Quitting smoking

An increasing number of people are giving up smoking and feeling the benefits. A number of studies have shown that most smokers would like to stop and that many have tried and failed. They should be encouraged; most people who finally quit have tried more than once before succeeding.

There is no simple way to break the habit. Some smokers just stop, while others need help. This might come from the use of nicotine replacement through chewing gum or stick-on patches. There are also prescription medicines available, e.g. bupropion (Zyban and Prexaton) and varenicline (Champix) that can help reduce cravings and withdrawal symptoms. Hypnotherapy and acupuncture have helped many. It may also help to access some of the Government organisations that can help smokers quit.

Why you should stop smoking

Health hazards associated with smoking include chronic lung and airways disease, lung cancer as well as other cancers, cardiovascular disease, cataracts in the eye, gastrointestinal disease, circulation problems, harm to the fetus of pregnant women, harm to family through passive smoking, and premature ageing of the skin.

Most people are aware of the hazards of smoking through advertising, public awareness campaigns and often peer pressure. They are probably ‘told’ these facts often. Family and/or friends may have tried confrontation, bribery or punishment! However, you will give up smoking only when you have made up your mind to do so. When this happens, smoking cessation products and plenty of support from others can help.

If you suddenly stop smoking, the addiction to nicotine can cause severe cravings and other withdrawal symptoms such as irritability, restlessness and loss of concentration.

Some tips to help you quit

If you are thinking of trying to stop, here are some helpful tips.

  • Pick a time when your life is ‘normal’, with no major events or stresses likely.
  • Choose a date in advance and tell your family and friends.
  • Stop in the morning and have a good breakfast.
  • Avoid temptation such as pubs, clubs and friends who smoke.
  • Reward yourself frequently for the first few days. New clothes, a massage or a new hairstyle are good rewards.
  • Avoid your usual ‘trigger factors’ such as alcohol, drinking coffee, chatting on the telephone.
  • Change your routines.
  • Take more exercise.
  • When you feel like a cigarette drink a glass of water or eat a sweet.
  • Watch your weight, but don't worry too much if you put a bit on at first. It will come off later when you settle into life as a non-smoker.
  • Keep reminding yourself about the money you are saving and the longer, healthier life you can expect.
  • Giving up smoking may take a number of attempts, but this is normal. If one method of giving up doesn’t work, there are others that can be tried which may be better for you.

The ‘buddy’ system can make quitting twice as easy

In one stop-smoking program, the use of a ‘buddy’ system more than doubled the success rate. If you want to quit smoking find someone else who also wants to stop. You don't need to know them well; you might advertise at work or through friends. Ring each other at least once a day for support.

And remember—however many times you have already tried unsuccessfully to stop in the past, the next attempt might be the one that brings success. The first 2 weeks are the hardest. You can do it!

Smoking cessation products and services

Quitting smoking is more likely to be successful when you have help from your family doctor or another health professional. Your doctor can provide you with information and motivation to quit, and will also be able to refer you to appropriate counselling services that can guide and support your quit smoking approach.

Nicotine replacement therapy

Nicotine replacement therapy includes patches, chewing gum, inhalers, tablets and lozenges.

These provide nicotine replacement that can be slowly reduced as you give up smoking. Some well-known brands in Australia are Nicabate, Nicorette and Nicotinell.

It is important to determine the correct strength of the product being used. Under-dosing may lead to nicotine craving. Some people require a patch as background replacement and the occasional piece of gum at times of intense craving for a cigarette.

Most nicotine replacement products should be used in conjunction with a comprehensive advice and support programme. Ask your doctor or pharmacist for advice.

It is also important that you follow the product instructions closely, and that you do not exceed the stated doses. Product manufacturers recommend giving up smoking cigarettes when starting treatment.

Nicotine patches must be kept out of reach of children and pets because even used patches may contain sufficient nicotine to poison. Fold the sticky ends of the patch together and dispose of the patch carefully.

The patches may cause skin reactions on the area where they are applied. Always re-apply on a new part of the skin.

Prescription medicines

Depending on your individual circumstances, your doctor may prescribe medicines such as bupropion (e.g. Prexaton, Zyban) or varenicline (brand name Champix) that can help reduce your dependence on nicotine. Rather than supplying an alternative source of nicotine, these medicines work at the neurological level, helping to reduce your body's craving for nicotine.

These medicines carry the risk of significant side-effects, which your doctor should discuss with you before starting treatment.

Usually, you start taking the tablets while you are still smoking and then stop smoking on a set date in your second week of treatment. Like any medicine to help you stop smoking, the tablets should be used in conjunction with a comprehensive treatment programme. Ask your doctor for advice.

Non-medicine therapies

Complementary therapies, such as acupuncture and hypnosis, may help with quitting but there is a lack of good quality evidence from clinical trials showing that these therapies are effective. Attending support groups may also help you quit smoking.

Last Reviewed: 20 December 2012
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References

1. Cancer Council NSW. Quit smoking. Last updated 9 Feb 2012. http://www.cancer.org.au/preventing-cancer/reduce-your-risk/quit-smoking.html (accessed Feb 2013).
2. Mayo Clinic. Nicotine dependence. Last updated Aug 10 2012. http://www.mayoclinic.com/health/nicotine-dependence/DS00307 (accessed Feb 2013).
3. eMIMS. February 2013. Prescribing information. Champix, Prexaton, Zyban. Accessed Feb 2013.
4. Zwar N, Richmond R, Borland R, et al. Supporting smoking cessation: a guide for health professionals. Melbourne: The Royal Australian College of General Practitioners, 2011. http://www.racgp.org.au/your-practice/guidelines/smoking-cessation/ (accessed May 2013).
5. Australian Government Quitline. Quitting methods and what to expect (updated 30 May 2012). http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/quitting-methods (accessed May 2013).
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