Smoking: Ways to Quit for Good
Why should I quit smoking?
Because it could save your life. They don't call cigarettes "cancer sticks" and "coffin nails" for nothing. When you smoke, you're exposing yourself to more than 4,800 chemicals, including cyanide, benzene, and ammonia -- and at least 69 of those chemicals can cause cancer. Perhaps the best known is nicotine, an addictive compound that can make it ferociously hard to stop smoking.
Although smoking may feel good, it hurts every organ in your body and accounts for 1 out of 5 deaths each year. Cigarette smokers are 2 to 4 times more likely to suffer from heart disease, the leading cause of death in the U.S. You're at much greater risk of getting lung cancer than a nonsmoker. You're also more likely to suffer from hardening of the arteries, bronchitis, shortness of breath, or emphysema, which causes a slow, painful death. What's more, you're at an increased risk for stroke and twice as likely to have a heart attack as a nonsmoker.
These hazards may seem pretty far away when you're young. But it probably won't be long before your face starts looking sallow, and later you'll likely develop signs of "smoker's face," premature wrinkling marked by dozens of tiny creases -- something that nonsmokers typically don't get. Smoking also gives you bad breath and stains your teeth and fingers, and the secondhand smoke from your cigarettes is likely to irritate friends and family members who don't smoke. (It's also hazardous to their health -- more than 49,000 people die annually of lung cancer and heart disease from breathing other people's smoke, according to the American Lung Association.)
How will my health improve if I stop smoking?
Your body benefits as soon as you stop smoking. According to the American Lung Association, within 20 minutes of your last cigarette, your elevated blood pressure and pulse rate drop. After a couple of days, your abilities to smell and taste improve and your damaged nerve endings start to repair themselves. Within a few months, walking and other physical activities will become easier and your lung function increases. After 10 years, you'll have nearly halved your odds of getting lung cancer.
Your friends and family also benefit when you stop smoking. A nonsmoker who's married to a smoker has about a 30 percent higher risk of developing lung cancer than one who lives with a nonsmoker. Children whose parents smoke are more likely to suffer from pneumonia or bronchitis in the first two years of life than are children who live in smoke-free households. By quitting cigarettes, you're protecting your loved ones as well.
How can I quit successfully?
- Make a plan. Preparing to quit is an important first step. There's no one right way to stop smoking, but smokers who lay the groundwork are much more likely to succeed. Make a list of the people, places, and pastimes associated with your smoking -- anything that "triggers" your behavior. One of the hardest things about being a regular smoker and then giving it up is that you'll always know how good that after-dinner smoke tastes.
- Come up with a plan for coping with each of those triggers. For example, after a meal, you may want to get up and take a walk -- or brush your teeth. If a cigarette automatically appears in your mouth when you leave work at the end of the day, substitute a lollipop or a toothpick (the oral fixation fostered by smoking is one of its more insidious aspects). If a glass of wine makes you reach for a cigarette, you may want to avoid alcohol for the first week or so.
- Set a quit date. Pick a date that's realistic and allows you to develop your plan. Try to select a time period when you don't anticipate being under much stress yet will be too busy to sit around thinking about smoking. It may also help to start at a time when you'll have a little extra impetus. For example, if you're going to visit people around whom you can't smoke (your grandparents or your in-laws, perhaps), vow to remain smoke-free after the trip is over. You'll have a few days under your belt already.
- Tell your friends and family about your plan. Having their support and knowing they're counting on you can increase your motivation to stick with it.
- If involving others doesn't suit you, become a "quiet quitter." For some people, kicking the habit without all the fanfare and questions from concerned supporters is easier in the long run. Knowing that everyone's "counting on you" might stress you to the point of failure instead of bolstering your resolve. Which approach will work best depends on your personality.
- Take it day-by-day -- or even trigger-by-trigger. This may sound like "addiction-speak," but it works. To approach the process by thinking, "I can't wait until I've been nicotine-free for a week" won't help you with that craving you get with your morning coffee on the very first day.
Who and what can help me quit?
The good news is that there's a lot of support available. These resources include organizations, tools, and techniques. Check out the following:
A number of organizations in your community may sponsor classes or support groups that guide smokers through the quitting process. Participants learn to identify smoking triggers, set a quit date, and find alternatives to smoking. If there is a fee, your medical plan may pay part of it; call to find out. Check the phone book and Internet to see what smoking cessation groups are available.
The American Cancer Society (http://www.cancer.org or (800) ACS-2345) can refer you to a chapter in your area.
The American Lung Association (http://www.lungusa.org or (800) LUNG-USA) is another great resource.
Nicotine replacement products. Taking the form of gum or a patch, these release nicotine into your body, helping to reduce the physical withdrawal symptoms that may occur during the first few weeks that you go without cigarettes. The gum delivers nicotine through the lining of your mouth, although it causes soreness and burning of the mouth in some people. The patch looks like a Band-Aid, is worn on the skin, and transmits an even flow of nicotine through the skin and into the bloodstream. (About 25 to 50 percent of those using it experience some itching or burning at the site of the patch; nausea, headache, cough, insomnia, and vertigo have also been reported.) Both products are available without a prescription at many drugstores and supermarkets.
Zyban (bupropion). As an antidepressant, bupropion is sold as Wellbutrin, but the product prescribed to ease the craving for cigarettes is known as Zyban. This prescription drug doesn't contain nicotine, and although researchers aren't sure how it works, the drug appears to help in brain chemistry that may occur when you quit smoking. It may diminish some withdrawal symptoms such as irritability, frustration, anxiety, and cravings. In 2005, the Food and Drug Administration issued an alert for bupropion citing research that showed an increased risk for suicidal behavior in children and adults when taking the medication for depression. If you're interested in using Zyban to help you quit, talk to your doctor about possible side effects before getting a prescription.
