If you smoke, you probably are quite aware that smoking is bad for your health — very bad, in fact. If you’ve been thinking about quitting, there is good news. There are more ways to kick the habit than ever before.
Why bother? Even if you’ve smoked for years, you’ll greatly improve your health. Within days, your blood vessels will regain much of the normal function that is damaged by smoking. Within weeks, you’ll be able to taste food better, and your sense of smell will recover from tobacco’s assault. Within months, symptoms of chronic bronchitis ease up, and lung function improves within a year. Quitting reduces the risk of heart attack and stroke within two to five years. And the risk of lung cancer begins to drop substantially within five to nine years of quitting.
How to quit There are four basic strategies for quitting. Most smokers start by trying to quit on their own, but many end up needing several methods and making several attempts before they kick the habit.
Strategy 1: Do it yourself
Cutting back slowly rarely works; nearly everyone who tries slides back up to their usual dose of nicotine. Cold turkey is the way to go, but it takes preparation. And even without professional help, cooperation from family and friends can be important. Here are some tips:
- Pick a quitting date and stick to it. In choosing a date, steer clear of stressful periods, and avoid holidays if you are likely to be invited to smoke-filled parties.
- Try to get other smokers in your household or circle of friends to join you in quitting—the mutual support can help you succeed.
- As your quit date approaches, throw out your ashtrays, clean your house, car, and clothes, and have your teeth cleaned. Once you’re away from it, you’ll see that smoking stinks.
- Anticipate withdrawal symptoms such as grumpiness, restlessness, irritability, hunger, headache, anxiety, and drowsiness or insomnia. The discomfort usually peaks one to three weeks after you quit, and then it gradually diminishes. To get through the rough patches, stock up on low-calorie snacks and sugarless gum or candy to keep your mouth busy. Plan enjoyable diversions to keep your mind busy. Think of ways to keep your hands busy.
- Begin an exercise program. It will relieve tension, promote good sleep, and help control weight gain. Walking for 30 minutes a day can really help.
- Stay away from secondhand smoke. Don’t even think about smoking “just one” — even a single puff will set you back.
- Think positively — you can quit. Take it one day at a time. And if you slip, try, try again — either on your own or with one or more of the other strategies for quitting.
Strategy 2: Behavioral support
Quitting may be hard, but it doesn’t have to be lonely. Many employers, health plans, and hospitals offer individual or group counseling. Your doctor or your local chapter of the American Lung Association or American Cancer Society can refer you to a program in your area. Telephone support can also help; you can try it for yourself by calling the National Smoking Cessation Hotline at 800-QUIT-NOW. Hypnosis is another alternative that has helped some smokers break free.
Strategy 3: Nicotine-replacemen t therapy
Nicotine replacement is safe. You’ll get less nicotine than from cigarettes, and you won’t get any of the tar, carbon monoxide, and other damaging substances in tobacco. Plan to start nicotine-replacemen t therapy—nicotine patches, gum, lozenges, inhalers, or nasal sprays—on the day you quit smoking. If you are a heavy smoker, you’ll need higher doses. Estimate how much nicotine you need based on an average of 1 to 2 milligrams (mg) of nicotine per cigarette. Start with the full dose, then gradually taper down over several months. Under-dosing is more common than overdosing, but you should not smoke while using nicotine-replacemen t therapy.
Strategy 4: Prescription drugs
- Bupropion (Wellbutrin, Zyban) was initially approved to treat depression and was then approved for smoking cessation. It does not contain nicotine and can be used in combination with nicotine-replacemen t therapy. Typically, quitters start taking bupropion one to two weeks before their quit date. The usual dose is 150 mg once a day for the first three days, then 150 mg twice a day for 8 to 12 weeks, or longer if needed. Bupropion can reduce weight gain after quitting. Possible side effects may include dry mouth and insomnia; seizures are very rare.
- Varenicline (Chantix) is the newest drug approved for smoking cessation; although experience is still limited, it also promises to be the most effective. It blocks nicotine receptors in the brain while also partially stimulating these receptors to reduce nicotine withdrawal symptoms. The usual dose is 0.5 mg once a day for the first three days, then 0.5 mg twice a day for four days, followed by the full dose of 1 mg twice a day for 12 weeks or longer. The dose should be lowered in patients with severe kidney disease. Nausea is common, and bad dreams may occur. Mood disturbances and behavioral problems have developed, particularly in smokers with psychiatric problems, but it’s not clear that these are caused by the medication. Reports of accidents and visual abnormalities are also being investigated by the FDA. More research is needed.
For more information on treating addiction, order our Special Health Report, Overcoming Addiction: Paths toward recovery at www.health.harvard. edu/ADD.
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