Wednesday, October 31, 2007

Seven Sizzling Ways to Stop Smoking

Quitting smoking is one of the most daunting challenges you'll face in your life. It's an addiction that is both physical and psychological, but quitting smoking can be done. In fact, you'll have plenty of company: 1 million Americans quit every year, and almost 50 million Americans are former smokers.
You've seen the warnings. Heard the discussions. Received the advice. Listened to your kids nag you about it. You know you should quit smoking, but you never seem to get around to it.
Well, now is the time to get around to it.
"You know, there's no magic bullet, no device that will make it easy," says Jenny Duffey, who smoked for 13 years before quitting in 1989, and has written a book and taught seminars on quitting. "You have to want to quit—really want to quit—before you can do it."
There are certainly plenty of reasons to quit when you consider smoking's fatal link with lung cancer, emphysema, and heart disease, and the harmful effects of second-hand smoke on your family. Even the tobacco companies admit that there might be a relationship between smoking and death.
Yet quitting is one of the most daunting challenges you'll face in your life.

The Mind and Body Connection

That's because smoking is addictive—both physically and psychologically. The physical addiction can be traced to the nicotine in each cigarette. It hooks you just as completely as its more disreputable cousins, such as heroin and cocaine, say researchers, and the withdrawal symptoms—cravings, anxiety, nausea, cramps, depression, and dizziness—are similar.
Like these other drugs, nicotine surges through the bloodstream and gives smokers a high—a quick jolt that makes them think they feel better. But, in the meantime, what really happens is that smokers develop a tolerance for nicotine, which is why they go from a couple of butts a day as a teenager to 2 1/2 packs a day as an adult.
The psychological addiction is, in its own way, just as bad. Smoking becomes second nature, like blinking or breathing. If you consider that one pack of cigarettes can turn into 150 to 200 puffs a day, seven days a week, 52 weeks a year, you'll see how hard it is to de-program yourself.

The Key to Quitting

But you can quit. In fact, one million Americans quit smoking every year, and almost 50 million Americans are former smokers.
"The thing to keep in mind is that almost everyone who quits has to try more than once," says Anne Davis, M.D., a past president of the American Lung Association. "You shouldn't be discouraged. It's more rare to quit on the first try than on the fifth. Some people have to try as many as 10 or 11 times."
The key to quitting, say the experts, is patience and perseverance.

How to Do It

Keep these points in mind when you quit:

Know why you're quitting

Pick a reason that you believe in, be it for your family or for yourself. If you don't believe in your reason, it's that much harder to stop.

Change your environment

Worry about not smoking for just one day, and not for the rest of your life. Besides, it gets easier to stave off the desire the longer you don't smoke. The nicotine will be gone from your system in three to five days, and after about a month the worst of the withdrawal symptoms will go away.

Taper off

Some studies show that a majority of permanent quitters achieved their goal by quitting "cold turkey". But it doesn't make you any less of a man, says Dr. Davis, to try tapering off instead. "It doesn't mean you are weak, and don't have will power," she says. "What it means is that you realize there are other approaches that will work better."
The key to tapering off is to cut down the number of cigarettes you smoke each day. One way to do this, says Duffey, is to delay the first cigarette of the day. She recommends the two-hour approach. If you have your first smoke at 7 a.m., try holding out until 9 for a couple of days. Then, push it back until 11, and so on. By the end of four weeks, you won't be smoking at all. Whether you taper or quit cold, your goal must be the same: abstinence. If you choose to taper, don't let the process give you an excuse to delay the final step of quitting entirely.

Overwhelm the addiction

Think about the things that lead to lighting up, and don't do them. Get rid of the ashtrays at home. Don't pick up matches at a restaurant. Don't come back from lunch 15 minutes early to sneak in a cigarette break. Avoid places, like bars, where smoking is part of the atmosphere.

Practice the three D's

When you feel like a smoke, delay. Try to think of something else. Breathe deeply, and count to ten slowly as you do so. Drink water; aim for eight eight-ounce glasses a day, which helps flush the nicotine out of your system. Do something else: chew gum, tap a pencil or crack your knuckles until the craving passes.

Keep a diary

This technique, which has also been used effectively with people who eat too much, is surprisingly effective. Each time you feel like a cigarette, write down the time of day, what you're doing, and how badly you want a drag on a scale of 1 to 3, with 1 for the worst craving. A diary, says Dr. Davis, helps you to learn to unlearn the almost Pavlovian responses that make you want to smoke.
"Just because you fail once doesn't mean you can't quit smoking," says Dr. Davis. "Half the battle is knowing that it may require several attempts, and feeling confident that you'll eventually succeed."

Work with your healthcare provider

For best results in your plan to stop smoking, work with your healthcare provider. Studies show that measures such as over-the-counter nicotine patches, over-the-counter nicotine gum, prescription nicotine inhalers or nasal sprays, the prescription antidepressant bupropion, hypnosis, acupuncture, smoking cessation classes, support groups, and the like are the most effective when used in combination. So if you're going to use the patch, it's a good idea to find a support group, such as classes sponsored by the lung or heart associations.
American Lung Association
Tobacco Information and Prevention Source (TIPS)

Last reviewed August 2005 by Lawrence Frisch, MD, MPH


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