Kicking the Smoking Habit

Whether you’re a teen smoker or a lifetime pack-a-day smoker, quitting can be tough. But the more you learn about your options and prepare for quitting, the easier the process will be. With the right game plan tailored to your needs, you can break the addiction, manage your cravings, and join the millions of people who have kicked the habit for good.

Smoking is so addictive because of nicotine, the main drug in tobacco. Your brain quickly adapts to it and craves more and more to feel the way you used to feel with just one cigarette. Over time, the brain learns to predict when you are going to smoke a cigarette. You feel down and tired, so you think, “I need a cigarette,” and the cycle starts again. But it is not just about brain chemistry. Certain situations make you want to smoke. Everyone’s triggers are different. yours might include the smell of cigarette smoke, having an ashtray next to you, seeing a carton of cigarettes at the store, having certain food or drinks, ending a good meal, or talking with someone with whom you normally smoke cigarettes. Sometimes just the way you feel (sad or happy) is a trigger. One of the biggest keys to quitting smoking is spotting the triggers that make you crave smoking and trying to avoid them.

Quitting smoking can seem very 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 will cause your body to experience physical withdrawal symptoms and cravings. Because of nicotine’s “feel good” effect on the brain, you may also have become accustomed to smoking as a way of coping with stress, depression, anxiety, or even boredom. At the same time, the act of smoking is 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 from work or school, or during your commute home at the end of a long day. Perhaps friends, family members, and colleagues smoke, and it has become part of the way you related with them.

In a 2010 health survey, more than 70% of women said they wanted to quit smoking. More than half reported that they had tried to quit in the past year. The chance of quitting and staying quit is about the same for both men and women, but there may be some ways women are different. Quitting can help reduce the risk of many of the health problems linked to smoking. The risk of heart disease is reduced just 1-2 years after quitting. The risk of stroke can drop to that of a non-smoker within 2-5 years after quitting. Many women are afraid to quit for fear of gaining weight. Some women who quit smoking do add a few pounds, mostly in the first year. It varies, but women gain an average of around 10 pounds after quitting. This amount of weight gain can usually be controlled through diet and exercise. And the health benefits of quitting are much greater than any problems posed by a small weight gain.

Some studies have shown there may be differences in men and women who are trying to quit smoking. A few studies, for instance, found that nicotine replacement therapies seemed to help men more than women. Studies of other medicines, such as bupropion (Zyban) and varenicline (Chantix) have not found such a difference–men and women had the same success rates. Some of these studies used counseling or group support, which seemed to help men and women quit and stay quit. There’s also a question about how the monthly hormone changes can affect pre-menopausal women as they’re quitting smoking. Study results have been mixed about whether it works better for women to try quitting during the first or last parts of their menstrual cycles. Most of the studies seem to support the idea that women may have stronger urges to smoke jut before their menstrual period is due to start. This is about the same time women may have pre-menstrual symptoms. Because of this, some experts recommend that women quit smoking after the pre-menstrual symptoms.

There are different ways to quit smoking. Some work better than others. While some smokers successfully quit by going cold turkey, most people do better with a plan to keep themselves on track. About 90% of people who try quitting do it without outside support–no aids, therapy, or medicine. Although most people try to quit this way, it’s not the most effective and successful method. Only about 4%-7% are able to quit by cold turkey alone. A good plan addresses both the short-term challenge of quitting smoking and the long-term challenge of preventing relapse. It should also be tailored to your specific needs and smoking habits. This could include behavioral therapy, where you work with a counselor to find ways not to smoke. Together, you’ll find your triggers (such as emotions or situations that make you want to smoke) and make a plan to get through cravings. Or it could involve nicotine replacement therapy, where nicotine gum, patches, inhalers, sprays, and lozenges are used. They work by giving you nicotine without using tobacco. You may be more likely to quit smoking if you use nicotine replacement therapy. If you are younger than 18, you need to get your doctor’s permission to use it. This plan works best when you also get behavioral therapy and lots of support from friends and family.

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.

Do you feel the need to smoke at every meal?
Are you more of a social smoker?
Is it a very bad addiction (more than a pack a day)? Or would a simple nicotine patch do the job?
Do you reach for cigarettes when you’re feeling stressed or down?
Are there certain activities, places, or people you associate with smoking?
Is your cigarette smoking linked to other addictions, such as alcohol or gambling?
Are you open to hypnotherapy and/or acupuncture?
Are you someone who is open to talking about your addiction with a therapist or counselor?
Are you interested in getting into a fitness program?

