Smoking Cessation
Quitting smoking (smoking cessation) is one of the most important things you can do to improve your health and well-being. People who stop smoking decrease their risk of cancer, heart disease, stroke, and early death. Women who stop smoking before or during pregnancy reduce their risk of infertility or having a low-birth-weight baby. Most smokers in the United States report that they want to stop smoking, but kicking the smoking habit can be difficult. Most ex-smokers try several times, often as many as 8 to 10 times, before they are able to quit for good. The results are definitely worth those efforts.
HOW TO QUIT SMOKING
- Be committed. Keep in mind why you want to quit and stay motivated.
- Get help from your doctor and continue to follow up with your doctor, especially during the first month.
- Choose a firm date to quit and mark your calendar. Choose a time that is not particularly stressful and that does not involve situations associated with smoking.
- Begin to cut back prior to your quit date.
- Consider joining a support group of ex-smokers or other stop-smoking programs such as those offered by the American Lung Association or the American Cancer Society.
- Tell friends, family, and coworkers that you are quitting smoking so that they can offer motivation and support.
- Remove smoking from your environment. Avoid places where people congregate to smoke. Remove cigarettes from your car, home, and work.
- Anticipate that you may experience withdrawal symptoms, such as cigarette cravings, anxiety, irritability, and restlessness, even with nicotine replacement or drug treatment. These symptoms usually peak at 1 to 3 weeks after quitting but generally become manageable within a few weeks.
- Eat a healthy diet and stay active in order to help with stress and to minimize weight gain.
Nicotine replacement therapy helps relieve the withdrawal symptoms that many smokers say prevent them from quitting. It contains nicotine but without the harmful substances found in cigarettes. Nicotine gum, patches, and lozenges are available over the counter. Nicotine inhalers and nasal sprays are available by prescription.
NON-NICOTINE DRUG THERAPY
Bupropion and varenicline are approved prescription drugs to help patients stop smoking. Both medications are generally well tolerated. The most common adverse effects are insomnia from bupropion and nausea from varenicline.
Most smokers trying to quit need drug therapy or nicotine replacement therapy. Talk with your doctor about the therapy appropriate for you.
Prevention and cessation of cigarette smoking
Most of the health problems related to cigarette smoking, including cancer and cardiovascular disease and respiratory disease, can be reduced by stopping smoking. Quitting smoking is beneficial at all ages, and the earlier in life one quits, the greater the benefits. People who quit smoking cut their risk of lung cancer by 30% to 50% after 10 years compared to continuing smokers, and cut their risk of oral and esophageal cancer in half within 5 years after quitting.
The damaging effects of smoking are even greater for cancer survivors, who have an increased risk of cancer recurrence, new cancers, and long-term side effects from cancer treatment. Stopping behaviors that are harmful to the body, such as smoking, can improve long-term health and quality of life.
Many methods of quitting smoking have been studied. The following are the more common methods used to help smokers quit.
Counseling Methods: People who have even a brief counseling session with a health care professional are more likely to quit smoking. The ASK, ADVISE, ASSESS, ASSIST, and ARRANGE model was developed to help health care professionals with their patients who smoke. Using this model, the physician asks the patient about their smoking status at every visit; advises the patient to stop smoking; assesses the patient’s willingness to quit; assists the patient by setting a date to quit smoking, provides self-help materials, and recommends use of nicotine replacement therapy (such as the nicotine patch); and arranges for follow-up visits.
Childhood cancer survivors who smoke may be more likely to quit when they take part in peer-counseling smoking cessation programs. In these programs, trained childhood cancer survivors offer support to other childhood cancer survivors who smoke. More people have been able to quit with peer-counseling than with self-help programs. Childhood cancer survivors who smoke can speak with their doctors about peer-counseling programs.
Drug Treatment: Various drug treatments are successful in helping people quit smoking. These include nicotine replacement products such as nicotine gum, the nicotine patch, nicotine nasal spray, nicotine inhalers, and nicotine lozenges. Nonnicotine medications such as bupropion, an antidepressant, and varenicline, a drug that mimics the way nicotine acts in the body, have also been studied and approved as aids to help people quit smoking. People who use drug treatments, no matter which kind, are more likely to be successful in their effort to quit smoking after 6 months and 12 months than those who use a placebo or no replacement at all.
Smoking Reduction: When smokers fail to completely quit smoking, they may still benefit from reducing the number of cigarettes they smoke. The more a person smokes, the higher his risk of developing lung cancer and other smoking-related cancers. Therefore, using medications or other means to smoke less may reduce smoking-related harms. Studies show that smokers who cut back are more likely to stop smoking in the future. However, smoking less should not be seen as a substitute for quitting smoking altogether, and is harmful if the smoker inhales more deeply or smokes more of each cigarette to try to control nicotine cravings. Nicotine replacement products may help guard against this.