Help to Stop Smoking

The immediate and long-term health benefits of quitting smoking pertain to anyone at any age. Research shows that more than half of all smokers who continue to smoke will end up dying from a smoking-related illness.

Quitting reduces your risk of lung and other cancers, heart and lung disease, blood clots, strokes, cataracts, and respiratory infections plus other problems. It improves the health of others by reducing their exposure to secondhand smoke.

If you smoke, you and those around you are exposed to more than 4,000 chemicals in cigarette smoke. Many of these chemicals are found in wood varnish, rat and insect poison, arsenic, and nail polish remover--things most people would never consider inhaling!

Smokers who quit can save money, set a good example for children, have more energy and a better sense of smell and taste, cough less, and look and smell better. Many workplaces now prefer to hire non-smokers so a person’s job prospects also may expand.

Coping with Nicotine Dependence

Quitting smoking is difficult, and many smokers try several times before they quit for good. One reason is that they are addicted to nicotine, a drug found naturally in tobacco.

When a smoker tries to cut back or quit, the lack of nicotine leads to unpleasant symptoms, both mental and physical. Mentally, the smoker is faced with giving up a habit, which calls for a major change in behavior and lifestyle.

Physically, the body reacts to the absence of nicotine. Nicotine withdrawal symptoms usually start within a few hours of the last cigarette and peak about two-three days later and can include any of the following:

• Dizziness (which may only last 1-2 days after quitting).
• Feelings of frustration, impatience, restlessness and anger.
• Irritability, anxiety and depression.
• Trouble falling asleep, staying asleep, bad dreams or nightmares.
• Trouble concentrating.
• Headaches and tiredness.
• Increased appetite.

These symptoms often lead the smoker to start smoking cigarettes again to boost blood levels of nicotine back to a point where there are no symptoms. It is important to remember that these symptoms are temporary!

Nicotine Replacement Therapy

Nicotine replacement therapy (NRT) gives the smoker small doses of nicotine which help relieve some of these withdrawal symptoms and lets the body gradually become accustomed to less nicotine. There are many forms of NRT, including patches, gums, sprays, inhalers, and lozenges.

Remember, only one type of NRT should be tried at a time, only for a limited time, and should be tapered down before stopping. Read and follow all package directions carefully, including who should or should not use NRT. Finally, you should not begin using NRT until ready to stop smoking cigarettes.

Nicotine patches give a measured “dose” of nicotine through the skin, usually in the form of a 16 or 24-hour dose. It should be placed below the neck, but above the waist. Typically, users will try a full-strength patch for four weeks, followed by four weeks using a lower dose.

Nicotine gum acts faster than patches, and the dosing can be more controlled. The gum should be chewed slowly and allowed to sit inside the mouth against the cheek for 20-30 minutes. No more than 20 pieces should be chewed in one day (one-two pieces per hour is common). The gum should be tried for at least one-three months, but no more than six months.

Nicotine lozenges are the newest form of over-the-counter NRT. They come in different doses and can be used for up to 12 weeks, but not more than 20 lozenges per day. The user should not eat or drink for 15 minutes before using a lozenge.

Nasal spray and inhalers are available only by prescription. Both are expensive, but act quickly to stop withdrawal symptoms and cravings. Nicotine inhalers are said to be the closest thing to smoking a cigarette, which some people find appealing.

Two popular non-nicotine medications that reduce nicotine withdrawal symptoms include Zyban and a newer drug called Chantix. Chantix has the added benefit of also reducing a person’s urge to smoke. Studies show that half of Chantix users have quit after 12 weeks. Both medications are available by prescription.

Before you actually quit smoking, consider these steps to prepare:

• Write down all the reasons to quit. Reread the list and add to it often.
• Think about past attempts to quit and recall what worked and what did not.
• Keep track of why and when you smoke. Avoid “triggers” such as being around other smokers, certain places, events etc.
• Make sure you have a support system in place such as family members and co-workers. Find someone who quit recently and learn how they were successful.
• Set a date as your “quit” goal. Give yourself enough time to prepare and set short-term goals, or “baby steps” to success.
• Have a strategy for dealing with cravings (e.g., chew gum, take a walk, call a friend, etc.)

Quitting is challenging, but thousands of people have quit successfully. Stopping smoking is the best single step that smokers can do to enhance the length and quality of their lives and of those around them.

Elaine Abrams, RN
Certified Health Educator and Community Health Coordinator, Nursing & Home Care, Wilton, CT

RESOURCES

American Cancer Society, 599 Clifton Road, NE, Atlanta, GA 3032, 800-ACS-2345, www.cancer.org

American Lung Association, 61 Broadway, 6th Fl., New York, NY 10006; 800-LUNG-USA; www.lungusa.org

Centers for Disease Control & Prevention (CDC) Quit Smoking Hotline, 4770 Buford Highway, NE, MS F-10, Atlanta, GA 30341-3717; 800-QUIT-NOW; www.cdc.gov/tobacco/quit_smoking/index.htm