How I Quit Smoking Smoking Cessation Tips, Real Success Stories and Expert Advice

Quitting smoking is a challenge, but a doable one. From patches to programs, there are lots of options available. Several former smokers reveal how they finally broke the habit, and a smoking cessation expert weighs in on how others can use their techniques to quit successfully... About 70% of adult smokers in the U.S. want to quit, but don’t. There’s a good reason. Smoking feels good, says Michael Fiore, M.D., M.P.H., professor of medicine at the University of Wisconsin-Madison School of Medicine and Public Health, and director of its Center for Tobacco Research and Intervention (UW-CTRI). “It both calms and stimulates you at the same time,” he says. “It’s unusual that way.” It’s also why quitting feels as difficult to give up as eating. Within 7-10 seconds of a concentrated dose of nicotine (one drag of a cigarette), a flood of dopamine and other neurochemicals engulf the brain’s pleasure centers. “No wonder it’s difficult to quit,” Fiore says. “The good news, though, is it can be done.” In fact, the U.S. now has more former smokers than current ones. In 2009, about 50 million adults called themselves former smokers, according to the Centers for Disease Control and Prevention. They used many ways to stub out smoking, including stopping cold turkey, using medications and counseling. Lifescript’s Medical Detective talked to four former smokers about how they gave up the habit. Their tips may help you. Also, to make sure they’re not just blowing smoke, Fiore weighs in on their techniques, and adds a few tips of his own. How I Quit Smoking: Cold turkey Terry Gobright, 61, quit smoking 26 years ago on the day she learned she was pregnant. She had smoked moderately for 16 years. The New York native grew up in a house where her father was a heavy smoker, as were three of her four siblings. “Everyone around me smoked,” Gobright says. “I woke up to the smell of cigarettes.” When her pregnancy was confirmed, the associate TV producer quit cold turkey because keeping her fetus safe was paramount. Her biggest challenge: “I had to keep my hands busy. Part of my everyday activities was getting the cigarettes, lighting them up, emptying the ashtray. The big [problem] was filling up that time.” At work it was easy to stay busy, but at home she kept a whirlwind pace by cooking, cleaning and gardening more than usual. When the urge to smoke reared its head, she thought of her father, who died of emphysema two years after she quit. Expert Feedback: “I commend [Gobright] for stopping smoking when she was pregnant,” Fiore says. “Smoking while pregnant is one of the leading causes of stillbirths and delayed development.” But her cold-turkey approach to smoking cessation has one of the lowest success rates, despite being the most popular method. Only one in 20 smokers succeeds, Fiore says. “If a person successfully quits, I’m totally supportive of any method,” he adds. “But based on science, there are better ways.” Still, Gobright employed one important trick in her successful smoking-cessation effort: Keeping your hands busy is important, so make plans to occupy them before you quit, Fiore says. How I Quit Smoking: Distraction Nilsa Rios, 62, smoked for 28 years. The half-a-pack-a-day smoker quit once but took up the habit again, like many others. “I felt ashamed about taking it up the second time,” Rios says. “I was sneaking them and felt awful.” Eight years after resuming, she gave up cigarettes again – this time for good. To help her through the process, she relied on an unusual item: candles. For several months, whenever she got the urge to smoke, she lit a scented votive candle, whether at work – her boss gave her the OK – or home. The scent, glow and pleasure of it put her in the “right state of mind” to stay away from cigarettes, she says. “It took my mind off the urge to smoke and gave me something else to focus on,” Rios says. “If you’re not ready to quit, don’t bother,” she advises. “Mentally, you really have to be there.” Expert Feedback: Rios created a pleasant substitute for cigarettes, a key strategy in smoking cessation, Fiore says. For many people, smoking is linked to pleasurable activities, such as socializing, a work break, sex or a reward for completing a hard task, Fiore says. Many smokers, therefore, can’t imagine experiencing pleasure without cigarettes, and grabbing a pack after quitting is common. “You have to make sure when you’re quitting to find other pleasures in life,” for example, exercise, entertainment or a hobby, Fiore says. Fighting the urge is difficult for the first few weeks to three months, “but remember [that] the short term is the hard part,” he says. “It’s not the rest of your life.” How I Quit Smoking: The patch The smell of tobacco, alcohol and eating: To Deborah James, 57, that trio was as irresistible as fudge to a chocoholic. “Beer or alcohol triggered the urge for nicotine,” says the Northern California resident, who smoked half