Tobacco smoke is a mixture of over 7,000 chemicals, hundreds of which are known toxins, 70 of which cause cancer. Tobacco smoking significantly increases the risk of many diseases and premature death. The good news, however, is that smoking cessation can greatly reduce these risks, even within years of quitting. People who quit smoking are at decreased risk for lung cancer, many other cancers, heart disease, lung disease, and infertility (in women of reproductive age). In addition, pregnant women reduce their risk of having a baby with low birth weight.
Most smokers become dependent on nicotine, which is the addictive substance in tobacco products that leads to physical dependence and tolerance. This makes quitting very challenging due to withdrawal symptoms, which include irritability, anxiety, difficulty concentrating, cigarette cravings, and increased appetite.
Fortunately there are plenty of resources available to assist in the process of smoking cessation. Quitting without aid has a low success rate long-term, but behavioral strategies such as counseling and prescription medications can significantly help improve the odds.
Oftentimes, tobacco is associated with daily routines such as morning coffee, an alcoholic drink, or the end of a meal. It is important to anticipate these triggers and find strategies to combat them. This can include finding a substitute for tobacco, developing alternative routines to avoid triggers, and utilizing a support system. Examples include finding non-tobacco oral substitutes for tobacco such as gum, sugarless candy, straws, toothpicks, lip balm, toothbrush, and bottled water; implementing routine changes such as switching from morning coffee to tea, taking a brisk walk after meals, or calling a supportive friend; while driving, remove all tobacco from the car, have the car interior detailed, or listen to book on tape or talk radio. During stressful times or intense cravings, try practicing deep breathing, taking a break from the situation, calling a friend or family member, self-massage, or nicotine replacement therapy. Avoid consuming alcohol in the early stages of quitting as it can lead to relapse, and limit contact with others who are smoking as this can make quitting more difficult.
The use of nicotine replacement therapy in various forms decreases the frequency and intensity of withdrawal cravings. The urge to smoke may persist, but it will be easier to manage. The options include nicotine patches, gums, and lozenges. The patch is applied daily upon waking up and releases a small, but continuous, amount of nicotine through the skin. The most common side effect is irritation of the skin. The gum and lozenges are placed inside the mouth and are used in place of cigarettes when the craving to smoke arises.
Two prescription medications have also been shown to assist with cessation. Bupropion (Wellbutrin) and varenicline (Chantix) should be started at least one week prior to quitting and can take up to 4 weeks to reach peak effectiveness. Chantix has received publicity for its psychiatric side effects and should be used with caution in those with uncontrolled psychiatric illness. It can also cause sleep disturbances and should be taken with food and not at bedtime to help alleviate this.
If you are a smoker, talk to your doctor about creating a personalized plan to help you quit.