The immediate rewards of quitting smoking:

Kicking the tobacco habit offers some benefits that you will notice right away and some that will develop over time. These rewards improve most peoples’ day-to-day lives a great deal:

Breath smells better
Stained teeth get whiter
Bad smell in clothes and hair go away
Yellow fingers and fingernails disappear
Food tastes better
Sense of smell returns to normal
Everyday activities (such as climbing stairs or light housework) no longer leave them out of breath
They can be in smoke-free buildings without having to go outside to smoke
Smoking is expensive. Not only the cost per year for cigarettes, but also higher costs for health and life insurance.
Better social acceptance. Smoking can cost you friends, money, and convenience.
Smoking can cost you your job. Most employers today prefer to hire non-smokers. Smokers tend to call in sick more, and thus increase the cost of insurance, and the need to hire short-term replacements.

Benefits of quitting smoking over time:

20 minutes after quitting: Your heart rate and blood pressure drop.
12 hours after quitting: The carbon monoxide level in your blood drops to normal.
2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.
1 to 9 months after quitting: Coughing and shortness of breath decreases; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
1 year after quitting: The excess risk of coronary heart disease is half that of a continuing smoker’s.
5 years after quitting: Risk of cancer of the mouth, throat, esophagus, and bladder are cut in half. Cervical cancer risk falls to that of a non-smoker. Stroke risk can fall to that of a non-smoker after 2-5 years.
10 years after quitting: The risk of dying from lung cancer is about half that of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decreases.
15 years after quitting: The risk of coronary disease is that of a non-smoker’s.

These are just a few of the benefits of quitting smoking for good. Quitting smoking lowers the risk of diabetes, lets blood vessels work better, and helps the heart and lungs. Quitting while you are younger will reduce your health risks more, but quitting at any age can give you back years of life that would be lost by continuing to smoke.

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 you plan to quit.

Let your friends and family in out 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 (no emergency pack!), 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 you with withdrawal and suggest other alternatives. If you can’t see a doctor, you can get many products over the counter at your local pharmacy or grocery store, including the nicotine patch, nicotine lozenges, and nicotine gum.

How to quit smoking: Identify your triggers.

Keep a craving journal. A craving journal can help you zero in on your patterns and triggers. For a week of 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 or overwhelming feelings? Managing unpleasant feelings such as stress, depression, loneliness, fear, and anxiety are some of the most common reasons why adults smoke. 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, using sensory relaxation strategies, and practicing simple breathing exercises. For many people, an important aspect of quitting is to find alternative ways to handle these difficult feelings without smoking. 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 time thinking about the different ways you intend to deal with stressful situations and the daily irritations that would normally have you reaching for a cigarette.

Everyone is different, and how hard it will be to quit will depend on a number of things.

The number of cigarettes you smoke daily–the more you smoke, the harder it will be to quit.
The number of people you spend time with who smoke (friend, family, and co-workers)–you will need to surround yourself with non-smokers, or enlist a smoker who you are around all the time to quit with you.
The reasons you smoke (such as to control your weight, to fit in, or during social situations)–in other words, the triggers you need to look for so you can avoid them.

Focus on the benefits of quitting. Within hours of stopping cigarettes, your body starts to recover from the effects of nicotine and additives. Your blood pressure, heart rate, and body temperature–all of which are higher than they should be because of the nicotine in cigarettes–return to healthier levels. You can breathe easier. Poisonous carbon monoxide in your blood drops, so your blood can carry more oxygen. Quitting helps your whole body. It can even help your looks, as you will be less likely to get wrinkles when you are still young. And you will save money as well.

Tips for avoiding common smoking triggers.

Alcohol: Many people have a habit of smoking when they drink. TIP: switch to non-alcoholic drinks or drink only in places where smoking inside is prohibited. Alternatively, try snacking on nuts and chips, or chewing on a straw or cocktail stick.
Other smokers: When friends, family, and co-workers smoke around you, it is doubly difficult to quit or avoid relapse. TIP: Your social circles need to know that you are changing your habits so talk about your decision to quit. Let them 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, don’t take all your coffee breaks with smokers only, do something else instead, or find non-smokers to have your breaks with.
End of a meal. For some smokers, ending a meal means lighting up, and the prospect of giving that up may appear daunting. Tip: replace that moment after a meal with something such as a piece of fruit, a (healthy) dessert, a square of chocolate, or a stick of gum.
Try to stay away from situations that normally make you feel like smoking, especially during the first 3 months. This is when you are most likely to start smoking again.

