U.S. Department of Health and Human Services
Public Health Service
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This guides you from thinking about stopping through actually doing it - from the day you quit to quitting for keeps. It gives tips on fighting temptation - and what to do if you give in - and on avoiding weight gain (a handy Snack Calorie Chart is included). By telling you what to expect, it can help you through the day-to-day process of becoming and remaining a nonsmoker.
Here you'll find a variety of tips and helpful hints on kicking your smoking habit. Take a few moments to look at each suggestion carefully. Pick those you feel comfortable with, and decide today that you're going to use them to quit. It may take a while to find the combination that's right for you, but you can quit for good, even if you've tried to quit before.
Many smokers have successfully given up cigarettes by replacing them with new habits, without quitting "cold turkey," planning a special program, or seeking professional help.
The following approaches include many of those most popular with ex-smokers. Remember that successful methods are as different as the people who use them. What may seem silly to others may be just what you need to quit - so don't be embarrassed to try something new. These methods can make your own personal efforts a little easier.
Pick the ideas that make sense to you. And then follow through - you'll have a much better chance of success.
KNOWING WHAT TO EXPECT...
INVOLVING SOMEONE ELSE...
WAYS OF QUITTING...
Cut down the number of cigarettes you smoke
Don't Smoke "Automatically"
JUST BEFORE QUITTING...
ON THE DAY YOU QUIT...
IMMEDIATELY AFTER QUITTING...
Find new habits
When you get the crazies
About gaining weight
Many people who're considering quitting are very concerned about gaining weight. If you're concerned about gaining weight, keep these points in mind:
Tips to help you avoid weight gain...
SNACK CALORIE CHART
WHAT HAPPENS AFTER YOU QUIT SMOKING...
Within 12 hours after you have your last cigarette, your body will begin to heal itself. The levels of carbon monoxide and nicotine in your system will decline rapidly, and your heart and lungs will begin to repair the damage caused by cigarette smoke.
Within a few days, you'll probably begin to notice some remarkable changes in your body. Your sense of smell and taste may improve. You'll breathe easier, and your smoker's hack will begin to disappear, although you may notice that you still cough for a while. And you'll be free from the mess, smell, inconvenience, expense, and dependence of cigarette smoking.
As your body begins to repair itself, instead of feeling better right away, you may feel worse for a while. It's important to understand that healing is a process - it begins immediately, but it continues over time. These "withdrawal pangs" are really symptoms of the RECOVERY process (see "Withdrawal Symptoms and Activities That Might Help).
Immediately after quitting, many ex-smokers experience "symptoms of recovery" such as temporary weight gain caused by fluid retention, irregularity, and dry, sore gums or tongue. You may feel edgy, hungry, more tired, and more short-tempered than usual and have trouble sleeping and notice that you're coughing a lot. These symptoms are the result of your body clearing itself of nicotine, a powerful addictive chemical. Most nicotine is gone from the body in 2-3 days.
It's important to understand that the unpleasant after-effects of quitting are only temporary and signal the beginning of a healthier life. Now that you've quit, you've added a number of healthy productive days to each year of your life. Most important, you've greatly improved your chances for a longer life. You've significantly reduced your risk of death from heart disease, stroke, chronic bronchitis, emphysema, and several kinds of cancer - not just lung cancer. (Cigarette smoking is responsible every year for approximately 130,000 deaths from cancer, 170,000 deaths from heart disease, and 50,000 deaths from lung disease.)
WITHDRAWAL SYMPTOMS AND ACTIVITIES THAT MIGHT HELP*SYMPTOM ACTIVITY
Dry mouth; sore throat, Sip ice-cold water or fruit juice, or gums, or tongue chew gum
Headaches Take a warm bath or shower. Try relaxation or meditation techniques.
Trouble sleeping Don't drink coffee, tea, or soda with caffeine after 6:00 p.m. Again, try relaxation or meditation techniques.
Irregularity Add roughage to your diet, such as raw fruit, vegetables, and whole- grain cereals. Drink 6-8 glasses of water a day.
Fatigue Take a nap. Try not to push yourself during this time; don't expect too much of your body until it's had a couple of weeks.
Hunger Drink water or low-calorie liquids. Eat low-fat, low-calorie snacks (see Snack Calorie Chart).
Tenseness, irritability Take a walk, soak in a hot tub, try relaxation or meditation techniques.
Coughing Sip warm herbal tea. Suck on cough drops or sugarless hard candy.
*Adapted from "Quitting Times: A Magazine for Women Who Smoke," funded by the Pennsylvania Department of Health; prepared by Fox Chase Cancer Center, Philadelphia.
QUITTING FOR KEEPS...
