid all or nothing thinking. Don’t give up and let a slip turn into a major relapse.
- Throw out the rest of the pack.
- You’re not a failure if you slip.
- The more times you try to quit, the greater your chance of success.
- Learn from your experience. What you could have done differently.
- Never forget your reasons for quitting in the first place.
Step 3: Stock Up on Supplies
Every smoker understands that smoking is also an oral addiction. When you quit smoking your brain will still crave the oral sensation of a cigarette. As part of your smoking cessation plan, stock up on oral substitutes like gum, raw vegetables, carrot sticks, hard candy, coffee stirrers, straws, etc.
If you’re planning to use nicotine replacement or smoking cessation drugs talk to your doctor at this point. Learn how to use them. Find out about potential side effects and what to look out for.
Step 4: Pick a Quit Date
A quit date is a personal commitment. It is important because it prepares your mind subconsciously. Pick a date within the next month. It doesn’t have to be a special day.
Avoid a day when you know you’ll be busy, tense, or have a special event that could be a trigger. Write down your quit date somewhere, and look at it every day. Let your determination build as you get closer.
If you are going to use smoking cessation medication like Zyban (Wellbutrin, bupropion) or Chantix (Champix, varenicline), your doctor may have suggested that you start using them now. Ask your doctor how far ahead of your quit date you should start taking your pills.
Step 5: Let People Know
Quitting is easier with support. Choose people who you think will be helpful. Tell them your plan and how they can help. Also tell them how they cannot help.
- Friends can help distract you.
- They can listen to you.
- Sharing your struggles makes them lighter.
- But explain that you want to keep your conversations light. Nothing serious that will add to your tension.
Step 6: Remove All Smoking Reminders
Smoking like any addiction is triggered by people, places, and things. For other addictions, the objects that are triggers are usually drug paraphernalia. In this case the paraphernalia include cigarettes, matches, lighters, and ashtrays. Get rid of all of them. Don't save anything “just in case.”
Freshen your environment at home, work‚ and in your car. The smell of cigarettes is definitely a trigger, especially in the beginning.
Step 7: The First 2 Weeks
The first two weeks are critical for your success. If you can get though the first two weeks your chance of success is much higher.(3) Therefore it is important to give yourself the best chance you can during these critical weeks.
The first two weeks are all about distractions, keeping busy, and being good to yourself. Keep busy with fun, low stress activities and avoid high stress ones.
- Plan lots of dates with friends. Get out of the house. Go for walks, bike rides, or go to the gym. Go to a movie. Be good to yourself.
- Keep your hands busy. Some people like to use a pen, a straw or a coffee stirrer.
- Drink lots of water.
- Call the people who have offered to help. Everyone understands how difficult this is. People will be happy that you’re doing it. Don’t try to do it alone.
- If you just sit there with your cravings, you are giving them room to grow.
- Relax and breathe deeply.
Avoid High Risk Situations
- Don’t hang out with smokers. That’s like a crack addict hanging out with crack addicts. No matter how friendly and supportive your smoking friends are, they are still a high risk environment for at least the first several months.
- Practice saying, “No thank you, I don’t smoke anymore.”
- Understand that you will encounter high risk situations that you haven’t thought of. If you find yourself triggered, plan to get up and leave quickly.
- A change of scenery can make all the difference.
Talk to Yourself
- Most cravings only last 10 - 20 minutes. Distract yourself, and the cravings will pass. When you think about using, talk to yourself and keep yourself busy.
- “I refuse to believe that smoking is more powerful than me.”
- “I won’t give smoking any more power over my life.”
- “I chose to be a non-smoker.”
- “One day at a time.”
Step 8: Maintenance and Coping Strategies
Quit smoking one day at a time. Don't think about quitting forever. That can be overwhelming. Deal with right now, and the days will start to add up.
Be good to yourself. This is probably the most important and undervalued coping strategy in quitting smoking. It is one of the most difficult things for anyone to do, especially someone with an addiction.
