In this topic, you'll find
strategies for quitting smoking and staying smoke-free. Find where you want to
Maybe you have already
taken your last puff or are ready to quit today. That's
great. This information will help you keep your resolve to kick the habit
Or maybe you want to plan ahead
before you quit. How ready are you to quit? To find out, use the
Interactive Tool: Are You Ready to Quit Smoking?
It's okay if you aren't ready now. But you may
want to quit at some point. So keep learning and preparing yourself. Many
smokers do quit. You can too.
Think about why you want to quit. Maybe you want to protect your heart and
your health and live longer. Or maybe you want to be a good role model for your
kids or spend your money on something besides cigarettes. Your reason for
wanting to change is important. If your reason comes from you—and not someone
else—it will be easier for you to try to quit for good.
Find out how smoking can affect you:
Quitting smoking is hard. Some people who have quit say that it was the hardest thing they have ever done. But many people like you have been able to quit smoking. And you don't have to do it alone. Ask your family, friends, and doctor to help you. Get what you need to help you quit for good.
After you quit, try not to smoke at all—not even one
puff. Prevent a slip (smoking one or two cigarettes) or relapse (returning to
regular smoking) by avoiding smoking triggers, at least at first. These
triggers can include alcohol and stress. Don't keep cigarettes in your house or
car. If you do slip, stay calm. Remind yourself that you have a
plan, and think about how hard you've worked to quit for good.
Quitting is hard because
your body depends on the nicotine in tobacco. Giving it up is more than
just kicking a bad habit. Your body has to stop
craving the nicotine. Nicotine gum, lozenges, patches,
and other medicines can help reduce the cravings without the harmful effects of
You also have to change
your habits. You may not even think about smoking. You just do it. You may
smoke when you are stressed. Or maybe you have a cigarette
with coffee. Before you quit, think of new ways to handle these things. For
example, call a friend or practice deep breathing when you feel stressed. Try
chewing sugarless gum instead of smoking. Go for a walk when you have a break
at work. Stay around nonsmokers.
You are likely to crave cigarettes and may feel grouchy, restless, or sad
for the first 2 to 3 weeks after you quit. It may be hard to focus on tasks.
Or you may have trouble sleeping and want to eat more. But you won't feel bad
forever, and medicine can help. Using medicines and products like nicotine gum
or patches can help with cravings and make it easier to resist smoking.
You may worry about gaining
weight after you stop smoking. Don't let this stop you. If you do gain weight, you can focus on losing it after you have successfully quit smoking.
You can take steps to
lower your chance of gaining weight:
Use quit-smoking medicines or nicotine replacement. They may make gaining weight less likely while you are quitting smoking.
Most people quit
and restart many times before they stop smoking for
good. If you start smoking again after you quit,
don't give up. Each time you quit, even if it is just for a short time, you get
closer to your long-term goal.
Remind yourself that by quitting
you may avoid serious health problems and live longer. Remember your reasons
for quitting. Maybe you want to protect your heart and your health and live
Each time you quit, you learn more about what helps and
what gets in the way. Think about why you started smoking again and about what you will do differently next time. If you tried to quit without medicines or a program,
think about trying them next time. Medicines and nicotine replacement (gum,
patches, lozenges) can double your chances of
success.1 And using medicines and counseling is even more effective. You can do it!
Deciding to quit:
How to quit:
Health Tools help you make wise health decisions or take action to improve your health.
Most people don't think about when
or why they smoke. They just do it. But knowing when and why you smoke can help
you choose the quitting strategy that is most likely to work. Perhaps you
form to find your reasons(What is a PDF document?) for smoking.
One Woman's Story:
"I went to nursing school, and
it [smoking] was the thing to do." Smoking helped relieve the stress.-Nancy, 54
Read more about Nancy and how she quit smoking.
children and teens use cigarettes, cigars, and smokeless tobacco because their
friends do. Movies and TV shows can make smoking seem attractive.
Teens, especially girls, often use smoking to try to control their
Teens may think that smoking is a way to look more mature,
independent, and self-confident to their peers. They may smoke to rebel against
their parents. But most teens do not know how addictive cigarettes are. If your child smokes, it might help to talk with him or her
about some of the
reasons to stop smoking. If you smoke or have quit,
talk with your teen about how hard it can be to quit after you've started
Children and teens are more likely to smoke if their
parents smoke. And they are more likely to quit if their parents quit.
