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Health Guidelines

Stopping Smoking: What Works Best?

Smoking Quick Facts

Smoking-related diseases claim an estimated 430,700 American lives each year

Smoking costs the United States approximately $97.2 billion each year in health-care costs and lost productivity

Cigarettes contain at least 63 distinct cancer-causing chemicals

Secondhand smoke is responsible for approximately 3,000 lung cancer deaths annually in U.S. nonsmokers

Approximately 22.3 million American women are smokers. More American women die annually from lung cancer (67,600) than breast cancer (40,800)

4.5 million U.S. teenagers are cigarette smokers. 22.4 percent of high school seniors smoke on a daily basis

Of the current 48 million smokers, more than 33 million report they want to quit smoking. 44.3 million adults have already stopped smoking

Nicotine replacement therapies are helpful in quitting when combined with a behavior change program such as the American Lung Association's Freedom From Smoking®

Every year in the United States, premature deaths from smoking rob more than 5 million years from the potential lifespan of those who have died

After 1 year smoke free, the excess risk of heart disease caused by smoking is reduced by half. After 15 years of abstinence, the risk is similar to that of people who've never smoked

Male smokers who quit between ages 35-39 add an average of 5 years to their lives. Female quitters in this age group add 3 years.

Cigarette smoking causes 430,700 deaths each year

Each cigarette smoked shortens life expectancy by about 11 minutes

Source: American Lung Association and American Heart Association

Most smokers know that smoking causes lung cancer, heart disease, and emphysema. So why do they continue to smoke? They become addicted to nicotine and quitting is not easy. 70% of current smokers report that they want to quit. About one-third of all smokers attempt to quit each year. But few seek help and most don't stop.

People who stop smoking experience withdrawal symptoms such as irritability, anger, difficulty concentrating, insomnia, anxiety, and sometimes depression. Another stumbling block for many is the possibility of weight gain.

Smokers have a much higher rate of success when they seek help. According to a recent article in the New England Journal of Medicine, people who seek help are more than twice as likely to succeed. So, if you know someone who has tried and failed, encourage them to try again. Here are the suggestions made in this article to help improve a person's chances of stopping.

Physician support. Talking over your problem with your physician helps. He or she can help direct you to sources of support and counseling if needed. Your doctor can also help prescribe cessation aids such as nicotine replacement therapy (NRT) or other medications that improve success in quitting.

Counseling. Individual or group counseling is effective when provided by a trained stop smoking counselor and when provided over a period of at least 4 weeks. Typically, you will learn to identify smoking cues and how to break the link between these cues and smoking. For example, if you normally smoke after eating it's imperative that you substitute a different activity immediately after eating such as going for a walk or engaging in some activity you enjoy.

You also learn strategies for coping with stress, managing nicotine withdrawal symptoms, and preventing relapse by anticipating tempting situations and rehearsing coping strategies. It also helps to have someone helping you in the stopping process, someone to report to, and someone to call on for help if needed.

Nicotine Replacement. Person who use nicotine replacement therapy (NRT) are much more likely to succeed in quitting, usually doubling the quit rate at one year. Ask your doctor for guidance. You may use NRT from eight weeks to six months.

Medications. Medicines such as Bupropion (Zyban), Aventyl, and Pamelor are antidepressants that also help smokers stop smoking. Ask your doctor wheather one of these medications might help you. Again, people who use these aids are generally twice as likely to succeed at quitting.

Preventing Weight gain. The average smoker gains 5-10 pounds after stopping. This can be overcome by initiating a daily activity program. Regular exercise also helps control anxiety, depression, and restlessness experienced during quitting. Choose moderate activities to begin with such as walking, biking, swimming, or golf. Build up to exercising a half hour or more daily.

Social Support. Don't try to go it alone. Get help from your doctor. Ask your dentist for help and a teeth cleaning as soon as you stop. Enlist the support of your spouse, family, and friends. It helps to have many people pulling for you and helping you succeed.

When you are ready to quit, line up counseling and set a quit date. On your quit date, eliminate as many smoking cues (triggers) as possible. Put away ash trays and have your clothes washed or dry-cleaned to remove the odor of smoke. Get your doctor's guidance regarding stopping aids. Have a supply of gum, carrot sticks, etc. ready to keep your mouth busy. Let your friends and family know when you plan to stop.

When the quit date arrives, stay busy, follow your plan, avoid any extra stress or pressures, keep physically active, drink lots of water, and think positive. Remember that half of all smokers have quit. You can too.

Additional Resources
The American Lung Association www.lungusa.org/tobacco
American Cancer Society, Quitting Smoking
American Heart Association, "How can I Quit Smoking?"
National Cancer Institute, www.nci.nih.gov
CDC, "You Can Quit Smoking"
National Women's Health Information Center, A Breath of Fresh Air
Office on Smoking and Health www.cdc.gov/tobacco
USDHHS, You Can Quit Smoking -- Help for Pregnant women

Reference

Nancy A. Rigotti, M.D., Treatment of Tobacco Use and Dependence, New England Journal of Medicine 346(7):506-512, Feb. 14, 2002

Making Healthy Choices articles are written by Don Hall, DrPH, CHES president of LifeLong Health with contributions from associated health professionals. Content is general health information from evidence based research. It's purpose is not to treat disease or take the place of advice by your doctor but to promote healthy lifestyles. Persons with health problems should contact their physician for specific guidance.