Some health insurance plans cover the costs of these quitting aids. Both nicotine replacement products and Zyban can have side effects. Consult your doctor about any of these products before trying them, particularly if you're pregnant or have heart disease or another chronic illness, to make sure the products are safe for you.
You may also want to consider alternative methods, which include hypnosis and acupuncture, to help you stop smoking.
How can I cope with cravings once I do quit?
When the desire for a cigarette gets intense, California Smokers' Helpline recommends trying the Four D's:
- Delay: Look at your watch, and wait a couple of minutes. Often, the urge to smoke will be gone by the time the second hand has circled twice. (As the days pass, the urges will come less often.)
- Distraction: Whatever you were doing when the urge to smoke surfaced, do something else. If you're alone, find someone to talk to. If you're sitting, take a short walk.
- Drinking water: Water helps satisfy the need to put something in your mouth and your body -- and it's good for you.
- Deep breathing: Inhale slowly and deeply. Pause when your lungs are full, and count to five. Then exhale slowly. Repeat several times.
Some other tips on fighting urges:
- Keep busy. If you find yourself obsessing about smoking, find something to do. Come up with activities that engage you in some way: Make a quick phone call, take a short walk, talk with a coworker or friend.
- Develop new interests. Take a class, embark on a household improvement project, or start an exercise routine. Exercise -- whether walking, biking, jogging, swimming, or taking an aerobics class -- can distract your mind and body from the desire for cigarettes. Any of these activities can make you feel better and improve your health. And chances are the healthier you feel, the less you'll want to taint that by smoking.
- Get support and encouragement. Make an arrangement with someone you can call anytime, day or night, whenever the urge to smoke gets overwhelming. This can be particularly helpful if you have a sudden emotional shock or a slipup. Your "support buddy" can be a friend (try to choose someone who's positive and understanding yet firm) or someone from the California Smokers' Helpline.
How can I keep from gaining weight after I quit?
Not everyone gains weight after giving up cigarettes. However, without nicotine, your metabolism will return to a normal, slower speed. So if you find yourself eating more and you don't exercise, you will probably gain a few pounds. To prevent this, avoid high-fat foods and constant snacking (unless the snacks are along the lines of carrot sticks and apples.) Exercise throughout the day, if you can: Take the stairs at work instead of the elevator, go for a brisk walk each day, and start or add to your fitness program.
Try not to panic about modest weight gain. The health risks of smoking far surpass the risks of gaining five to 10 pounds. Smoking causes more than 400,000 deaths each year in the United States. If you're in a healthy weight range now, you'd have to gain about 100 to 150 pounds after quitting to make your health risks as high as they were when you smoked!
What if I fail the first time?
If you slip up and have a cigarette or two, it doesn't need to bring your program to a crashing halt. "Cheating" or lighting up once over a cup of coffee needn't put you back on the road to a pack a day. Remind yourself that quitting is hard. Just like anything that's difficult, you're not going to get it right immediately. Figure out what caused you to smoke, and learn from it. The key is to move on from the slipup, because berating yourself will only add to your stress and may make you fall off the wagon completely. Treat it as a bump in a road you're still traveling down. Remind yourself why you want to quit, and get back on track again as a nonsmoker.
Try to remember how much better you started feeling right before you slipped up. Use that as motivation. If you went three days without a cigarette, try to make it a week this time.
You may not succeed the first time you try to quit smoking. You might even need to give up your plan for the time being. Try to identify what barriers made you stumble in your attempt to quit and how you could overcome them when you try again. Once you've refined your plan and revived your fervor, you're ready.
What if I'm just not ready to quit?
Being ready is important to success. Different things motivate different people to stop smoking. Recognize that smoking is an addiction. Edwin B. Fisher, Jr., a psychologist and director of the Division of Health Behavior Research at the University of North Carolina, points out, "The more you identify your reasons for smoking and the reasons you want to quit, the more likely you'll be successful."
Paying more attention to when you smoke and what triggers your desire for a cigarette can be a first step in your preparations. Build up your motivation to quit: Write down five reasons you want to quit, and look at the list every day. By taking your own wishes and needs into account, you can come up with a plan that will work for you.
Center for Disease Control and Prevention's Quit Smoking Center http://www.cdc.gov/tobacco/how2quit.htm
American Lung Association http://www.lungusa.org/tobacco
Campaign for Tobacco-Free Kids http://tobaccofreekids.org
American Lung Association. Smoking 101 Fact Sheet. http://www.lungusa.org
American Lung Association. Secondhand Smoke Fact Sheet. http://www.lungusa.org/
Food and Drug Administration. Bupropion hydrochloride. http://www.fda.gov/cder/drug/InfoSheets/patient/BupropionPT.htm
Edwin B. Fisher Jr., PhD. American Lung Association's 7 Steps to a Smoke-Free Life. John Wiley and Sons Inc..
U.S. Surgeon General, You Can Quit Smoking, www.surgeongeneral.gov/tobacco/consquits.htm
U.S. Surgeon General, Tips for the First Week, www.surgeongeneral.gov/tobacco/1stweek.htm
American Lung Association. Secondhand Smoke Fact Sheet.
Tobacco Information Prevention Source. Cigarette Smoking-Related Mortality. http://www.cdc.gov/tobacco/research_data/health_consequences/mortali.htm
University of North Carolina. Faculty. http://www.sph.unc.edu/
American Lung Association. Benefits. http://www.lungusa.org/site/
Centers for Disease Control. Health Effects of Cigarette Smoking. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/health_effects.htm