Quitting Smoking

What should I do if I want to quit smoking?

It's a good idea to start by talking with your doctor or nurse. It is possible to quit on your own, without help. But getting help greatly increases your chances of quitting successfully.

When you are ready to quit, you will make a plan to:

• Set a quit date
• Tell your family and friends that you plan to quit
• Plan ahead for the challenges you will face, such as cigarette cravings
• Remove cigarettes from your home, car, and work

How can my doctor or nurse help?

Your doctor or nurse can give you advice on the best way to quit. They can also give you medicines to:

• Reduce your craving for cigarettes
• Reduce your "withdrawal" symptoms (symptoms that happen when you stop smoking)

Your doctor or nurse can also help you find a counselor to talk to. For most people who are trying to quit smoking, it works best to use both medicines and counseling.

You can also get help from a free phone line (1-800-QUIT-NOW) or go online to www.smokefree.gov.

What are the symptoms of withdrawal?

When you stop smoking, you might have symptoms such as:

• Trouble sleeping
• Feeling irritable, anxious, or restless
• Getting frustrated or angry
• Having trouble thinking clearly

These symptoms can be hard to deal with, which is why it can be so hard to quit. But medicines can help.

Some people who stop smoking become temporarily depressed. Some people need treatment for depression, such as counseling or medicines or both. People with depression might:

• No longer enjoy or care about doing the things they used to like to do
• Feel sad, down, hopeless, nervous, or cranky most of the day, almost every day
• Lose or gain weight
• Sleep too much or too little
• Feel tired or like they have no energy
• Feel guilty or like they are worth nothing
• Forget things or feel confused
• Move and speak more slowly than usual
• Act restless or have trouble staying still
• Think about death or suicide

If you think you might be depressed, tell your doctor or nurse right away. They can talk to you about your symptoms and recommend treatment if needed.

If you ever feel like you might hurt yourself, go straight to the nearest emergency department or call for an ambulance (in the US and Canada, dial 9-1-1). You can also call your doctor or nurse and tell them it is an emergency, or reach the US National Suicide Prevention Lifeline at 1-800-273-8255 or www.suicidepreventionlifeline.org.

How does counseling work?

• What triggers you to want to smoke, and how to handle these situations
• How to resist cravings
• What you can do differently if you have tried to quit before

You can meet with a counselor in one-on-one sessions or as part of a group. There are other ways to get counseling, too, such as over the phone, through text messaging, or online.

How do medicines help you stop smoking?

Different medicines work in different ways:

• Nicotine replacement therapy – Nicotine is the main drug in cigarettes, and the reason they are addictive. These medicines reduce your body's craving for nicotine. They also help with withdrawal symptoms.

There are different forms of nicotine replacement, including skin patches, lozenges, gum, nasal sprays, and inhalers. Most can be bought without a prescription. Also, health insurance might cover some or all of the cost.

It often helps to use 2 forms of nicotine replacement. For example, you might wear a patch all the time, plus use gum or lozenges when you get a craving to smoke.

• Varenicline – Varenicline (brand names: Chantix, Champix) is a prescription medicine that reduces withdrawal symptoms and cigarette cravings. Varenicline can increase the effects of alcohol in some people. It's a good idea to limit drinking while you're taking it, at least until you know how it affects you.

Even if you are not yet ready to commit to a quit date, varenicline can help reduce cravings. This can make it easier to quit when you are ready.

• Bupropion – Bupropion (sample brand names: Wellbutrin, Zyban) is a prescription medicine that reduces your desire to smoke. It is also available in a generic version, which is cheaper than the brand name medicines. Doctors do not usually prescribe bupropion for people with seizures or who have had seizures in the past.

It might also be helpful to combine nicotine replacement with bupropion or varenicline. In some cases, a person might even take both bupropion and varenicline. Your doctor or nurse can help you figure out the best combination for you.

What about e-cigarettes?

Sometimes people wonder if using electronic cigarettes, or "e-cigarettes," can help them quit smoking. Using e-cigarettes is also called "vaping." Doctors do not recommend e-cigarettes in place of medicines and counseling. That's because e-cigarettes still contain nicotine as well as other substances that might be harmful. It's also not clear how they can affect a person's health in the long term.

What if I am pregnant and I smoke?

If you are pregnant, it's really important for the health of your baby that you quit. Ask your doctor what options you have, and what is safest for your baby.

Will I gain weight if I quit?

You might gain a few pounds. This can be frustrating for some people, but it's important to remember that you are improving your health by quitting smoking. You can help prevent gaining a lot of weight by staying active and eating a healthy diet.

What if I am not able to quit?

If you don't quit on your first try, or if you quit but then start smoking again, don't give up hope. Lots of people have to try more than once before they are able to completely quit.

It might help to try to understand why quitting did not work. There might be something you can do differently when you try again. It can help to figure out what situations make you want to smoke, so you can avoid them.

What else can I do to improve my chances of quitting?

• Get regular exercise. Any type of physical activity, even gentle forms of movement, is good for your health. Physical activity can also help reduce stress.
• Stay away from smokers and places that make you want to smoke. If people close to you smoke, ask them to quit with you or avoid smoking around you.
• Carry gum, hard candy, or something to put in your mouth. If you get a craving for a cigarette, try one of these instead.
• Don't give up, even if you start smoking again. It takes most people a few tries before they succeed.