Your tendency will be to not reward yourself while you’re quitting. You’ll think that you don’t deserve it yet. You will think that you only deserve a reward once you have had a long stretch of not smoking. But that’s old thinking. This is your opportunity to learn better coping strategies.
How you can be good to yourself is different for everyone. Pursue new ways of rewarding yourself the same way you pursued your addiction. You are learning new thinking patterns that will be helpful in the rest of your life.
Don't try to diet while quitting smoking. Too much deprivation is bound to backfire. Instead, try eating more fruits and vegetables.
Celebrate Your Victories
Don’t focus on your struggles and ignore your successes. You probably tend to disqualify the positives and focus on the negatives. But don’t underestimate how far you have come. Reinforce your victories.
- Take the money you’ve saved and buy yourself a treat once a week. Or save the money for something bigger like a trip.
- Plan ahead for your milestones and make sure you recognize them with some celebration, big or small.
- Rewards don’t have to be financial. You could plan to get together with your friends and do something.
- Get plenty of rest and eat healthy. Lack of sleep and excessive sugar are known triggers.
- Use substitutes for oral cravings like gum, raw vegetables, carrot sticks, hard candy, coffee stirrers, straws.
- Stress is a big trigger for smoking.
- Relax by taking a few slow, deep breaths. Inhale through your nose and exhale through your mouth. Repeat it 5 times and see how you feel.
- When you have cravings, think of how strong you have been so far.
- Remember your reasons for quitting.
- Refuse to let your addiction win.
- Think of the benefits to your health, finances, and family.
- Remind yourself that there is no such thing as just one cigarette.
- Start to see yourself as a non-smoker. That is the ultimate payoff. You are freeing yourself from the control of your addiction.
Nicotine Replacement Therapy (NRT)
Nicotine replacement therapy (NRT) helps reduce nicotine withdrawal symptoms that many smokers say is their main reason for not quitting. Nicotine replacement therapy increases the rate of quitting by 50 to 70 percent (4)
Nicotine replacement therapy is not a substitute for coping strategies. It deals with the physical addiction to nicotine, but does not deal with the behavioral or psychological addiction to smoking. So some sort of smoking cessation program and strategy is still important.
IMPORTANT: What follows is general medical information, and is not tailored to the needs of a specific individual. Some people may not be able to use nicotine replacement therapy because of allergies or other conditions. You should always consult your physician when making decisions about your health.
How to Decide Which Nicotine Replacement Therapy?
There are three broad categories of nicotine replacement therapy: nicotine that is absorbed through the skin, mouth, and airways. Here are some important points to help you decide:
The nicotine patch is convenient because it provides long term relief from nicotine withdrawal, and you only have to think about it once a day.
The nicotine patch is the most studied type of nicotine replacement therapy, and significantly increases your chances of success by 50 to 70 percent
Nicotine Lozenges and Nicotine Gum
Nicotine lozenges and nicotine gum provide short term relief from nicotine withdrawal symptoms. They also help deal with oral cravings that a nicotine patch cannot.
The most effective smoking cessation combination is a nicotine patch for long term relief, and nicotine lozenges for breakthrough carvings.(5)
The nicotine in lozenges and gum is absorbed through the inner surface of your mouth rather than through your stomach. Food and drinks can affect how the nicotine is absorbed. Therefore you shouldn’t eat or drink for at least 15 minutes before using nicotine gum or lozenges, and you shouldn’t eat or drink while you are using them.
Most people find nicotine lozenges easier to use than nicotine gum. Nicotine gum can stick to dental work.
How do you use nicotine lozenges? Suck on a lozenge until it is fully dissolved, about 20 to 30 minutes. Do not bite or chew it like hard candy, and do not swallow it.
How do you use nicotine gum? Chew the gum slowly until you get a peppery taste or tingle in your mouth. Then hold it inside your cheek (park it) until the taste fades. Then chew it again to get the tingle back, and park it again.
