The Five Steps That Can Help You Quit

There are a lot of different ways to give up smoking. Studies have shown that you have the best chance of quitting for good if you follow these 5 steps:

1. Get Ready
2. Get Support and Encouragement
3. Learn New Skills and Behaviors
4. Get Medication and Use It Correctly
5. Be Prepared For Difficult Situations or Setbacks

Step 1. Get Ready

• Set a Quit Date. It is important to set a date to quit so you can mentally and emotionally prepare for it. Set one that is not in the middle of an overly stressful period in your life, but don't wait until your life is without any stress because that day will never come!
• Change your environment. Get rid of all cigarettes and ashtrays in your home, car and place of work. Don't let people smoke in your home or car. Avoid spending time with people who do smoke and places where people smoke, such as bars and smoking sections of restaurants. Spend more time with people who you know are supportive of your new lifestyle and will help you.
• Participate in a regular exercise program at least three times a week - pick something that you like and change it when you get bored.
• Take up a hobby that requires you to use your hands.
• Review your past attempts to quit. Think about what worked and what did not.
• Once you quit, don't smoke - NOT EVEN A PUFF!

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Step 2. Get Support and Encouragement

Studies have shown that you have a better chance of successfully quitting if you have help. You can get support in many ways:

• Tell your family, friends and coworkers that you are going to quit and you want their support. Ask them not to smoke around you or leave cigarettes out.
• Talk to your healthcare provider (for example, doctor, dentist, nurse, pharmacist, psychologist or smoking counselor).
• Get individual, group or telephone counseling. The more counseling you have, the better your chances are of quitting. Programs are given at local hospitals, health centers and other organizations.
• The use of medicine typically doubles your chances of quitting and quitting for good! Although the medicines can be costly, in the long run you will save a lot of money by giving up smoking.

If you’d like to see what we have to offer, call our Quitline at 1- 800- 639 - QUIT (7848).

Step 3: Learn New Skills and Behaviors

It is important to learn new skills and behaviors to live as a non-smoker. You can learn new ways to deal with stress, to problem solve and to lessen your chances for setbacks. Try the following:

• When you first try to quit, change your routine. Take a different way to work. Drink tea instead of coffee. Eat breakfast in a different place.
• Do something to reduce your stress. Take a hot bath, exercise, or read a book.
• Drink a lot of water and other fluids.
• Develop a healthier lifestyle - eat healthy foods and remember to exercise at least three times a week. 
• Brush your teeth frequently with a fresh tasting toothpaste (there is no rule that says you should only brush your teeth twice a day!).
• Try to distract yourself from urges to smoke. Talk to someone, go for a walk or busy yourself with a task.
• Plan something enjoyable to do every day.

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Step 4. Get Medicine and Use It Correctly

Medicine can help you stop smoking and lessen the urge to smoke. The use of medication can double your chances of quitting and quitting for good. Everyone who is trying to quit may benefit from using a medication. Some people benefit from using a combination of the medicines.

Talk to your doctor or other healthcare provider about taking a medicine to help you quit. Let your doctor know if:

• you are pregnant;
• you are nursing a baby;
• you are smoking fewer than 10 cigarettes per day;
• you have a medical condition.

What medicines are available to help me quit?

The U.S. Food and Drug Administration (FDA) has approved a number of medicines to help you give up smoking:

Varenicline (Chantix^TM) - This is a new and different type of medicine for quitting smoking. Chantix acts at sites in the brain affected by nicotine. It works in two ways:

1. lessens withdrawal symptoms
2. blocks enjoyable effects of smoking

Chantix^TM is a pill that must be prescribed by a health care provider. Begin taking Chantix^TM  one week before your Quit Date. It is okay to continue to smoke before your Quit Date. Don't use the nicotine patch while taking Chantix^TM .

Chantix^TM is generally taken for at least 12 weeks. If you have quit smoking at the end of 12 weeks, your doctor may advise taking it for 12 more weeks. In recent studies, people who continued taking Chantix^TM for 6 months were much more likely to quit and remain tobacco-free at one year. Some people have an upset stomach the first week of taking Chantix^TM .