When you're craving
tobacco, it's hard to focus on quitting. Preparing yourself before you quit can
help. Before you quit, get ready for a life without nicotine.
One Man's Story:
Planning was key to
John's success. "The [stop-smoking] class taught me how to get ready to quit."-John, 39
Read more about John and how he quit smoking.
motivate you to quit smoking? Think about it. It's important to have your own
reasons for quitting.
Use this self-test to help you discover what
motivate you to quit smoking(What is a PDF document?).
healthy is a common reason to want to quit smoking. Or maybe you want to feel
more in control of your life, instead of feeling controlled by tobacco.
Teens may have other reasons to quit smoking.
Talk to your family and friends about quitting.
Their support might help you decide to quit.
What worries you about
smoking? Make a list. Talk about it with your doctor. You may worry about:
It was throat pain that helped
Nate give up smoking for good. Dealing with a sore throat all the time just
wasn't worth it anymore. "In the end, I made up my mind and quit."-Nate, 27
Read more about Nate and how he quit smoking.
What do you gain by
quitting? You can:
What you need to know
Symptoms include feeling grouchy or depressed and having trouble sleeping or
Here are some things that can
Failure in the past
If you weren't able to quit in
the past, don't lose hope. Studies show that each time you try to quit, you
will be stronger and will have learned more about what helps and what makes it
Most people try to quit many times before they can quit for good.
You may gain some weight when
you stop smoking. Don't try to avoid this by going on a strict diet at the same
time. This will make it even harder to stop smoking.
You can take
steps to lower your chance of gaining weight:
Depression or nervousness
Medicines and counseling can
help treat nervousness or depression. Talk to your doctor.
Lack of support
Support can improve your
chances of quitting. Look for people who have stopped smoking, or seek out
those family and friends who support your goal to quit. Online and phone
support can also help:
Living with or being around
someone who smokes
It would be easier for you to
quit if those around you didn't smoke. Discuss quitting together. If this isn't an option, talk to the
person(s) about not smoking around you. When you can, avoid places where others are smoking.
If you enjoy smoking when you drink alcohol, you may need to give up alcohol when you quit smoking, at least for a while.
Stress can lead to smoking, but smoking doesn't really make stress go away.
To control stress, learn what
causes your stress and how to change the way you react. For suggestions, see the topic
smoking habits or not being able to avoid smoking
Assess your tobacco use(What is a PDF document?) to discover your smoking triggers. For some people,
morning coffee and going out with friends are common
Teen issues, such as fitting in
with the crowd and dealing with stress
Fresher-smelling clothes and
breath are just a few
reasons for teens to quit smoking. They may actually
improve their chances of fitting in. Also, feeling good physically may help
teens deal with stress in healthier ways than by smoking.
have depression or
anxiety, talk to your doctor before you quit smoking. He or she may have helpful ideas on which medicines may work best for you to quit smoking.
Smoking can also affect the level of certain medicines in your
blood. If you take medicines for a health problem, talk with your doctor before
you quit smoking to see whether you should change the dose of any of your
When it comes to
quitting smoking, some people find it helpful to plan ahead. Others don't. Do
what works for you. If you are ready to quit right now,
see the section
Ready to Quit Today?
If you prefer to
plan ahead, start by asking yourself some questions. Are you a goal-setter? How
confident do you feel that you will succeed at giving up smoking? Asking
yourself these questions is one way to prepare yourself for quitting.
Your reason for wanting to
quit is important. Maybe you want to protect your heart and your health and
live longer. Or maybe you want to spend your money on something besides
cigarettes. If your reason comes from you—and not someone else—it will be
easier for you to try to quit for good.
After you know
your reasons for wanting to quit, use the U.S. Surgeon General's five keys to
quitting: get ready, get support, learn new skills and behaviors, get and use
medicine, and be prepared for relapse.
Contact your doctor or local health
department to learn about medicines and to find out what kinds of help are
available in your area for people who want to quit smoking. Telephone helplines operated by your state can also help you find information and support for
Check with your insurance provider to find out
if medicines and counseling are covered under your health plan. Your employer
may also help pay the cost of a quit-smoking program or provide help to pay for
Here are some
other ways to get ready to quit smoking:
You will have a better chance of quitting successfully
if you have help and support from your family, friends, and coworkers.
Others sources of support include:
You can also find online support along with
quit-smoking programs that you can attend. People who use telephone, group, or one-on-one
counseling are much more likely to stop smoking than people who try to quit on their own.
