Smoking Cessation. Where do I start?

According to the US Surgeon General, quitting smoking is the single most important step that smokers can take to enhance the length and quality of their lives. It has been reported that over 70% of smokers want to quit and as many as 50% try to quit every year. This is equally, if not more important, for people who have received a cancer diagnosis. Continuing to use tobacco during treatment can make treatments more difficult to tolerate, increase side effects, and even undermine their effectiveness.

The addiction to all forms of tobacco is real and difficult to overcome, even more so without support. Support can come from other ex-smokers, family and friends, supportive websites (quit nets) and phone numbers (quitlines), medication, and formal support programs. Despite these resources, it often takes multiple attempts for a person to give up smoking for good. So, where should a person who wants to quit start?

Get Started

The first step to quitting is deciding you want to quit and making a commitment to quitting. It sounds simple, but it is critical. You can't quit because (insert friend or family member) wants you to, you have to want to quit. Write down the reasons you want to quit and put them somewhere you can refer to them for inspiration when times get tough.

Set a Date

Got your list? Good, now pick a quit date and gather support. Experts suggest setting a quit date within 2 weeks and sticking with it. Let friends and family know and ask them to support you. Maybe that means taking a walk with you or meeting for lunch when you really want a cigarette. It may mean just being understanding when you're just not acting like yourself and perhaps in a bad mood. Having a friend to talk to who has quit can be helpful. If you don't have one, consider joining an online support group through smokefree.gov, or Become an ex. Other options can include text message programs through these organizations, quit apps on your phone, and Facebook groups.

Talk to Your Provider

Remember that tobacco use is not just a habit, but an addiction. Unfortunately, only 5-10% of smokers who attempt to quit "cold turkey" are successful long-term. The U.S. Department of Health and Human Services recommends that, unless advised by a healthcare provider, people who smoke 10 or more cigarettes a day should use medication therapy in every attempt to quit. There are a number of medications that can help you quit and your healthcare provider can help you choose which is best for you.

Make an appointment to discuss your plan with your healthcare provider and ask them for suggestions to help you be successful. They can recommend medications, information about what to expect (withdrawal symptoms, common challenges), or referrals to organized cessation support programs. Continue to involve your healthcare provider during the quitting process. They can be good sources of information and support. (Read about smoking cessation aids.)

Tips to Help You be Successful

Have you tried to quit before? You are not alone! On average, it takes smokers seven attempts to quit for good. Think about past attempts. What was successful about the attempts to quit, and what caused them to ultimately be unsuccessful? Think of ways to avoid those previous pitfalls. There are some common obstacles, including living with someone who smokes. Ask them to quit with you or not smoke in front of you. Being in a place where others are smoking can be far too tempting, so avoid those situations for a while. Alcohol is often associated with smoking, so try to avoid the bar scene for a while. Many ex-smokers report feeling better and breathing better within a few days of quitting, but this can make them think it is okay to smoke again. Remember, quit means quit, not just a puff here and there. One puff quickly reverts back to the old habit by increasing the urge to smoke, making quitting harder. So practice abstinence from smoking!

Think about situations that you normally light up in; can you avoid them? Change your daily routine to not be in those familiar situations. Do you smoke in the car on the way to work? Can you take public transportation or carpool with a nonsmoker until that habit is broken? Have to pass the smokers on your way out to lunch? Can you take another route, pack a lunch or ask a non-smoking support buddy to come along? Planning ways to deal with common situations will make it easier to deal with them after your quit date. Keep yourself busy during the first few weeks. Visit friends, start exercising, get to those around the house jobs you've been putting off.

The day before your quit date is final preparation time. Throw away all your tobacco- that means all of it! Check your car, your purse, your coat pocket. You don't want any unnecessary temptations! Get rid of (or hide) the paraphernalia that goes along with smoking; lighters, matches, and ashtrays. Make sure you have things on hand to keep your mouth occupied that aren't necessarily food, such as sugarless gum, mints, or candy.

The first few weeks will be tough, but remember your reasons for quitting and call on your support people. You may experience nicotine withdrawal, which can manifest as irritability, depression or sadness, headache, inability to concentrate, and a craving for cigarettes. Nicotine replacement therapies can help with these symptoms. Withdrawal symptoms typically last 2 weeks and then start to decrease, so hang in there.

If you happen to have a cigarette, get right back on the quitting horse. Think of what led to the slip and how to prevent it from happening again. Call on your support people or healthcare provider, call a quitline or visit a quitnet chat room. Remind yourself frequently what a great accomplishment every smoke-free day is for you. You are setting a great example for other smokers and improving your health. Quitting is not easy, but you will be rewarded with improved health and well-being. Not to mention all the money you will save!

To find local quit smoking programs or groups, try contacting your health insurance company or local hospital or call the American Cancer Society helpline (1-800-277-2345). Ask someone you know who has quit or your primary care physician for recommendations. Use good judgment - if a program seems too good to be true or charges a lot of money, ask your healthcare provider about it first.

Resources for More Information

Smoking Cessation Aids: This article reviews the available treatments, both pharmacologic (drug) and non-pharmacologic, to aid in successful smoking cessation.

Smokefree.gov: provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking. From the National Cancer Institute.

Become an EX: A project of the Truth Initiative and Mayo Health, this resource includes an active social community, text, and email messaging support, expert guidance and interactive quitting tools.

Tobacco-Free Kids: one of the nation's largest non-governmental initiatives, with the goal of protecting children from tobacco addiction and exposure to secondhand smoke. They offer talking points and support for parents.

QuitLogix: An online program designed to help people quit smoking successfully. While it is run by the State of Pennsylvania, you do not have to be a resident to participate.

The American Cancer Society: There are many excellent resources and printed materials (brochures/booklets) available from the American Cancer Society. Learn more by visiting their website or by calling their toll-free number, 1-800-227-2345. Representatives can also help you find local in-person support resources.

Freedom From Smoking Online: This online resource for adults is an adaptation of the American Lung Association's gold standard, group clinic that has helped thousands of smokers to quit for good.

CDC Tobacco Information Page: Contains lots of helpful information covering: statistics, kids and smoking, quitting, research information (Surgeon General's Reports), etc.

Nicotine Anonymous: a 12 step Fellowship of men and women helping each other live nicotine-free lives.

U.S. Environmental Protection Agency: Information about second-hand smoke and smoke-free homes, cars, and kids.

Do you live in the Philadelphia Area? You may qualify for smoking cessation studies at the Center for Interdisciplinary Research on Nicotine Addiction.