Bupropion SR (Zyban®) - This is a pill that decreases your desire to smoke. It is a prescription medicine and should not be taken if you are taking certain other medicines. Make sure that your doctor is aware of all medicines you take. You should start taking this pill 7-10 days before your Quit Date. Most people need to continue taking this medicine for up to six months. Ask your doctor how long you should take this medicine. The following medicines are Nicotine Replacement Treatments. This means that they provide nicotine to your body in a form other than smoking. These medicines should be started on your Quit Date. It is important that you don't smoke when using nicotine replacement treatments. Also, it is important to follow the instructions in the package so you can benefit from the treatment.

Nicotine Gum (Nicorette®) - This gum is available without a prescription. When you chew nicotine gum, it releases nicotine and it is absorbed by the blood vessels in your mouth. This gum should be chewed a few times to release the nicotine and then placed between your cheek and gum.

Nicotine Nasal Spray (Nicotrol NS®) - The nicotine nasal spray delivers nicotine very quickly - within 7-10 seconds - into your bloodstream. This helps to reduce craving for a cigarette. It is available by prescription from your doctor.

Nicotine Inhaler (Nicotrol®) - The nicotine inhaler is a small device that you hold in your hand and inhale, similar to a cigarette. As you inhale from it, nicotine is quickly delivered into your blood stream. This helps to reduce craving for a cigarette. It is available by prescription from your doctor.

Nicotine Patch (Habitrol®, NicoDermCQ, Nicotrol, ProStep®) - There are a number of nicotine patches available. Some require a prescription and others are available over-the-counter. Some generic patches are available at a lower cost. A nicotine patch is placed onto your skin and releases nicotine into your blood stream. It maintains an even level of nicotine in your system without smoking. Keep in mind that it can take up to 2 hours for your blood level of nicotine to reach that level when you put a new patch on each morning. It is important that you don't smoke when wearing a patch.

Nicotine Lozenge (Commit®) - The nicotine lozenge can be helpful for people who want to keep their mouth busy. It releases nicotine as you allow the lozenge to dissolve slowly in your mouth. You can buy it without a prescription. It is available in two strengths.

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Step 5. Be Prepared for Difficult Situations or Setbacks

Be prepared for feelings, situations or activities that make you want to smoke. Remember to use the new skills you have learned. Most setbacks occur within the first 3 months after quitting. Don't be discouraged if you start smoking again. Use this situation to learn how to avoid future temptations and get back on track! Remember, most people try several times before they finally quit.

Here are some difficult situations to watch for, and some advice on how to avoid them:

Weight Gain - Some smokers gain weight when they quit, usually less than 10 pounds. This is due to a change in metabolism and an increased amount of food eaten. Women have more of a tendency to gain weight than men.

What can I do to gain as little weight as possible?

Try the following:

• Plan meals that are healthy and low calorie, low fat.
• When grocery shopping, shop from a list and avoid aisles with tempting high calorie, high fat foods.
• Have low calorie, low fat snacks available; ban junk food from your home.
• Store food out of sight.
• Drink a lot of water or low calorie beverages.
• Exercise 3-5 times per week - you will feel better. And, it’ll reduce your urge to eat because you’ll be away from the refrigerator!

Don't let weight gain keep you from your main goal - quitting smoking. Some quit smoking medicines (nicotine gum, Zyban®) may help reduce weight gain.

Limit or phase-out time with other smokers - Being around others who smoke can make you want to smoke. If your spouse smokes, encourage him/her to quit with you; or, at least, to avoid smoking in the home and cars (or other vehicles). Try to spend more time with people who don't smoke.

Think before you drink - Drinking alcohol lowers your chances of success. At least during the first few weeks of quitting, avoid drinking alcohol. Later, as you are more comfortable with your smoke-free lifestyle, try to limit the amount you drink and the frequency.

Be ready for bad moods, mood swings, or depression - There are a lot of ways to improve your mood other than smoking. Regular exercise and getting enough rest are very important, especially during the first few weeks. Smoking affects chemicals in the brain that are associated with mood and emotions. Some people smoke to elevate their mood or to help them feel better about themselves. If you tend to feel depressed , talk to your doctor about Zyban®. This medicine lowers your desire to smoke and is also an anti-depressant.

Find other ways to deal with stress or pressure - Many people use smoking to help them deal with stress or pressure. As you quit, you will need to learn to deal with stress or pressure in other ways. Try the following:

• Change what you can, let go of what you can't control.
• Try to see things in a more positive way.
• Get support from your (non-smoking) family and friends.
• Make time for yourself.
• Practice deep breathing and relaxation exercises .

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This information has been approved by Epi Mazzei, R.N. (January 2007).