Quitting smoking: Cold turkey with a side of support
A co-worker wants to chit-chat. You are curt and fidgety. You snap, “not now!” Then you apologize and admit that you’re not yourself today. What’s missing? You reach for your cigarettes in your shirt pocket and a feeling of panic sets in. They’re gone! You quit smoking just yesterday, cold turkey. No patch, no doctor, no support. Now you wonder how long you can hold out.
Some smokers can quit smoking “cold turkey.” That means just stopping and not smoking again, ever. For most smokers though, especially heavy smokers, using medication along with therapy or behavioral support offers the best chance of success. In fact, studies show this combo can double your chances of staying tobacco-free.
Medication
Medication treats nicotine withdrawal, the body’s response when it is deprived of the drug nicotine. So, medication helps reduce the urge to smoke while you set out to change your behavior. There are seven drugs approved by the U.S. Food and Drug Administration (FDA). Five are nicotine products, and two are non-nicotine pills.
Nicotine products. Nicotine replacement products reduce the nasty withdrawal symptoms and nicotine cravings that 70 percent to 90 percent of smokers say is their only reason for not giving up cigarettes, according to the American Cancer Society. While it’s still a drug, you don’t get the cancer-causing chemicals found in cigarettes and other tobacco products. Nicotine products include:
1. The patch. You wear a patch with varying doses of nicotine. The nicotine is delivered through the skin. You wean yourself off nicotine by giving yourself lower-dose patches from week to week.
2. Nicotine gum. This is fast-acting nicotine delivered through the mucous membranes in the mouth. You can control the dose of nicotine more than with the patch. You may prefer the gum if your skin is sensitive to the patch.
3. Nicotine inhaler. This is available by prescription only. The inhaler is a thin, plastic tube with a nicotine cartridge inside. You may find this method helpful because it is the most like smoking.
4. Nicotine nasal spray. Available by prescription only, the spray relieves nicotine withdrawal symptoms right away.
5. Nicotine lozenge. The lozenge is sold over-the-counter in two strengths. You choose the strength depending on how soon you smoke your first cigarette after you wake up.
Non-nicotine medications. These medications are available by prescription. They also reduce cravings and withdrawal symptoms. They include:
1. Bupropion SR. This is a long-acting antidepressant that helps relieve the symptoms of nicotine withdrawal. You can use this drug alone or with a type of nicotine replacement therapy. You start it one to two weeks before you quit. Do not take this drug if you have a history of:
* Seizures
* Alcohol abuse
* Serious head injury
* Bipolar (manic) depression
* Eating disorder (anorexia or bulimia)
2. Varenicline tartrate (Chantix). This reduces the severity of nicotine cravings and the intensity of withdrawal symptoms. Varenicline is normally taken for 12 weeks. If you quit during that time, you can continue therapy for an extra 12 weeks to increase your chance of remaining tobacco-free.
Support and planning
Set a quit date and prepare for it.
* Pick the date and mark it on your calendar.
* Tell friends and family of your quit day.
* Create a smoke-free environment around you. Throw out your cigarettes.
* Stock up on sugarless gum, cinnamon sticks, carrot sticks and hard candy.
* Decide on a plan. Will you use nicotine replacement therapy? Will you attend a smoking cessation class? If so, sign up now.
* Set up a support system. This could be a group class, Nicotine Anonymous or a friend who has successfully quit and is willing to help you.
Work through rough moments. Even when on medication to curb nicotine withdrawal, you’ll still have moments when you want to smoke, especially during the first few weeks after your quit date. Here are a few tips to handle these:
* Spend time in public places where smoking is not allowed.
* Avoid triggers for smoking, especially coffee or alcohol. Try other things to drink, such as teas or juice.
* If you need to have something in your mouth, use your supply of sugarless gum or cinnamon sticks.
* Continue to seek support. Learn from others who have quit with group therapy or online or phone support.