If a partner or friend is quitting, you can help.
Since you won't
be smoking, decide what you are going to do instead. Make a plan to:
The U.S. Food and Drug
Administration (FDA) has approved several medicines to help people quit
smoking. You will double your chances of quitting even
if medicine is the only treatment you use to quit. Your odds get even better
when you combine medicine and other quit strategies, such as
You won't have to take
medicines forever—just for as long as it takes to help you quit. Your employer
or health plan may help pay the cost of a quit-smoking program or provide help
to pay for medicines. And remember that no matter how much it costs to buy
medicines to help you stop smoking, it's still less than the
cost of smoking.
medicines and using telephone or in-person counseling or a quit-smoking program
at the same time greatly increases your chances of success.
Most people are not
successful the first few times they try to quit smoking. If you start smoking
again, don't feel bad about yourself. A slip or relapse is just a sign that you
need to change your approach to quitting. Make a list of things you learned. And think about when you want to try again, such as next week, next month, or
next spring. Or you don't have to wait. If you're still motivated to quit, you
can try again as soon as you want.
You might get some ideas for
things you can do differently by looking at "Prepare for roadblocks"
in the section
Thinking About Quitting? Maybe you can try something
new next time, such as a new medicine or program. You might try combining
tools, such as counseling and medicine. Keep trying, and don't be fooled into
thinking that smoking "light" cigarettes will help. They do not make smoking
If you slip or smoke a little, don't give up. Talk to someone who has quit smoking, or to a counselor, to get ideas of what to do. If you are taking medicine or using nicotine replacement, keep doing so unless you go back to regular smoking.
Quitting smoking is hard, but it
can be done. To stay motivated, keep reminding yourself why you want to quit
smoking. Make a list of your reasons to quit and the benefits you expect from
quitting. Put your list of reasons on your bedroom dresser, in your wallet, or
on the refrigerator. Review it whenever you are struggling with the quitting
process. Add to your list whenever another reason or benefit occurs to you.
See the topic
Quick Tips: What to Do When You Crave Nicotine.
If you have tried to quit smoking before, remember that most people try
to quit many times before they are successful. Don't give up.
Nancy hit upon a key that
helped her quit for good. "Finally what woke me up—after 3 years of failure—was
the realization of what happened when I relapsed. ... I quit drinking not
because alcohol scares me, but because when I drink, I want to smoke."-Nancy, 54
Congratulations! You are
taking a big step. You are ready to quit today. It's exciting. But it can also
be scary. If you're not quite ready yet, but you think
you will be soon, see the section
Thinking About Quitting?
If you've been
planning to quit, you may already know that when you stop smoking, you may not
feel so great at first. Some people feel grouchy and have headaches or
cravings. The good news is that these things are at their worst in the first 2
to 3 weeks after you quit, although they can last longer. And there are things that can help.
decided to quit today but haven't planned ahead, don't
worry. Here are some things to consider to help you succeed:
Using nicotine replacement products
and/or medicine doubles your chances of
quitting.1 When you quit
smoking, your body craves the nicotine that it was used to getting when you
smoked. But the nicotine isn't the harmful part of smoking or chewing. It's all
the other things in tobacco that are bad for you, such as tar and carbon monoxide. Nicotine from medicine is absorbed so slowly and at such low levels that it is rarely addictive.
help you through the stress of losing this part of your life. Your doctor can prescribe medicines that can get you through withdrawal. And he or she can help you plan the best way to use nicotine replacement products. Friends and
family can provide shoulders to lean on, and they can encourage you to stay
smoke-free. They can help distract you when you want to smoke, and they can
understand when you're a bit grouchy.
People who use telephone, group, or one-on-one
counseling are much more likely to stop smoking. Experienced counselors have practical ideas that can help you succeed. Here
are some ways to get support:
If you quit
today but haven't planned ahead, now is a good time to plan your quit strategy.
Think of problems or barriers you have faced. And think of ways to reward
yourself for reaching specific milestones. Write out your
personal action plan(What is a PDF document?).
information, see the
Planning Your Strategy to Quit section of this topic.
You are taking
an important step to improve your life. Make sure that you know your reasons
for quitting smoking. The most common reason to quit is to live longer. It's a
gift you can give yourself and your family.
