Smoking Cessation

There are three basic questions you have to answer in developing your personal plan for quitting smoking:

• What type of program is best for you? A self-help plan. If this is your choice, everything you need is in this kit. A group support program or individual counseling to supplement the information in this kit.
• What method of quitting is best for you? Cold turkey. You set a quit date and when that day comes, you stop smoking entirely. Nicotine fading. A process of changing the type of cigarettes you smoke to gradually reduce your nicotine intake before you quit altogether.
• Do you want to use medications to boost your effort? Many smokers quit successfully without assistance from nicotine replacement products or drug treatment. This is a popular approach. Nicotine replacement. Current choices among nicotine patches, nicotine sprays, nicotine nasal sprays, and nicotine inhalers are widely available in the market. Medication available from your doctor can also help in quitting smoking. Some people have found that hypnosis and acupuncture also helps.

Each of these questions is independent of the others. You can decide on one or more choices for each.

Experts have found that the most popular method of quitting is cold turkey. But you should be careful about this method, because just throwing away your cigarettes on a whim rarely works for more than a day or two. On the other hand, planning a quit date and then quitting all-or-nothing on that date always works.

There's nothing more tried and proven than group smoking cessation clinics. These programs are offered by many hospitals and in many worksites, as well as by voluntary agencies such as the American Lung Association.

Smokers often wonder whether they should try quitting on their own or through a group program. There's no sure answer. But think about how you like to work. If you like to work things out for yourself (such as build furniture or home devices from kits), then quitting on your own may be for you. On the other hand, if you work well in groups, and enjoy meetings, then a group program may work for you.

If you're trying to decide whether a group is right for you, here are questions to ask when you call for information:

• Is the program convenient? Find out where it's being held, what day and time, and how many sessions are involved.
• Is the staff well-trained and professional? Ask who will be leading the group.
• Does the program provide what you need? Find out whether the program emphasizes lectures or group discussions.
• What is the success rate of the program? Research shows that group programs are successful for about 20% to 30% of participants.
• How much will it cost? Group programs can cost less than $50 and as much as several thousand dollars.

With the nicotine fading method you reduce your nicotine dose slowly over one or two weeks but still smoke your regular number of cigarettes. You can do this by switching brands. By switching to cigarettes with lower levels of nicotine, you can gradually bring down your addiction to nicotine before you quit smoking.

If you choose this method, it is important to establish a written plan to fade. There is tendency to smoke more cigarettes when you reduce their nicotine content. As you proceed with nicotine fading, it's important to remember that this is merely a temporary measure. The main benefit to your health, of course, comes from quitting entirely.

If you feel that you are severely addicted to cigarettes, you may wish to consider using a nicotine substitute product: Nicotine gum, Nicotine patch, Nicotine nasal spray, or Nicotine inhaler.

Here are some important things that you should know about nicotine replacement products:

• Nicotine patches and nicotine gum are available over-the-counter. The nicotine nasal spray and nicotine inhaler are currently available only by prescription from a doctor.
• These products provide a small amount of nicotine that will help relieve many of the withdrawal symptoms that a smoker may feel when quitting.
• The goal is to be free of both cigarettes and the nicotine substitute within three to six months.

Nicotine replacement must not be used by pregnant or nursing women. With any nicotine substitute, it's always wise to check with your doctor to see if there are medical reasons you should not use these products.

Nicotine Gum

The gum releases small amounts of nicotine, which is absorbed into the body through the mucous membranes of the mouth. Most smokers chew 10 to 15 pieces of gum a day. Chew it slowly until you feel a tingle, then shift the gum between your cheek and gum. Do not use nicotine gum while you are drinking.

Nicotine Patch

The nicotine patch is applied to your skin. Over a prolonged period of time, the nicotine dissolves right through the skin and enters the body. You should never smoke while using the patch. Some smokers start with the strongest patch, then switch to a medium-strength patch for a few weeks.

Other Products

Nicotine replacement therapy can also be administered via a nasal spray, or by an oral inhaler. These products are available only by prescription. The inhaler has the advantage of satisfying the "hand-to-mouth" ritual smokers miss when they quit.

Is Nicotine Replacement Unhealthy?

Many people worry that nicotine replacement products are just as bad as smoking cigarettes. They're definitely not. They do not have all the tars and poisonous gases that are found in cigarettes. They provide less nicotine than a smoker would get from cigarettes.

The pill is Zyban, the trade-name for a sustained-release tablet of bupropion hydrochloride. The drug boosts the body's levels of two "brain chemicals," dopamine and norepinephrine – the same thing happens with nicotine.

Zyban is usually taken twice a day – one pill in the morning and one in the early evening. It takes about a week for the pill to reach an effective level in the body. Therefore, smokers must start taking the pill before they quit smoking.

The non-nicotine pill is available only by prescription. The drug is not recommended for:

• Women who are pregnant or breast-feeding.
• People with a history of eating disorders.
• Anyone taking a monoamine oxidase inhibitor (MAO) medication for depression.
• People who have a seizure disorder, such as epilepsy.

Other common side effects include dry mouth and difficulty in sleeping.

Two alternative therapies – hypnosis and acupuncture – have sparked particular interest as aids quitting smoking.

Hypnosis is a state of attentive and focused concentration that is induced by the use of "therapeutic suggestion." When employed by psychologists, physicians, and others trained in its use, hypnosis may help in quitting smoking. It should be part of a systematic quit smoking program.

Acupuncture is an ancient Chinese therapy that involves stimulating specific anatomic points in the body. As with all other therapies, acupuncture works best for smoking cessation when it's used in combination with a serious effort to quit.

Before you start your countdown to quit day, do consider making an appointment with your doctor to discuss your plans. Your doctor may want to take baseline measurements of your heart rate, blood pressure, and weight. Don't forget your dentist either. One good way to begin your quit program is to have your dentist clean your teeth, so you'll see some immediate improvement in your appearance right at the start.

You have come a long way, and you've already made a lot of decisions. Now is the time to set a date to quit!

Pick a day to quit – about 7 to 14 days from now. Try to choose a day that makes personal sense to you. But whatever day you choose, be sure to:

• Mark the date on your calendar. Circle it in red.
• Be determined to quit on that date.
• Spend plenty of time getting used to the idea.
• Cross off each day on the calendar as you count down to Quit Day.

Tell yourself that on that day, you will absolutely stop smoking. No fooling around, no kidding yourself, no halfway measures. Just quit. No more cigarettes!