Nicotine Inhalers and Nicotine Nasal Spray
Nicotine inhalers and nasal sprays are the most fast acting of all nicotine replacement methods. But because they work so quickly they have a higher risk of becoming addictive.
Nicotine inhalers mimic the use of cigarettes, which can make them even more addictive.
Both nicotine inhalers and nasal sprays require a doctor’s prescription.
How Long Should You Use Nicotine Replacement Therapy?
The US Food and Drug Administration suggests the following. “Users of Nicotine Replacement Therapy (NRT) products should still use the product for the length of time indicated in the label - for example, 8, 10 or 12 weeks. However, if they feel they need to continue using the product for longer in order to quit, it is safe to do so in most cases.”(6)
The American Cancer Society notes that “The FDA has approved using the patch for a total of 3 to 5 months.”(7)
In other words, follow the instructions, but it is reasonable to use the patch for up to 5 months, if you have the approval of your health care professional.
In my experience, most people relapse when they taper down too quickly from the full strength 21 mg patch to the 14 mg patch.
Can You Get Too Much Nicotine (Nicotine Overdose and Nicotine Poisoning)?
Yes, if you use nicotine replacement therapy incorrectly. Speak to your health professional about the correct way to use it.
Here are some symptoms of nicotine overdose or nicotine poisoning:
- Agitation, restlessness. tremors
- Fast or irregular heartbeat
- Nausea, vomiting, abdominal pain, diarrhea
- Cold sweats, pale skin
If you experience any of these symptoms call your doctor. More serious symptoms of nicotine overdose or nicotine poisoning include:
- Disturbed vision or hearing
- Dizziness or faintness
- Rapid breathing
Call Poison Control and get emergency help if you suspect nicotine overdose or nicotine poisoning.
How Safe is Nicotine Replacement Therapy?
Nicotine replacement therapy is considered safe for smokers with a history of cardiovascular disease. It does not increase the risk of heart attacks and strokes in smokers with a history of cardiovascular disease.(4)
There is not enough evidence to be absolutely sure that nicotine replacement therapy is safe for pregnant women.(8) However, many physicians feel that nicotine replacement therapy is much safer than smoking.
Smoking Cessation Medications
There are prescription drugs that can help you quit. Some can be used along with nicotine replacement therapy. Most have to be started before your planned quit day, and all need a prescription.
IMPORTANT: This is general medical information, and is not tailored to the needs of a specific individual. You should always consult your physician when making decisions about your health.
Zyban (Wellbutrin, bupropion)
Zyban (Wellbutrin, bupropion) is a prescription antidepressant that was later discovered to reduce nicotine cravings and help people quit smoking. It does not contain nicotine. It acts on chemicals in the brain that cause nicotine cravings. Large scale studies have shown that Zyban is at least as effective as nicotine replacement therapy in smoking cessation.(9)
Zyban works best if you start it 1 to 2 weeks before you quit smoking. The usual dosage is 150 mg tablets once or twice per day. Your doctor may want to continue it for 8 to 12 weeks after you quit smoking to help reduce the chance of relapse.
The most common side effects include: dry mouth, trouble sleeping, agitation, irritability, indigestion, and headaches.
Antidepressants may increase the risk of suicide in persons younger than 25. When prescribed for smoking cessation, there have been four suicides per one million prescriptions and one case of suicidal ideation per ten thousand prescriptions.(10)
Zyban (Wellbutrin, bupropion) should not be taken if you have or have ever had the following:
- Seizures (Bupropion can cause or worsen seizures)
- Heavy alcohol use, or cirrhosis
- Serious head injury
- Bipolar (manic-depressive) illness
- Anorexia or bulimia
- If you’re taking sedatives or have recently taken an MAOI, (an older type of antidepressant).
