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Smoking Cessation

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Updated November 13, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Smoking tobacco is one of the surest ways of reducing your life expectancy, and making a good bit of your shortened life span one of chronic illness and disability. If you are a smoker, smoking cessation is the healthiest thing you will ever do for yourself.

How Do People Quit Smoking?

Smoking is a chronic, addictive disease, but not everyone is addicted to the same extent. About 15% of smokers are apparently not strongly addicted to nicotine -- and these are probably the people you've heard about who have just been able quit smoking "cold turkey."

For most smokers, quitting takes a lot of work, planning, and perseverance. It is often best to quit with the help of your doctor, who can not only "coach" you in your efforts, but can also help you decide whether and when to use prescription smoking cessation aids.

Often, a good first step is to establish a definite date for quitting. Tell your family and friends about the quit date and try to get their support. Prepare yourself (and loved ones) to deal with the symptoms of nicotine withdrawal -- depression, anxiety, frustration and short temper, as well as nicotine craving. Avoid spending time with smokers, and avoid places and activities you have associated with smoking. Make other healthy changes in your lifestyle at the same time -- such as beginning an exercise program -- to reinforce the fact that you are turning over a new leaf and becoming a healthier person. Talk to your doctor about support programs for smoking cessation, such as group counseling. Relaxation therapy and hypnosis can also help you cope with the symptoms of tobacco withdrawal.

Medications For Smoking Cessation

Medications can help significantly in the effort to quit smoking, if you are willing to accept the expense and risk of side effects. You should talk to your doctor about whether medications might be helpful in your case. These medications include:

  • Nicotine replacement therapy: Taking nicotine can help (but not eliminate) the symptoms of nicotine withdrawal. Nicotine replacement therapy comes in the form of skin patches, gum, nasal spray, inhalers, and lozenges. Using nicotine replacement to take the edge off the withdrawal symptoms can double a person's odds of successfully quitting.

  • Zyban (bupropion): Zyban is an antidepressant medication that can improve the likelihood of success in quitting smoking. Its chief side effects are dry mouth, headache and insomnia. It should be avoided in people with seizure disorders, since it can increase the likelihood of seizures.

  • Chantix (varenicline): Chantix is a drug that works on nicotine receptors in the brain to reduce the symptoms of nicotine withdrawal. Clinical studies have suggested that Chantix can significantly improve smoking cessation as compared to placebo, Zyban, or nicotine replacement therapy. Chantix can cause nausea, sleep disturbances, and in a small number of people, neuropsychiatric disturbances including suicidal thoughts.
Frequently, medications are used in combination - either Zyban or Chantix, along with nicotine replacement therapy. Your doctor will help you decide on the best use of medications in your effort to quit smoking.

If You Relapse

Many, many individuals who successfully quit smoking have failed to quit with past efforts. Relapsing is common, does not reflect on your character, and should not deter you from trying again. Your health, and your loved ones, are worth the renewed effort.

Summary

Smokers generally achieve the highest quit rates with a combination of behavioral changes, lifestyle changes and medications, in conjunction with a sympathetic and patient physician, and supportive family and friends.

About.com has an excellent Quit Smoking site, with lots of information, advice and support that can help you quit smoking, and after you quit, to stay off tobacco for good.

Sources:

Fiore, MC, Jaen, CR, Baker, TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Available at www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf (accessed Dec 5, 2010).

Rigotti, NA. Clinical practice. Treatment of tobacco use and dependence. N Engl J Med 2002; 346:506.

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