Smoke Signals — The Need-to-KnowSometimes being number one isn’t such a good thing. Smoking is currently the leading cause of preventable deaths in the U.S. Every year over 392,000 people die from tobacco-related diseases and 8.6 million Americans suffer from at least one serious illness or condition caused by smoking. The good news is that smoking prevalence is actually decreasing: In 2010, there were 45.3 million smokers in the U.S. (about nineteen percent of adults) — a 50 percent decrease from the 1960s.
Going cold turkey is notoriously tough because nicotine, the main chemical in tobacco, is an incredibly addictive substance. Nicotine alters the mood and acts as a stimulant, leading to feelings of well-being, stimulated memory and alertness, increased heart rate, decreased appetite, and elevated blood sugar.
Nicotine can make a person feel great while it’s in the body, but not so much when that person decides to quit. The absence of nicotine produces acute, uncomfortable withdrawal symptoms which can take between a few hours and a few days to set in. Withdrawal symptoms include cravings, anxiety, restlessness, difficulty concentrating, nightmares or trouble sleeping, headaches, increased appetite, irritability, and depression, which can then fuel a person to want a cigarette even more.
Clearing the Smoke — Your Action PlanOnce the decision is made to quit, it’s time to do some homework. Knowing as much as possible about the process beforehand makes it easier to prevent slip-ups and quit successfully.
Decide to QuitWhat are the pros and cons of quitting? Write down specific reasons for quitting and keep the list in view. Motivating factors can range from personal health (the tar and carbon monoxide in cigarettes increase the likelihood of heart disease, lung cancer, strokes, and emphysema; specific risks for women include blood clots, brittle bones, and infertility) to more “aesthetic” reasons (a long-term smoking habit can contribute to cataracts, gum disease, tooth decay, wrinkled skin, and yellow teeth and nails. Sexy, right?).
Personal relationships can also motivate someone to quit. Every year, 50,000 people die from exposure to secondhand smoke — meaning the decision to quit has a direct effect on the people around us. Smoking even affects unborn fetuses: Smoking while pregnant is linked to early births, low birth weight, and birth defects like heart issues or cleft palates.
Once you’ve clarified your reasons for quitting, it’s time to commit to a plan of action.
Pick a Quit Day and Make Preparations
- Tell family and friends, circle the day on a calendar, and schedule alerts into the cell phone and computer. Make it impossible to forget or back out at the last minute.
- Sign up for a group program and schedule a first meeting or pick out a self-help plan.
- Talk to a doctor about whether to consider nicotine replacement therapy (NRT) to curb cravings . NRT releases small amounts of nicotine — but none of the other chemicals found in cigarettes — via a patch, gum, lozenge, spray, or inhaler.
- Also discuss using prescription drugs to make the transition easier. Medications function by reducing nicotine cravings or blocking nicotine receptors (making smoking less pleasurable and withdrawal symptoms less painful).
- Get rid of smoking paraphernalia and stock up on oral substitutes like gum, hard candy, and carrot sticks.
- Tried to quit before? Think about what went wrong and learn from past mistakes. For example, if cold turkey didn’t work, try using NRT or medications the second time around.
- Pack your schedule around Quit Day and the week afterwards. Plan to spend as much time as possible in public spaces where smoking isn’t allowed (libraries, museums, restaurants, etc.) and commit to healthier activities that make you feel good.
Plan to Cope with Withdrawal
- Don’t smoke. Not even once.
- Stay active, drink lots of water, and ditch alcohol, which lowers resolve and is often associated with smoking.
- Try to avoid triggering activities like hanging out in bars, drinking coffee, or watching TV.
- If you decide to take NRT or prescription drugs, use them correctly and consistently.
- Attend group meetings, make use of telephone counseling, and read self-help books.
- Mix up your daily routine by trying out different activities and hobbies, foods, or routes around town.
- Avoid situations where people are smoking or people who are known smokers. Instead, rely on a support system of friends and family who will encourage you to stay on track.
- Sometimes you can’t avoid the people or places that may trigger you to want a cigarette. In these cases, try to prepare in advance for refraining from smoking even in difficult situations.
- Keep physical substitutes for cigarettes on hand at all times. Gum, candy, and straws or toothpicks work for the oral component. Fill an empty hand with a pencil, stress ball, or marble.
- Don’t rationalize! Write down any rationalizing thoughts (ex: “I just need one to get me through this tough spot”). Once you’ve recognized the urge, find a distraction and move on.
- Use the acronym HALT to recognize a cigarette craving. Many people feel the urge to smoke when they are Hungry, Angry, Lonely, or Tired. Be aware of these triggers and deal with them by eating, calling a supportive friend, visiting a loved one, or going to bed.
- Practice mindfulness meditation. Take deep breaths and spend a moment or two recognizing a craving when it strikes. Be aware of the desire for a cigarette, accept it, and move on. This can be extremely helpful for developing awareness of triggers and helping you to "surf your urges."
- Celebrate smoke-free milestones with small treats like a nice dinner out, a trip to a museum, a yoga class, or a new book.
Address Slip-Ups and Relapses
- A slip-up is a one-time cigarette; a relapse is returning to a smoking habit. In both situations, try not to be too hard on yourself. Instead, resolve to get back on track — right away.
- Most importantly, learn from mistakes. Did something trigger a craving? Did a withdrawal management technique fail? Use the slip-up to improve your commitment to staying smoke-free.
But What About…Weight gain?
Some people delay quitting smoking because they worry about gaining weight. Many smokers do get heavier when quitting (since appetite rises again once nicotine leaves the body), but most gain fewer than 10 pounds. Focus on maintaining a healthy overall lifestyle by eating well, exercising, and avoiding junk food. Take quitting one day at a time and worry about losing weight (if necessary) later.
Along with learning to manage withdrawal symptoms and cravings, ex-smokers must find a way to deal with stress without lighting up. The good news? A new study found that people who successfully quit smoking were less anxious than smokers. Regardless of the science, some ex-smokers find they need a new way to cope with nerves. Physical activity is a great de-stressor, as are breathing techniques and meditation. Consider signing up for a stress-management class to help blow off some steam.
Even when a smoking habit is a thing of the past, it’s important to stay aware of health risks associated with cigarettes. Keep the doctor informed about any health issues, especially lung or heart problems like a troublesome cough or chest pain.
A smoking addiction is both mental and physical. Medications and NRT can help with the physical withdrawal symptoms, but successfully quitting requires emotional support, too. Talk to family and friends before beginning the process and set up a network of people to call or visit when cravings strike. Consider joining a quitting program like QuitNet, Freedom from Smoking, Nicotine Anonymous, or a local program through a hospital, workplace, or house of worship. It can often be helpful to surround yourself with people who have also quit smoking and can provide psychological support. If getting to a meeting is difficult, consider calling or texting an expert for advice.
No (Cigarette) Butts About It — The TakeawayQuitting isn’t a walk in the park, but the long-term health advantages far outweigh the struggle of fighting a nicotine addiction. The best way to successfully stop smoking is to prepare and plan for every situation so the temptation to light up never catches flame. Talk to doctors, friends, family, and addiction specialists to figure out the best way to kick the habit and take control of your health. Regardless of whether a smoking habit is brand new or 50 years strong, it’s never too late to stop smoking and reap big health benefits.
For more information and resources to help quit smoking, check out the North American Quitline Consortium, EX, The American Cancer Society, or The American Lung Association.