Now you're ready to develop a new habit - not smoking. Like any other habit, it takes time to become a part of you; unlike most other habits, though, not smoking will take some conscious effort and practice. This section of the booklet can be a big help. You'll find many techniques to use for developing the nonsmoking habit and holding on to it.
By reading this section of the booklet carefully and reviewing it often, you'll become more aware of the places and situations that prompt the desire for a cigarette. You'll also learn about many nonsmoking ways to deal with the urge to smoke. These are called coping skills. Finally, you'll learn what to do in case you do slip and give in to that urge.
Keep your guard up
The key to living as a nonsmoker is to avoid letting your urges or cravings for a cigarette lead you to smoke. Don't kid yourself - even though you've made a commitment not to smoke, you WILL sometimes be tempted. But instead of giving in to the urge, you can use it as a learning experience.
First, remind yourself that you've QUIT and you're a NONsmoker. Then, look closely at your urge to smoke and ask yourself:
The urge to smoke after you've quit often hits at predictable times. The trick is to anticipate those times and find ways to cope with them - without smoking. Naturally, it won't be easy at first. In fact, you may continue to want a cigarette at times. But remember, even if you slip, it doesn't mean an end to the nonsmoking you. It does mean that you should try to identify what triggered your slip, strengthen your commitment to quitting, and try again.
Look at the following list of typical triggers. Does any of them ring a bell with you? Check off those that might trigger an urge to smoke, and add any others you can think of:
If you're like many new nonsmokers, the most difficult place to resist the urge to smoke is the most familiar: home. The activities most closely associated with smoking urges are eating, partying, and drinking. And, not surprisingly, most urges occur when a smoker is present.
How to dampen that urge
There are seven major coping skills to help you fight the urge to smoke. These tips are designed for you, the new nonsmoker, to help you nurture the nonsmoking habit.
1. Think about why you quit - Go back to your list of reasons for quitting. Look at this list several times a day - especially when you're hit with an urge to smoke. The best reasons you could have for quitting are very personally yours, and these are also your best reasons for staying a nonsmoker.
2. Know when you're rationalizing - It's easy to rationalize yourself back into smoking (see "Common Rationalizations"). Don't talk yourself into smoking again. A new nonsmoker in a tense situation may think, "I'll just have one cigarette to calm myself down." If thoughts like this pop into your head, stop and think again! You know better ways to relax - nonsmokers' ways, such as taking a walk or doing breathing exercises.
Concern about gaining weight may also lead to rationalizations. Learn to counter thoughts such as "I'd rather be thin, even if it means smoking." Remember that a slight weight gain is not likely to endanger your health as much as smoking would (cigarette smokers have about a 70-percent higher rate of premature death than nonsmokers). And review the list of healthy, low-calorie snacks that you used when quitting.
3. Anticipate triggers and prepare to avoid them - By now you know which situations, people, and feelings are likely to tempt you to smoke. Be prepared to meet these triggers head on and counteract them. Keep using the skills that helped you cope in cutting down and quitting:
4. Reward yourself for not smoking - Congratulations are in order each time you get through the day without smoking. After a week, give yourself a pat on the back and a reward of some kind. Buy a new record or treat yourself to a movie or concert. No matter how you do it, make sure you reward yourself in some way. It helps to remind yourself that what you're doing is important.
5. Use positive thoughts - If self-defeating thoughts start to creep in, remind yourself again that you're a nonsmoker, that you don't want to smoke, and that you have good reasons for it. Putting yourself down and trying to hold out through willpower alone are not effective coping techniques. Mobilize the power of positive thinking!
6. Use relaxation techniques - Breathing exercises help to reduce tension. Instead of having a cigarette, take a long deep breath, count to 10, and release it. Repeat this five times. See how much more relaxed you feel?
7. Get social support - The commitment to remain a nonsmoker can be made easier by talking about it with friends and relatives. They can congratulate you as you check off another day, week, and month as a nonsmoker. Tell the people close to you that you might be tense for a while, so they know what to expect. They'll be sympathetic when you have an urge to smoke and can be counted on to help you resist it. Remember to call on your friends when you're lonely or you feel an urge to smoke. A buddy system is a great technique.
Not smoking is habit-forming
Good for you! You've made a commitment not to smoke, and by using this booklet, you know what to do if you're tempted to forget that commitment. It's difficult to stay a nonsmoker once you've had a cigarette, so do everything possible to avoid it.
If you follow the advice in this booklet and use at least one coping skill whenever you have an urge to smoke, you will have quit for keeps!
Relapse: If you do smoke again
If you do smoke again - and many successful ex-smokers relapse at least once before they quit for good - here's what to do:
I'm under a lot of stress, Your body's used to nicotine, so you and smoking relaxes me. naturally feel more relaxed when you give your body a substance it's come to depend on. But nicotine really is a stimulant - it raises your heart rate, blood pressure, and adrenaline level. Most ex-smokers feel much less nervous just a few weeks after quitting.