You're not alone in going back
to smoking. Most people who quit try many times before they quit for
Don't feel bad about yourself. A
relapse is just a sign that you need to try a different approach to quitting
smoking. If you tried to quit without medicines or a program, think about
trying them next time. Medicines and nicotine replacement (gum, patches,
lozenges) can double your chances of success.1 And using medicines and counseling is even more effective.
Think about what made you start smoking again.
Maybe you couldn't handle the cravings. Or maybe you didn't have enough support
from family or friends. Maybe something stressful happened that triggered the
urge to smoke, and then you couldn't stop.
Whatever it was,
remember that help is here when you are ready to try again. You might want to
Thinking About Quitting? or
Planning Your Strategy to Quit in this topic.
Nate's struggle to
quit was a constant cycle of attempts and relapses. It was hard on his
"It seemed like trying just made it more difficult
to quit. I felt like a failure every day."-Nate, 27
Read more about Nate and how he quit for good.
To quit smoking, you have to learn how to deal with your cravings and temptations to smoke. But staying smoke-free involves learning how to think and act like a nonsmoker.
Many people who are able to make it through those first tough weeks without smoking run into trouble about 3 to 4 weeks after they quit. Surprisingly, this is just about the time when physical cravings have stopped. And yet—people often go back to smoking. Why does this happen? Some researchers found that staying smoke-free may depend on how well someone has been able to start seeing himself or herself as a nonsmoker.3
Many of the changes you feel when
you first quit smoking don't feel good.
Nicotine withdrawal can
make you feel grouchy, hungry, and nervous. You may have trouble sleeping or
concentrating. These symptoms can last for a few days to several weeks. But
they do go away, especially if you take medicine. You may struggle with
smoking habits and rituals. This is a lot to deal
with, but keep at it. You will feel better.
The following tips may help you in the first few weeks:
To stay smoke-free, you will have to make it past a second big challenge. This will come about 3 to 4 weeks after you quit, when you notice that your physical cravings are almost gone. Making it past this second big challenge will depend on how well you have been able to start thinking and acting like a nonsmoker. You will be able to enjoy and value a smoke-free lifestyle when you:3
There are many ways you can make positive changes in your life, such as starting an exercise program or
learning how to manage stress.
If you're reading this, you may be
thinking about quitting smoking or making a plan to quit. Or maybe you have
already tried to quit a few times. You probably already know that smoking is
bad for your health and that quitting will reduce your risk of getting a
disease related to smoking, such as heart or lung disease.
If you continue to smoke, there is a 1 out of 2 chance that you will die earlier because of smoking. Smokers, on average, die 13 to 14 years sooner than people like them who are not smokers.4 If you quit, most of your risk for having a heart attack or getting cancer goes away. The sooner you quit, the more you reduce your risks.
Everyone who uses tobacco would benefit from quitting. When you quit
smoking—no matter how old you are—you will decrease your risk of:
Nancy was working as a nurse
and was exposed to someone who had a bad case of pneumonia. As a precaution,
Nancy was checked for pneumonia. The X-ray revealed that she didn't have
pneumonia—but her lungs did show early signs of emphysema. "It scared the
daylights out of me. ... I really made myself focus on the future of my life. I
want to be skiing when I'm 70. I don't want an oxygen tank."-Nancy, 54
In addition to reducing your risk of diseases in the
future, you will notice some benefits right away after you stop smoking. Your
shortness of breath, energy, and asthma symptoms will likely get better within the first
2 to 4 weeks after you quit. (But don't be surprised if you cough more in the
first week after you quit, as your lungs try to clear themselves.)
There are other benefits to quitting:
Natural, low-tar, and low-nicotine "light" cigarettes are
not any safer to smoke than regular cigarettes. Do not be misled into thinking
that these products are any better for you. They are not.
You can get cancers of the throat and mouth from using
cigars, pipes, or chewing tobacco.
Avoiding diseases caused
by smoking and being in control of your life are good
reasons for teens to quit.
If you are a teen and you smoke, chew tobacco, or use snuff, you
probably already know that tobacco is bad for you. If you are like most teens,
you intend to quit at some point, but you may not feel it's very important to
quit now. But the longer you use tobacco, the greater your risk for becoming
addicted to it. After you're hooked, it's even harder to quit.
The American Cancer Society (ACS) conducts educational
programs and offers many services to people with cancer and to their families.
Staff at the toll-free number have information about services and activities
in local areas and can provide referrals to local ACS divisions.