a pack a day for 20 years. In the mid-’90s, worried about the health damage from her smoking habit and eager to quit, James put a nicotine-replacement patch on her skin. The size of a bandage, the over-the-counter patch slowly releases nicotine into the body. Smokers are weaned from nicotine over 10 weeks by replacing used patches with ones delivering increasingly smaller doses of the drug. Inhalers and nasal sprays – sold by prescription – do the same. The patches curbed James’ nicotine craving, although not always the urge to smoke. Still, she didn’t light up for two years. Then trouble walked in the door. “I met a guy who was a smoker and a drinker,” James says. “I’d light a cigarette for him and not inhale, but having a beer triggered the urge to smoke.” She quickly was hooked again. By 2002, with the boyfriend out of her life, a new urge took hold: to quit smoking for good. On Aug. 2, she lit her last cigarette at noon, bought nicotine patches and wore them for six weeks. “I quit smoking and never touched another cigarette after that,” James says. Expert Feedback: Nicotine patches, gum and lozenges are proven smoking-cessation tools. The nicotine patch helped “damp down James’ physiological addiction, allowing her to break the psychological urge,” Fiore says. Those urges often are prompted by triggers like drinking, eating and other pleasurable activities. It’s important to use enough nicotine in the beginning – one dose of nicotine (in a patch or gum) per each cigarette smoked, then taper off, Fiore advises. Smokers who don’t use enough initially “are in a chronic state of withdrawal,” he says. That’s why Fiore recommends new former smokers use a patch around the clock. Another tip: “Always keep lozenges and gum in your pocket for sudden urges,” he advises. Gum and lozenges deliver quick bursts of nicotine through the mouth lining. They, and patches, are available without prescription. Boxes of gum cost about $30-$50 online, depending on the number of pieces sold. Patches run about $20-$50. How I Quit Smoking: Counseling programs Jane Norris, 45, had smoked at least a pack a day for 20 years. She quit smoking about five times, but only for short periods. Worried about her health and heeding her kids’ pleas to quit, she joined a smoking-cessation program at a Santa Monica, Calif., hospital seven years ago. “It finally did the job!” she says. Everyone in her program quit smoking on the third session of the four-week program. At weekly meetings, participants shared how they felt about giving up cigarettes and their grief at losing the habit. “Talking about our feelings of loss and sharing how hard it was to quit smoking made me feel less alone,” Norris says. “There was strength in numbers. We helped each other get through the hard process.” She still wishes she could light up now, but doesn’t struggle with urges any more, she says. Expert Feedback: Group, individual and phone counseling are all effective, especially with medications, Fiore says. [The federal Food and Drug Administration (FDA) has approved seven medications, including two prescription pills: Varenicline (sold as Chantix) blocks the rewarding effects of nicotine while helping with withdrawal symptoms. Bupropion (sold as Zyban or Wellbutrin) does the same, plus helps with depression symptoms. Insurance often covers the cost of smoking-cessation medications.] The support of family, peers and health-care providers is vital too, Fiore says. But self-help materials, the most common type of counseling, aren’t especially effective if used alone, according to a 2000 U.S. Department of Health and Human Services article. They often promote relaxation and breathing exercises, stress relief, meditation and physical exercise, but experts recommend professional counseling and medication to boost their effectiveness. More tips for smoking cessation: Ready to quit? Here are more tips from Fiore to make your efforts a success: See your health-care provider for smoking cessation programs and medications. Counseling plus one or more medications works best. Get rid of all smoking paraphernalia – cigarette packs, lighters and ashtrays. Don’t keep “emergency” cigarettes. Most people break down and use them, Fiore says. Set a quit date. Keep busy on your quit day. Plan a full day of enjoyable activities, and avoid alcohol, a common smoking trigger. Figure out how to change routines that trigger tobacco use. Start an exercise program to take your mind off triggers and urges, and improve your overall health. Get free telephone support from QuitLine at 800-QUIT-NOW (784-8669). For more information about stopping smoking, visit http://www.ctri.wisc.edu/ Smokers/smokers_Quit.Tips.htm or the CDC: http://www.cdc.gov/tobacco /data_statistics/fact_sheets/ cessation/quitting/index.htm For more expert advice and information, visit our Smoking Cessation Health Center. Are You Ready to Quit Smoking? By now you should know that smoking increases your risk for heart disease, lung cancer, stroke and more.