Smoking makes me more Trouble concentrating can be a short- effective in my work. term symptom of quitting, but smoking actually deprives your brain of oxygen.
I've already cut down Cutting down is a good first step, to a safe level. but there's a big difference in the benefits to you between smoking a little and not smoking at all. Besides, smokers who cut back often inhale more often and more deeply - negating many of the benefits of cutting back. After you've cut back to about seven cigarettes a day, it's time to set a quit date.
I smoke only safe, low-tar These cigarettes still contain harm- low-nicotine cigarettes. ful substances, and many smokers who use them inhale more often and more deeply to maintain their nicotine intake. Also, carbon monoxide intake often increases with a switch to low-tar cigarettes.
It's too hard to quit. Quitting and staying away from I don't have the willpower. cigarettes is hard, but it's not impossible. More than 3 million Americans quit every year. It's important for you to remember that many people have had to try more than once, and try more than one method, before they became ex-smokers, but they HAVE done it, and so can you.
I'm worried about gaining Most smokers who gain more than weight. 5-10 pounds are eating more. Gaining weight isn't inevitable - there are certain things you can do to help keep your weight stable. (See "Tips To Help You Avoid Weight Gain".)
I don't know what to do That's a common complaint among with my hands. ex-smokers. You can keep your hands busy in other ways - it's just a matter of getting used to the change, of not holding a cigarette. Try holding something else, such as a pencil, paper clip, or marble. Practice simply keeping your hands clasped together. If you're at home, think of all the things you wish you had time to do, make a list, and consult the list for alternatives to smoking whenever your hands feel restless.
Sometimes I have an This is a common feeling, especially almost irresistible urge within the first 1-3 weeks. The to have a cigarette. longer you're off cigarettes, the more your urges probably will come at times when you smoked before, such as when you're drinking coffee or alcohol or are at a cocktail party where other people are smoking. These are high-risk situations, and you can help yourself by avoiding them whenever possible. If you can't avoid them, you can try to visualize in advance how you'll handle the desire for a cigarette if it arises in those situations.
I blew it, I smoked a Smoking one, or even a few, cigarette. cigarettes doesn't mean you've "blown it." It does mean that you have to strengthen your determination to quit, and try again - harder. Don't forget that you got through several days, perhaps even weeks or months, without a cigarette. This shows that you don't need cigarettes and that you CAN be a successful quitter.
FOR FURTHER INFORMATION...
The National Cancer Institute operates a toll-free Cancer Information Service (CIS) with trained personnel to help you. Call 1-800-4-CANCER* to reach the CIS office serving your area, or write: Office of Cancer Communications, National Cancer Institute, National Institutes of Health, Building 31, Room 10A24, Bethesda, MD 20892.
The following organizations also can help you. Contact them to learn more about quitting for keeps.
American Cancer Society**
The American Cancer Society (ACS) is a voluntary organization composed of 58 divisions and 3,100 local units. Through "The Great American Smokeout" in November, the annual Cancer Crusade in April, and numerous educational materials, ACS helps people learn about the health hazards of smoking and become successful ex-smokers.
American Heart Association**
The American Heart Association (AHA) is a voluntary organization with 130,000 members (physicians, scientists, and laypersons) in 55 state and regional groups. AHA produces a variety of publications and audio-visual materials about the effects of smoking on the heart. AHA also has developed a guidebook for incorporating a weight-control component into smoking cessation programs.
American Lung Association**
A voluntary organization of 7,500 members (physicians, nurses, and laypersons), the American Lung Association (ALA) conducts numerous public information programs about the health effects of smoking. ALA has 59 state and 85 local units. The organization actively supports legislation and information campaigns for non-smokers' rights and provides help for smokers who want to quit, for example, through "Freedom From Smoking," a self-help smoking cessation program.
Office on Smoking and Health
The Office on Smoking and Health (OSH) is the Department of Health and Human Services' lead agency in smoking control. OSH has sponsored distribution of publications on smoking-related topics, such as free flyers on relapse after initial quitting, helping a friend or family member quit smoking, the health hazards of smoking, and the effects of parental smoking on teenagers.
*In Hawaii, on Oahu call 524-1234 (call collect from neighboring islands). Spanish-speaking staff members are available during daytime hours to callers from the following areas: California, Florida, Georgia, Illinois, New Jersey (area code 201), New York, and Texas.
**Consult your local telephone directory for listings of local chapters.
National Cancer Institute (NCI)
NIH Publication No. 89-1647 Revised April 1988 February 1989
*Adapted from "Clinical Opportunities for Smoking Intervention - A Guide for the Busy Physician", National Heart, Lung, and Blood Institute. NIH Pub. 86-2178, August 1986.