The American Lung Association provides programs of
education, community service, and advocacy. Some of the topics available
include asthma, tobacco control, emphysema, infectious disease, asbestos, carbon monoxide, radon,
website provides resources for quitting smoking and tobacco prevention, including information for children, teens, researchers, and scientists.
There are also reports from the Centers for Disease Control and Prevention (CDC), fact sheets, a publications catalog, a smoking and health resource library, and other materials, such as buttons, calendars, and eCards.
This is also the location for the State Tobacco Activities Tracking and Evaluation (STATE) System.
The National Cancer Institute (NCI) is a U.S. government
agency that provides up-to-date information about the prevention, detection,
and treatment of cancer. NCI also offers supportive care to people who have cancer
and to their families. NCI information is also available to doctors, nurses,
and other health professionals. NCI provides the latest information about
clinical trials. The Cancer Information Service, a service of NCI, has trained
staff members available to answer questions and send free publications.
Spanish-speaking staff members are also available.
This organization provides information for the public on
drugs. It contains information about how certain drugs affect the brain.
The toll-free number is a single access point to the National
Network of Tobacco Cessation Quitlines. Callers are automatically routed to a
state-run quitline, if one exists in their area. If there is no state-run
quitline, callers are routed to the National Cancer Institute (NCI) quitline,
where they may receive help with quitting smoking, informational materials, and
referrals to other resources.
This website provides free information and
professional assistance to help support people who are trying to quit smoking.
The information provided is for both the immediate and long-term needs of
people who are trying to quit and for friends and family who care about them.
This website includes an online guide to
quitting smoking, local and state telephone quitlines, the National Cancer
Institute's national telephone quitline and instant messaging service, and
publications that can be ordered or downloaded and printed. There is also a link to women.smokefree.gov, which has more resources for women who want to quit smoking.
CitationsStead LF, et al. (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews (1).Fiore MC, et al. (2008). Clinical Practice Guideline: Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: U.S. Department of Health and Human
Services. Also available online:
http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf.Segan CJ, et al. (2006). The challenge of embracing a smoke-free lifestyle: A neglected area in smoking cessation programs. Health Education Research, 23(1). American Cancer Society (2010). Prevention and Early Detection: Guide to Quitting Smoking. Atlanta: American Cancer Society. Available online: http://www.cancer.org/Healthy/StayAwayfromTobacco/GuidetoQuittingSmoking/index.Sunday SR, Folan P (2004). Smoking in adolescence:
What a clinician can do to help. In VC Reichert et al., eds, Medical Clinics of North America, 88(6): 1495–1515.
Philadelphia: Saunders. Other Works ConsultedAmerican Cancer Society (2009). Child and teen tobacco use. Available online: http://www.cancer.org/docroot/PED/content/PED_10_2X_Child_and_Teen_Tobacco_Use.asp.Benowitz NL, Brunetta PG (2010). Smoking hazards and cessation. In R Mason et al., eds., Murray and Nadel’s Textbook of Respiratory Medicine, 5th ed., vol. 1, pp. 968–984. Philadelphia: Saunders.Flouris AD, Oikonomou DN (2010). Electronic cigarettes: Miracle or menace? BMJ, 340: c311.Hughes JR (2009). Nicotine-related disorders. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 1, pp. 1353–1360. Philadelphia: Lippincott Williams and Wilkins.National Institute of Diabetes and Digestive and Kidney Diseases (2010). You Can Control Your Weight as You Quit Smoking (NIH Publication No. 03-4159). Bethesda, MD: Weight-Control Information Network. Also available online: http://win.niddk.nih.gov/publications/smoking.htm.National Institutes of Health (2010). Tobacco addiction: Fact sheet. Available online: http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=119&key=T#T.U.S. Department of Health and Human Services (2010). Cardiovascular diseases. In How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General, chap. 6. Atlanta: U.S. Department of Health and Human Services. Also available online: http://www.surgeongeneral.gov/library/tobaccosmoke/report/index.html.U.S. Department of Health and Human Services (2010). Cardiovascular diseases. In How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General, chap. 6. Atlanta: U.S. Department of Health and Human Services. Also available online: http://www.surgeongeneral.gov/library/tobaccosmoke/report/index.html.U.S. Preventive Services Task Force (2009). Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspstbac2.htm.Yamin CK, et al. (2010). E-cigarettes: A rapidly growing Internet phenomenon.
Annals of Internal Medicine, 153(9): 607–609.
November 12, 2012
Adam Husney, MD - Family Medicine
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