Stages of Your Smoking Cessation Program

After years of smoking, you think you’re finally ready to kick the habit. But what’s your first step? And what should you expect from a smoke-free life? Get expert advice on how to choose and start a smoking cessation program and 5 tips to stay cigarette-free... You’re sick of huffing and puffing after climbing a few stairs, standing outside in the heat or cold and spending a significant chunk of money on cigarettes. So, one day, you’ve finally had enough – you’re ready to quit. Now what? First, congratulate yourself. Women who quit smoking reduce their risks of lung and other cancers, heart disease, chronic obstructive pulmonary disease (COPD), infertility, wrinkles and disabling hip fractures in old age, according to the National Cancer Institute (NCI). Quitting isn’t easy, but a variety of treatments and smoking cessation programs can help you become smoke-free. “Quitting smoking is a behavior you have to learn, just like smoking was,” says Megan E. Piper, Ph.D., lead researcher at the University of Wisconsin’s Center for Tobacco Research and Intervention. Here are the first steps to getting started on a smoking cessation program: Pick a quit day. When you decide to quit smoking, choose a date within two weeks, the NCI suggests. If you smoke at work, pick a weekend or a day off. Clean house. Toss cigarettes, lighters and ashtrays from your home, work and car. Beware of triggers. What elements of daily life – like driving a car, drinking coffee or feeling stressed – set off your craving to smoke? Plan how you’ll handle them while you’re quitting. Spread the news. Tell your family, friends and co-workers that you’re ready to quit. Ask them not to smoke in front of you. See your doctor. Discuss smoking cessation programs, treatments and possible withdrawal symptoms. Print out Questions to Ask Your Doctor and take it to your next appointment. Cessation Medications and Treatments Smoking cessation programs may include nicotine replacement therapy (NRT), prescription pills and counseling. Nicotine replacement therapy (NRT) Smokers are addicted to nicotine, a mood-altering chemical that stimulates the brain to produce more endorphins, or “feel-good” hormones. When you quit, your body and brain crave it. Nicotine replacement products contain the chemical, helping relieve cravings and decreasing likelihood of a relapse. They usually have half the nicotine of a single cigarette, but deliver it more gradually than smoking. Some smokers worry that nicotine replacement therapy is as harmful as cigarettes, but that’s not true, experts say. “There are 4,000 chemicals in cigarettes,” Piper says. “You’re using only one to get off the 3,999 others.” You’re also not inhaling toxic substances such as carbon monoxide and tar. The Food and Drug Administration (FDA) has approved five types of over-the-counter nicotine replacement products: The patch (which delivers nicotine through the skin), gum and lozenges. Nasal sprays and inhalers are prescription only. The most effective method is a combination of the nicotine patch and lozenge, Piper says. Closely follow package directions. Because many people don’t use nicotine replacement products correctly, they don’t get the full benefit, she warns. For example, they might not chew the nicotine gum long enough to get a full dose of the chemical. Prescription pills The FDA has approved two non-nicotine prescription drugs: bupropion (Zyban), an antidepressant, and varenicline (Chantix), which blocks smoking’s pleasurable effects. Both pills ease nicotine cravings, but they can have serious mental-health side effects, such as suicidal thoughts, depression, changes in behavior and hostility. Discuss the potential risks with your doctor. Counseling Nicotine replacement therapy and prescription drugs alone can help you quit, but combining medicine with counseling doubles your chance of success. “Every smoker should have coaching and take medicine to maximize her quit attempt, even if she’s tried to quit before,” Piper says. The exception is when a woman is pregnant, because smoking cessation drugs pose a risk to the fetus, she adds. To speak with a counselor for free, call the Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848), which is operated by the NCI’s Smokefree program. Or use its instant messaging service or mobile app. You can also speak with a counselor trained in smoking cessation programs at the American Lung Association’s Lung Helpline, which requires a paid membership of $15-$40. Your odds improve if you turn to face-to-face and online support groups, which allow you to share experiences with others trying to quit. Freedom from Smoking Online, run by the American Lung Association, provides an online community for smokers. For in-person support, Nicotine Anonymous holds meetings throughout the country. You can also ask your doctor if they know about support groups in your area. Maintenance Whether this is your first time quitting or you’ve tried before, today is a new start. Yes, you’ll crave cigarettes, but that doesn’t mean you have to give in. Manage cravings by keeping busy with activities where smoking is banned. For example go to a movie, window shop at the mall or visit a museum. And use any available support. Call family, friends or the Smoking Quitline, log on to your online community or attend a support meeting. Tell friends and family in advance of your quit day, and ask them to help during the first few weeks. Let them know if you’d like them to check on you or not discuss that you’re quitting. Nicotine Withdrawal Besides cravings, be prepared for the physical side effects of quitting. “Because smoking is an addiction, quitting has withdrawal symptoms,” Piper says. People who quit smoking face issues such as irritability, difficulty sleeping, gastrointestinal disturbances, fatigue and difficulty concentrating, she adds. You may also feel sad. “Women talk about missing cigarettes as if they’re best friends and mourn the loss of that friend,” Piper explains. If you think you may be depressed, see your doctor. They may refer you to a therapist or prescribe antidepressants. Withdrawal symptoms don’t last. For most people, the worst linger just a few days or weeks, according to the NCI. You may also gain weight, but don’t worry too much about it because it’s usually a minor side effect. “For most women who quit smoking, weight gain is small, about 5 pounds,” Piper says. And it’s often temporary, she adds. “Don’t replace cigarettes with calorie-laden food,” she advises. You can minimize or prevent weight gain by eating right and exercising, whether taking a 5-mile bike ride or quiet stroll, experts say. “If you’re craving a cigarette, walk around the block,” Piper suggests. Staying Smoke-Free Whether it’s been weeks, months or years since you quit smoking, you may still get cravings occasionally. If you slip up, here’s how to handle it: Don’t be hard on yourself. Just because you have one or two cigarettes doesn’t mean you’ve failed. Quitting takes practice. Stay positive. Reward yourself for times you went without smoking. Vow to deal with cravings better the next time. Learn from a slip. Did a trigger, like drinking coffee, tempt you to have a cigarette? If so, plan to deal with it better the next time. For example, have your morning coffee at a café that doesn’t allow smoking. Visit your doctor. If you’re not taking medication as part of your smoking cessation program, ask if one may be right for you. Get support. Call a cessation quit line, start attending meetings or sign up for an online program. And if you go back to smoking, it doesn’t mean you won’t successfully quit in the future. “Sometimes it’s the right time and place [to quit], and sometimes it’s not,” Piper says. The more times you try to kick your habit, the more you’ll learn about what it takes to stay smoke-free, she adds.