Sizzling Ways to Stop Smoking
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Sizzling Ways to Stop Smoking

Quitting smoking is one of the most daunting challenges you will face in your life. It is an addiction that is both physical and psychological. But, quitting smoking can be done. In fact, you will have plenty of company: millions of Americans are former smokers.

There are certainly plenty of reasons to quit when you consider smoking's fatal link with lung cancer, emphysema, and heart disease, and the harmful effects of second-hand smoke on your family.

You have seen the warnings. Heard the discussions. Received the advice. Listened to your kids nag you about it. You know you should quit smoking, but where do you start? Knowing what you are up against can help you form a successful plan to quit smoking.

The Mind and Body Connection

Smoking is addictive—both physically and psychologically. The physical addiction can be traced to the nicotine in each cigarette. It hooks you just as completely as other drugs, say researchers, and the withdrawal symptoms—cravings, anxiety, nausea, cramps, depression, and dizziness—are similar.

Nicotine surges through the bloodstream and gives smokers a high—a quick jolt that makes them think they feel better. But, what really happens is that smokers develop a tolerance for nicotine, which is why they increase from one pack a day to two packs a day.

The psychological addiction is, in its own way, just as bad. Smoking becomes second nature, like blinking or breathing. If you consider that one pack of cigarettes can turn into 150 to 200 puffs a day, seven days a week, 52 weeks a year, you will see how hard it is to de-program yourself.

The Key to Quitting

"You know, there is no magic bullet, no device that will make it easy," says Jenny Duffey, who smoked for 13 years before quitting in 1989, and has written a book and taught seminars on quitting. But, you can quit.

"The thing to keep in mind is that almost everyone who quits has to try more than once," says Anne Davis, MD, a past president of the American Lung Association. "You should not be discouraged. It is more rare to quit on the first try than on the fifth…"

The key to quitting, say the experts, is patience, perseverance, and having a plan.

How to Do It

Keep these points in mind when you quit:

Know Why You're Quitting

Pick a reason that you believe in, be it for your family or for yourself. If you do not believe in your reason, it is that much harder to quit.

Change Your Environment

Worry about not smoking for just one day, and not for the rest of your life. Besides, it gets easier to stave off the desire the longer you do not smoke. The nicotine will be gone from your system in 3-5 days, and after about a month the worst of the withdrawal symptoms will go away.

Taper Off

Some studies show that a majority of permanent quitters achieved their goal by quitting "cold turkey." But, there are many other options, like slowly decreasing the number of cigarettes you smoke.

The key to tapering off is to cut down the number of cigarettes you smoke each day. One way to do this, says Duffey, is to delay the first cigarette of the day. She recommends the two-hour approach. If you have your first smoke at 7 a.m., try holding out until 9 for a couple of days. Then, push it back until 11, and so on. By the end of four weeks, you will not be smoking at all. Whether you taper or quit cold, your goal must be the same: abstinence. If you choose to taper, do not let the process give you an excuse to delay the final step of quitting entirely. Set a quit day and stick to it.

Overwhelm the Addiction

Think about the things that lead to lighting up, and do not do them. Get rid of the ashtrays at home. Do not come back from lunch 15 minutes early to sneak in a cigarette break. Avoid places where smoking is part of the atmosphere.

Practice the Three D's

Delay; deep breathing; drink water. When you feel like a smoke, delay. Try to think of something else. Breathe deeply, and count to ten slowly as you do so. Drink water; aim for eight, eight-ounces (240 milliliters) a day, which helps flush the nicotine out of your system. Do something else, like chew gum, until the craving passes.

Keep a Diary

This technique, which has also been used effectively with people who eat too much, is surprisingly effective. Each time you feel like a cigarette, write down the time of day, what you are doing, and how badly you want to smoke on a scale of 1 to 3, with 1 for the worst craving. A diary, says Dr. Davis, helps you to learn to unlearn the responses that make you want to smoke.