Combining Zyban (Wellbutrin, bupropion) and Nicotine Replacement Therapy
Combining Zyban and nicotine replacement therapy, is usually more effective than either treatment alone.(11) Both medications work in different ways. Zyban reduces cravings by working on brain chemistry, and nicotine replacement therapy works by gradually weaning your body off nicotine.
Zyban combined with nicotine replacement therapy can slightly increase your blood pressure. Therefore monitoring of blood pressure is recommended in these cases.(12)
Chantix (Champix, varenicline)
Varenicline is a prescription medication that can reduce cravings and increase your chances of success.
How Does Chantix (Champix) Work?
Chantix is a partial nicotine agonist. It partially stimulates the nicotine receptors in the brain so you get a mild effect as if you were smoking, but at the same time it blocks the receptors from giving the full effect of smoking. This lessens the pleasure you get from smoking, and reduces nicotine withdrawal. Chantix (Champix, varenicline) should be started a week before your quit day.
Side Effects of Chantix (Champix)
Chantix (Champix, varenicline) significantly increases the risk of depressed mood, thoughts of suicide, and attempted suicide. One study looked at all serious side effects between 1998 and 2010 in the FDA's Adverse Event Reporting System (AERS). It concluded “Varenicline shows a substantial, statistically significant increased risk of reported depression and suicidal/self-injurious behavior. The findings for varenicline, render it unsuitable for first-line use in smoking cessation.”(13)
One of the main concerns with electronic cigarettes is that they mimic the use of regular cigarettes. If part of your reason for quitting smoking is that you don’t want to be controlled by your nicotine addiction, then electronic cigarettes would not be a good choice.
Studies have also shown that the vapor from electronic cigarettes has potentially harmful toxins.(14)
Reasons to Quit Smoking: Some Things You Probably Don’t Know About Smoking
Here are just a few smoking facts. Not a long list, but some key facts about the dangers of smoking.
Smoking causes more deaths each year than all of the following causes combined:(15)
- Alcohol abuse
- Illegal drug use
- Motor vehicle accidents
- AIDS and HIV
If you are recovering from drug or alcohol abuse, it doesn’t make sense to have worked hard for your recovery, and then drop dead from smoking.
Both the founders of Alcoholics Anonymous, Dr. Bob and Bill W. dropped dead from smoking. Smoking statistics tend to feel impersonal. But if you’re in recovery, that makes it up close and personal.
Smoking kills 6 million people each year worldwide.(16) In the United States, smoking kills more than 480,000 people each year.(17) That is the equivalent of two jumbo jets crashing every day with no survivors. (The number of passengers in two jumbo jets crashing every day for one year: 500 * 2 *365 = 365,000.)
More smokers die of heart disease and stroke rather than lung cancer. This is why people often underestimate how deadly smoking is. Perhaps your grandfather smoked his whole life and never died of lung cancer. Most smokers die of heart disease or stroke.
Smoking causes type 2 diabetes. Smokers are 30 – 40 percent more likely to develop diabetes.(17)
Those are just a few of the diseases caused by smoking. There is not an organ or system in your body that is not affected by the dangers of smoking. The full list of smoking diseases is too long and depressing.
Here are some reasons why people quit smoking:
- Are you worried about your health?
- Do you resent being controlled by your addiction?
- Do you know someone who has had health problems because of smoking?
- Are you trying to be a positive role model for your family?
- Do you want to save money?
- Smoking costs $2,500 to $5,000 a year. That's the price of a good vacation.
Second Hand Smoke Facts
Second hand smoke causes the same kinds of deaths as smoking.(18) There is no safe level of second hand smoke. Here are just two of the consequences of living with a smoker or working in a smoking environment.
Nonsmokers exposed to second hand smoke at home or at work are at higher risk of the following:(17)
- 25 – 30 percent more likely to develop heart disease and stroke
- 20 – 30 percent more likely to develop lung cancer
Children and Second Hand Smoke
Second hand smoke has been proven to damage children’s health and increase the risk of the following:(19)
- Asthma, pneumonia, and bronchitis
- Ear infections and the need for ear tubes
- Sudden Infant Death Syndrome (SIDS)
Isn’t it time you said - enough?