How to quit smoking: Coping with nicotine withdrawal symptoms.

Know that the first few days are the toughest, especially if you are quitting “cold turkey”. You will probably feel irritable, depressed, slow, and tired. Once you get past those first few days, you’ll begin to feel normal (but still have cigarette cravings). One thing to remember–every time you don’t smoke when you have a craving, your chances of quitting successfully go up.

Once you stop smoking, you will experience a number of physical symptoms as your body withdraws from nicotine. Nicotine withdrawal begins quickly, usually starting within thirty minutes to an hour of the last cigarette and peaking about 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
Difficulty concentrating
Restlessness
Increased appetite
Headaches
Insomnia
Tremors
Increased coughing
Fatigue
Constipation or upset stomach
Depression
Decreased heart rate

Unpleasant as these withdrawal symptoms may be, they are only temporary. They will get better in a few weeks as the toxins are flushed from your body. n the meantime, let your friends and family know that you won’t be your usual self and ask for their understanding.

Coping with Nicotine Withdrawal Symptoms

Symptom Duration Relief
craving for cigarette most intense during 1st week Wait out the urge; distract yourself;
but can linger from months take a brisk walk.
Irritability, impatience 2-4 weeks Exercise; take hot baths; use relaxation
avoid caffeine
Insomnia 2-4 weeks Avoid caffeine after 6pm; use relaxation
techniques; exercise; plan activities (such
as reading) when sleep is difficult
Fatigue 2-4 weeks take naps; do not push yourself
Lack of concentration a few weeks reduce workload; avoid stress
Hunger several weeks or longer drink water or low-calorie drinks; eat
low-calorie snacks
Coughing, dry throat several weeks drink plenty of fluids; use cough drops
nasal drip
Constipation, gas 1-2 weeks drink plenty of fluids, add fiber to diet
exercise

Preventing weight gain after you’ve stopped smoking.

Weight gain is a common concern when quitting smoking. Some people even use 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 5 pounds on average–and that initial gain decreases over time. It’s also important to remember that carrying a few extra pounds won’t hurt your heart as much as smoking will. Of course, gaining weight is NOT inevitable when you quit smoking.

Smoking acts as an appetite suppressant. It also dampens your sense of smell and taste. So after you quit, your appetite will likely increase and food will seem more appealing. Weight gain can also happen if you replace the oral gratification of smoking with eating, especially if you turn to unhealthy comfort foods. So it’s important to find other, healthy ways to deal with stress and other unpleasant feelings rather than mindless, emotional eating.

Nurture yourself. Instead of turning to cigarettes or food when you feel stressed, anxious, or depressed, learn new wyas to soothe yourself.
Eat healthy, varied meals. Eat plenty of fruits and vegetables and limit your fat intake. Seek out low-fat options that look appetizing to you and you will actually eat. Avoid alcohol, sugary sodas, and other high-calorie drinks.
Drink lots of water. Drinking lots of water–at least 6 – 8 ounce 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. Walking is a great form of exercise. 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 low-calorie or calorie-free foods. Good choices include sugar-free gum, carrot and celeary sticks, sliced bell pepper or jicama, or sugar-free hard candies.

Medication and therapy to help you quit smoking.

There are many different methods that have successfully helped people to quit smoking, including:

Quitting smoking cold turkey.
Systematically decreasing the number of cigarettes you smoke. One less every day does make a difference.
Reducing your intake of nicotine gradually over time.
Using nicotine replacement therapy or non-nicotine medications to reduce withdrawal symptoms.
Utilizing nicotine support groups.
Trying hypnosis, acupuncture, or counseling using cognitive behavioral techniques.

You may be successful with the first method you try. More likely, you’ll have to try a number of different methods or combination or treatments to find the ones that work best for you.

Medications to help you stop smoking. Smoking cessation medications can ease withdrawal symptoms and reduce cravings, and 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.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 or a nicotine patch. It works by delivering small and steady doses of nicotine into the body to relieve some of the withdrawal symptoms without the tars and poisonous gases found in cigarettes. This type of treatment helps smokers focus on breaking their 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) are intended for short-term use only.
Using a combination of treatment methods may raise your chances of quitting. For example, using both a nicotine patch and gum may be better than a patch alone. Other proven combos include behavioral therapy and nicotine replacement therapy, prescription medication with a nicotine patch, and a nicotine patch and nicotine spray. The FDA has not yet approved using two types of nicotine replacement therapy at the same time, so be sure to talk with your doctor firts to see if this is the right approach for you.

