Smoking - tips on how to quit

Smoking hazards — The addictive effects of tobacco have been well documented. It is considered to be mood and behavior altering, psychoactive, and abusable. As a multisystem pharmacological agent that is voluntarily administered, tobacco is believed to have an addictive potential comparable to alcohol, cocaine, and morphine. Tobacco and its various components increase the risk of cancer (especially in the lung, mouth, larynx, esophagus, bladder, kidney, pancreas, and cervix), heart attacks and strokes, and chronic lung disease.

Also known as: Cigarettes - tips on how to quit, Smoking cessation - tips on how to quit or Smokeless tobacco - tips on how to quit

Information

There are a lot of ways to quit smoking and many resources to help you. Family members, friends, and co-workers may be supportive or encouraging, but to be successful the desire and commitment to quit must be your own.

Most people who have been able to successfully quit smoking made at least one unsuccessful attempt in the past. Try not to view past attempts to quit as failures, but rather as learning experiences.

Stopping smoking or using smokeless tobacco is difficult, but anyone can do it.

Know the symptoms to expect when you stop. Common symptoms include:

An intense craving for nicotine
Anxiety, tension, restlessness, frustration, or impatience
Difficulty concentrating
Drowsiness or trouble sleeping, as well as bad dreams and nightmares
Drowsiness and trouble sleeping
Headaches
Increased appetite and weight gain
Irritability or depression

How severe your symptoms are depends on how long you smoked and how many cigarettes you smoked each day.

Feel ready to quit?

First and foremost, set a quit date and quit completely on that day. Before your quit date, you may begin reducing your cigarette use. But remember, there is no safe level of cigarette smoking. See: Making the decision to quit tobacco
List the reasons why you want to quit. Include both short- and long-term benefits. See: Making the decision to quit tobacco
Identify the times you are most likely to smoke. For example, do you tend to smoke when feeling stressed or down? When out at night with friends? While drinking coffee or alcohol? When bored? While driving? Right after a meal or sex? During a work break? While watching TV or playing cards? When you are with other smokers?
Let all of your friends, family, and co-workers know of your plan to stop smoking and your quit date. Just being aware that they know what you're going through can be helpful, especially when you are grumpy.
Get rid of all your cigarettes just before the quit date, and clean out anything that smells like smoke, such as clothes and furniture.

Make a plan about what you will do instead of smoking at those times when you are most likely to smoke.

Be as specific as possible. For example, drink tea instead of coffee -- tea may not trigger the desire for a cigarette. Or, take a walk when you feel stressed.
Remove ashtrays and cigarettes from the car. Place pretzels or hard candies there instead. Pretend-smoke with a straw.
Find activities that focus your hands and mind, but are not taxing or fattening. Computer games, solitaire, knitting, sewing, and crossword puzzles may help.
If you normally smoke after eating, find other ways to end a meal. Play a tape or CD, eat a piece of fruit, get up and make a phone call, or take a walk (a good distraction that also burns calories).

Make other changes in your lifestyle.

Change your daily schedule and habits. Eat at different times or eat several small meals instead of three large ones. Sit in a different chair or even a different room.
Satisfy your oral habits by eating celery or other low-calorie snack, chewing sugarless gum, or sucking on a cinnamon stick.
Go to public places and restaurants where smoking is prohibited or restricted.
Eat regular meals and don't eat too much candy or sweet things.
Get more exercise. Take walks or ride a bike. Exercise helps relieve the urge to smoke.

Set short-term quitting goals and reward yourself when you meet them.

Every day, put the money you normally spend on cigarettes in a jar. Then buy something pleasurable after a period of time.
Try not to think about all the days ahead you will need to avoid smoking. Take it one day at a time.
Even one puff or one cigarette will make your desire for more cigarettes even stronger. However, it is normal to make mistakes. So even if you have one cigarette, you don't need to take the next one.

Other tips to help you quit smoking and stick to it:

Enroll in a smoking cessation program (hospitals, health departments, community centers, and work sites often offer programs). Learn about self-hypnosis or other techniques. See: Stop smoking support programs
Ask your health care provider about prescription medications that are safe and appropriate for you. See: Medications for smoking cessation
Find out about nicotine patches, gum, and sprays. See: Nicotine replacement therapy

The American Cancer Society's web site -- -- is an excellent resource for smokers who are trying to quit, and the Great American Smokeout can help some smokers kick the habit.

Above all, don't get discouraged if you aren't able to quit smoking the first time. Nicotine addiction is a hard habit to break. Try something different next time. Develop new strategies, and try again. Many people take several attempts to finally kick the habit.

References

Benowitz NL. Tobacco. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 30.

Burke MV, Ebbert JO, Hays JT. Treatment of tobacco dependence. Mayo Clin Proc. 2008;83:479-483.

Fiore MC, Jaen CR, Baker TB, Bailey WC. . May 2008. Accessed October 30, 2010.

Hays JT, Ebbert JO, Sood A. Treating tobacco dependence in light of the 2008 U.S. Department of Health and Human Services clinical practice guideline. Mayo Clin Proc. 2009;84:730-735.

. Accessed October 30, 2010.

Review date:: October 31, 2010
Reviewed by:: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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