1) Kenford, S. L., Fiore, M. C., Jorenby, D. E., Smith, S. S., et al., Predicting smoking cessation. Who will quit with and without the nicotine patch.JAMA, 1994. 271(8): p. 589-94.
2) Ward, M. M., Swan, G. E., & Jack, L. M., Self-reported abstinence effects in the first month after smoking cessation.Addict Behav, 2001. 26(3): p. 311-27.
3) Cosgrove, K. P., Batis, J., Bois, F., Maciejewski, P. K., et al., beta2-Nicotinic acetylcholine receptor availability during acute and prolonged abstinence from tobacco smoking.Arch Gen Psychiatry, 2009. 66(6): p. 666-76.
4) Stead, L. F., Perera, R., Bullen, C., Mant, D., et al., Nicotine replacement therapy for smoking cessation.Cochrane Database Syst Rev, 2012. 11: p. CD000146.
5) Piper, M. E., Smith, S. S., Schlam, T. R., Fiore, M. C., et al., A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies.Arch Gen Psychiatry, 2009. 66(11): p. 1253-62.
6) Food and Drug Administration, Nicotine Replacement Therapy Labels May Change. www.fda.gov/ForConsumers/ConsumerUpdates/ucm345087.htm.
7) American Cancer Society, What are the types of nicotine replacement therapy? www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-types-of-nrt.
8) Coleman, T., Chamberlain, C., Davey, M. A., Cooper, S. E., et al., Pharmacological interventions for promoting smoking cessation during pregnancy.Cochrane Database Syst Rev, 2012. 9: p. CD010078.
9) Wu, P., Wilson, K., Dimoulas, P., & Mills, E. J., Effectiveness of smoking cessation therapies: a systematic review and meta-analysis.BMC Public Health, 2006. 6: p. 300.
10) Hughes, J. R., Stead, L. F., Hartmann-Boyce, J., Cahill, K., et al., Antidepressants for smoking cessation.Cochrane Database Syst Rev, 2014. 1: p. CD000031.
11) Loh, W. Y., Piper, M. E., Schlam, T. R., Fiore, M. C., et al., Should all smokers use combination smoking cessation pharmacotherapy? Using novel analytic methods to detect differential treatment effects over 8 weeks of pharmacotherapy.Nicotine Tob Res, 2012. 14(2): p. 131-41.
12) Jorenby, D. E., Leischow, S. J., Nides, M. A., Rennard, S. I., et al., A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation.N Engl J Med, 1999. 340(9): p. 685-91.
13) Moore, T. J., Furberg, C. D., Glenmullen, J., Maltsberger, J. T., et al., Suicidal behavior and depression in smoking cessation treatments.PLoS One, 2011. 6(11): p. e27016.
14) Drummond, M. B., & Upson, D., Electronic cigarettes. Potential harms and benefits.Ann Am Thorac Soc, 2014. 11(2): p. 236-42.
15) Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L., Actual causes of death in the United States, 2000.JAMA, 2004. 291(10): p. 1238-45.
16) World Health Organization, WHO report on the global tobacco epidemic 2013. www.who.int/tobacco/global_report/2013/en/.
17) CDC, 2014 Surgeon General's Report: The Health Consequences of Smoking—50 Years of Progress. www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm.
18) Environmental Protection Agency, Setting the Record Straight: Secondhand Smoke is a Preventable Health Risk. www.epa.gov/smokefree/pubs/strsfs.html.
19) CDC, 2006 Surgeon General's Report—The Health Consequences of Involuntary Exposure to Tobacco Smoke. www.cdc.gov/tobacco/data_statistics/sgr/2006/index.htm.
Next Page >
Last Modified:February 7, 2018