Alternative therapies to help you stop smoking.

There are several things you can do to stop smoking that don’t involve nicotine replacement therapy or prescription medications: ask you doctor for a referral or see References and Resources below for help finding qualified professionals in each area.

Hypnosis: A popular option that has produced good results. 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 quit 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 endorphons (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 (the “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 quit smoking. One well know 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 tobacco or chew, 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 in cigarettes. Users of smokeless tobacco also have a greatly increased risk of oral and neck cancers.

What to do if you slip or lapse.

Most people try to quit smoking several times before they kick the habit for good, so don’t beat yourself up if you start smoking again. Turn the relapse into a rebound by learning from your mistakes. 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 slip up and smoke a cigarette, 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. The choice is yours. A slip doesn’t have to turn into a full-blown relapse.

I started smoking again, now what?

Having a small setback doesn’t mean you’re a smoker again. Most people try to quit smoking several times before they kick the habit for good. Identify the triggers or trouble spots you ran into and learn from your mistakes.

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 now.
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 canot be used if you are smoking at the same time.

Resources and References:

Smokefree.gov–includes many helpful stop smoking tips and resources, including step-by-step guide to quitting and free Smokefree Apps you can download. (US Department of Health and Human Services)
Your First Step to Change: Smoking–self-change toolkit helps smokers learn about their addiction and take steps to overcome it. (The Division on Addictions, Cambridge Health Alliance and Harvard Medical School)
Guide to Quitting Smoking–Ways to improve your chances of quitting smoking and dealing with both the mental and physical addiction. (American Cancer Society)
Helpful Hints to Kick the Smoking Habit–Provides advice on how to successfully quit smoking. Includes a list of smoke-free suggestiong. (University of Maryland Medical Center)
Quit Meter–Calculate how much extra money you’ll have after quitting. (quitmeter.org)
Quit Smoking with Acupuncture–How acupuncture can reduce cravings and alleviate withdrawal symptoms to helpo you quit smoking. (Acupuncture Referral Service Acufinder.com)
Medicines to Help You Quit Smoking–Provides an overview of medicines to help you quit, including Nicotine Alternatives. (American Heart Association)
You Can Control Your Weight As You Quit Smoking–provides suggestions for what to do before, during, and after quitting smoking to prevent weight gain. (National Institutes for Health)
Help For Cravings and Tough Situations– A comprehensive guide to developing alternative coping strategies when quitting smoking (Mayo Clinic)
Quitlines–call 800-QUIT-NOW (800-784-8669) to get the number of your local quitline. (North American Quitline Consortium)
Freedom from Smoking Online–Provides a seven module program that supports you and walks you through a smoking cessation program. (American Lung Association)
Nicotine Anonymous Meetings– Search for local meetings of Nicotine Anonymous, a 12-step program modeled after Alcoholics Anonymous. (Nicotine Anonymous)
Helping A Smoker Quit:Do’s and Don’ts–Provides a general list of “do’s” and “don’ts” for supporting someone who is quitting smoking. (American Cancer Society)
How Can I Help My Friends and Family–describes appropriate ways to help a friend or family member who is quitting smoking. (California Smoker’s Helpline)

Authors: Lawrence Robinson and Melinda Smith, M.A. from www.helpguide.org/addiction/how-to-quit-smoking

Resources in the Redding area:

Butte County: Butte County Department of Public Health, Tobacco Education Program–Offers a list of programs in Butte County that offer smoking cessation classes and programs. 530-538-6109.

Shasta County: Project Ex Teen Smoking Cessation Program–Redding and Anderson. Offers a free 4 week program (8 class sessions) designed to help teens quit smoking. Call for info. 530-244-7194. Quit for Good Smoking Cessation Class Series–Redding. Offers a free 8 session program for quitting all types of tobacco use. Year-round. www.redding.mercy.org. 530-3729.

Siskiyou County: Siskiyou County Tobacco Education Program–Yreka. Offers smoking cessation for youth and adults. 806 S. Main St. 530-841-2127.

Tehema County: Tehema County Health Services Agency–Red Bluff. Offers smoking cessation referral services and information. 1860C Walnut St. 530-527-6824.