Smoking Cessation

General Information

Congratulations on your decision to quit smoking. This decision is the first and most important step in becoming a successful quitter! As you might know, quitting involves overcoming your physical as well as psychological and behavioral dependence on cigarettes.

Nicotine is an addictive drug which, when inhaled in cigarette smoke, reaches the brain faster than drugs that enter the body intravenously. Smokers become not only physically addicted to nicotine, but also link smoking with many social activities. This makes smoking a more difficult habit to break.

Each year about 1.3 million smokers quit successfully. With good smoking cessation programs, 20% to 40% of participants are able to quit smoking and stay off cigarettes for at least 1 year.

In 1995, an estimated 44.3 million adults were former smokers. Currently, prescription and over-the-counter products are available to help relieve withdrawal symptoms people experience when they quit smoking.

The surgeon general’s report states that after 1 year off cigarettes, the excess risk of heart disease caused by smoking is reduced by half. In 5 to 15 years, the risk of stroke for ex-smokers returns to the level of those who have never smoked. Male smokers who quit between ages 35 to 39 add an average of 5 years to their lives. Females who quit in this age group add 3 years to their lives.

Dangers for tobacco use

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

Cigarettes contain at least 43 distinct cancer-causing chemicals.

Smoking is directly responsible for 87% of lung cancer cases and causes most cases of emphysema and chronic bronchitis. Smoking is a major risk factor in coronary heart disease, stroke and asthma.

More than 22 million American women are smokers. Lung cancer caused an estimated 67,000 deaths in 1998, compared with 43,500 estimated female deaths caused by breast cancer.

Smoking by parents is also associated with a wide range of adverse effects in their children. These include exacerbations of asthma, increased frequency of colds and ear infections, and an increased risk of sudden infant death syndrome.

Smokers have the following increased risks for disease:

a. 2 fold greater risk of strokes
b. 6 fold greater risk of oral cancers
c. 10 fold greater risk of larynx cancer
d. 10 fold greater risk of chronic obstructive pulmonary disease (COPD)
e. 12 fold greater risk of lung cancer
f. 12 fold greater risk of heart disease

Other conditions and diseases associated or linked to smoking:

1. Pregnancy complications
2. Cervical cancer
3. Esophageal cancer
4. Bladder and kidney cancer
5. Pancreatic cancer
6. Leukemia
7. Gastric and duodenal ulcers
8. Skin wrinkling
9. Osteoporosis
10. Bone fractures
11. Cataracts and glaucoma
12. Impotence and infertility
13. Lower levels of “good cholesterol”
14. Peripheral vascular disease
15. Gum disease
16. Dental cavities
17. Stained teeth and bad breath
18. Financial burden
19. Poor tolerance for exercise
20. Socially unacceptable
21. Poor role model for children and grandchildren
22. Increased risk lung cancer and heart disease in spouse and children
23. High rates of smoking in your children

Rewards for quitting smoking

Immediate

1. Blood pressure lowers
2. Carbon monoxide level in blood drops to normal
3. Oxygen level in bleed increases to normal
4. Breath, car, and home smell better
5. Food smells and tastes better
6. Circulation improves
7. Lung function improves
8. Risks of gastric and duodenal ulcers decrease
9. Risks of peripheral artery disease decrease
10. Financial savings
11. Feel better about yourself
12. Can stop worrying about quitting
13. Loved ones get off your back” about smoking

Intermediate (months to 1 year)

1. Coughing, sinus congestion, fatigue, and shortness of breath decrease
2. Decreased risk of recurrent respiratory infections
3. Body’s overall energy increases
4. After 1 year, excess risk of heart disease is half that of a smoker
5. Financial savings
6. Improved health

Long Term

1. After 5 years, lung cancer death rate decreases by almost half
2. After 5 years, risk of cancer of the mouth, throat, and esophagus is half that of a smoker
3. After 5 to 15 years, stroke risk is reduced to that of a nonsmoker
4. After 10 years, lung cancer death rate similar to that of a nonsmoker
5. After 15 years, risk of coronary heart disease is that of a nonsmoker
6. Set hood role model for children and grandchildren
7. No worries about exposing loved ones to passive smoke
8. Overall improved health
9. Financial savings

Strategies to help quit smoking

How to prepare to quit smoking

1. Decide positively that you want to quit.
2. List all the reasons you want to stop.
3. Determine what makes you smoke. Keep a diary.
4. Choose a quit date within the nest one to two weeks.
5. Tell someone you are quitting and enlist his or her support.
6. Identify your rewards for quitting smoking.
7. Reduce you caffeine intake.

Prepare for your quit date

1. Throw away all your tobacco, lighter, ashtrays and other smoking related products.
2. Clean your clothes, car, drapes, and furniture to rid them of the smell of smoke.
3. Have your teeth cleaned to keep them free from stain.
4. Stay away from tobacco users.
5. Do something special that you have been putting off.

How to prepare to avoid urges to smoke

1. Spend more time with friends who do not smoke.
2. Find activities that make smoking difficult.
3. Keep oral substitutes handy. Try carrots, sunflower seeds, sugarless gum, straws, toothpicks, or apples.
4. Change your daily routine to break your old habits.
5. Distract yourself from thoughts of smoking by talking to someone or reading.
6. Use relaxation techniques such as deep breathing, yoga, or exercising.

Medications to help quit smoking

Research supports that almost everyone can benefit from using nicotine replacement.

Your health care provider can help you choose the most appropriate form of nicotine replacement or other medication. There are several choices of medications that can help with smoking cessation. However, the two most commonly suggested are nicotine and Zyban (wellbutrin).

Nicotine replacement is available in several forms including the patch form, chewing gum, and inhaled nicotine from a cigarette-like device.

Zyban is an oral medication that helps with the psychological issues that often contribute to a failed effort.

Each of these products have potential benefits and possible side effects, so each patient should discuss these with his or her physician and decide together which product is best to try.

What to do if you relapse and start smoking again

1. Stop smoking immediately.
2. Get rid of all tobacco products.
3. Don’t be too hard on yourself. Get back on track as soon as possible.
4. Realize that most people try several times before they successfully quit.
5. Identify your triggers that led you to smoking again and learn form your past mistakes.
6. Set a new quit date and began again.

Summary, Support, Links

Summary of keys for quitting

a. Get ready (set quit date)
b. Get support and encouragement
c. Learn new skills and behaviors
d. Get medication and use it correctly
e. Be prepared for relapse or difficult situations

Quitting smoking is hard! Be prepared for challenges, especially in the first few weeks.

Support groups: American Lung Association 933-8821

(Text compiled by Virginia Thomas, CRNP)

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