"Just because you fail once does not mean quitting is out of reach," says Dr. Davis. "Half the battle is knowing that it may require several attempts, and feeling confident that you will eventually succeed."

Discuss Medication

You may want to discuss with your doctor medicines that are available to help with smoking cessation. One example is varenicline (Chantix). It helps by blocking the pleasant effects that nicotine causes on the brain.

In addition to varenicline, there are a range of other medicines available to help you quit smoking. Examples include nicotine replacement products; which may be in the form of chewing gum, lozenge, nasal spray, or patches; and an antidepressant called bupropion.

Based on the research available so far, it appears that varenicline works better than placebo and bupropion , another antidepressant used for quitting smoking.

Taking varenicline has been associated, however, with some side effects. The most frequently reported include: nausea, headache , insomnia, bad dreams, and changes in the way food tastes. Varenicline and bupropion may also increase the risk of serious mood and behavior changes.

While medicines may be a good options for you, these are definitely not a magic cure. You still need to be very committed to quitting.

Work with Your Doctor

For the best results, work with your doctor. Together, you can test your lung function and compare the results to those of a non-smoking person. The results can be given to you as your lung age. Finding out your lung age right after having the test done may help you to stop smoking.

Your doctor can also discuss with you all of your options, such as:

  • Over-the-counter nicotine patches, gum and lozenges, which may be used alone or in combination
  • Prescription nicotine inhalers or nasal sprays
  • Prescription varenicline
  • Prescription antidepressant bupropion
  • Alternative therapies, like hypnosis and acupuncture
  • Smoking cessation classes
  • Self-help programs—For example, web and computer-based programs are an option. You can find many programs online, like the American Lung Association's Freedom From Smoking . There are also telephone quit lines, cell phone programs, and text messaging programs. To learn more about these options, visit smokefree.gov .
  • Group therapy

Trying a combination of these options may work best for you. For example, using a nicotine patch and going to group therapy may help you to become smoke-free.

Reward Yourself for Succeeding

Quitting is hard and you deserve a reward for meeting your short-term goals like being quit for one week, two weeks, or a month. Give yourself something you really want but have been putting off getting. Remember how much money you are saving by not buying cigarettes!

RESOURCES:

American Lung Association
http://www.lungusa.org/

Tobacco Information and Prevention Source (TIPS)
http://www.cdc.gov/tobacco/index.htm

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/

The Lung Association
http://www.lung.ca/

References:

DynaMed Editorial Team. Tobacco use disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated March 7, 2011. Accessed March 15, 2011.

Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

Potts LA, Garwood CL. Varenicline: the newest agent for smoking cessation. Am J Health Syst Pharm. 2007;64:1381-1384.

Public health advisory: FDA requires new boxed warnings for the smoking cessation drugs Chantix and Zyban. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm169988.htm . Published July 1, 2009. Accessed July 8, 2009.

White AR, Moody RC, Campbell JL. Acupressure for smoking cessation—a pilot study. BMC Complement Altern Med. 2007;14;7:8.

Williams KE, Reeves KR, Billing CB Jr, Pennington AM, Gong J. A double-blind study evaluating the long-term safety of varenicline for smoking cessation. Curr Med Res Opin. 2007;23:793-801.

Yacoub WG, Reisz G. Kicking butts: smoking cessation update. Mo Med. 2007;104:260-264.

3/25/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Parkes G, Greenhalgh T, Griffin M, Dent R. Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial. BMJ. 2008;336:598-600.

2/17/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2009;(1):CD001007.

7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Myung SK, McDonnell DD, Kazinets G, Seo HG, Moskowitz JM. Effects of Web- and computer-based smoking cessation programs: meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169:929-937.

11/13/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Piper ME, Smith SS, Schlam TR, et al. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Arch Gen Psychiatry. 2009;66(11):1253-1262.

12/21/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Whittaker R, Borland R, Bullen C, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(4):CD006611.



Last reviewed March 2011 by Brian Randall, MD


Last updated Updated: 3/15/2011

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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