Quitting smoking is the very best thing you can do for your health! Having said that, we all know that it is easier said than done. We all (including non-smokers) need to realize that smoking is an addiction and that quitting is not just an event but usually involves a process.
Stages of Change for Quitting
Most smokers go through "stages of change" before they eventually quit for good. These stages have been defined as:
| Stage | Mind State |
|---|---|
| Pre-contemplation | Not even considering quitting |
| Contemplation | Thinking about quitting sometime in the next 6 months |
| Preparation | Wants to quit within the next 4 weeks, and wants to prepare |
| Action | Has quit within the last month and is learning to cope without cigarettes |
| Maintenance | Has been smoke-free for over 6 months and wants to stay that way |
It is a major step for a smoker to move from one stage to the next, as it is another step towards being smoke-free. A positive attitude is a recipe for success and is required all along the way. For example, most smokers who try to quit relapse at least once before quitting for good. This event must be viewed as an opportunity to identify the "trigger" that caused the relapse, and to address that situation on the next quit attempt.
What Is the Best Strategy for Quitting?
Evidence has shown that matching strategies to the smoker's current stage of change, results in the best chance of eventually quitting for good. For example, if a smoker is in the "pre-contemplation" stage they require motivation from within and education about why it is important to quit smoking. Information should be offered, but being too pushy will just result in a push back and further denial or rationalization. On the other hand a person who wants to quit within a month is motivated and wants to quit soon. In this case, barriers to quitting must be addressed to make the chances of success as high as possible. Lozenges are now available as a form of nicotine replacement.
Why Should I Quit?
The benefits of quitting are numerous:
- You'll remove harmful second hand smoke from the inhaled air of friends and relatives.
- You'll reduce the risk of heart attack in 24 hours, cut it in half within one year and become the same as someone who has never smoked within 15 years.
- Within five years, the risk of death due to lung cancer is almost cut in half.
- Within 5 to 15 years, the risk of stroke is reduced to that of someone who has never smoked.
- Circulation improves and walking becomes easier within two weeks to three months.
- Smoker's cough disappears within one to nine months.
- Sense of taste and sense of smell will improve.
- You will have more energy.
- You will be in control, instead of the cigarettes.
- You'll have more money.
Medications to Help Those Ready to Quit Smoking
Approved quit smoking medications include nicotine replacement therapies (patch and gum) and a medication in pill form called bupropion (Zyban®).
Nicotine Replacement
Nicotine is the addictive substance in cigarettes, but it is the tobacco smoke containing over 200 toxins, 50 of which can cause cancer, that lead to most of the damage from smoking. Nicotine replacement therapy allows replacement of much of the nicotine, reducing the effects of withdrawal, while allowing you to become accustomed to not having cigarettes in your life. Nicotine patches keep a constant level of nicotine in your system, while nicotine gum is designed to replace cigarettes when the urge arises. When you feel ready, you should start to reduce the amount of nicotine you are using until you are able to continue without any nicotine replacement. Your Sobeys Pharmacist or doctor can discuss the nicotine replacement strategy that is best suited to your needs. Your Sobeys Pharmacist will also discuss the proper use of nicotine replacement products with you.
Bupropion (Zyban®)
Bupropion helps to reduce withdrawal effects by keeping the levels of chemicals in the brain responsible for the pleasurable effects of smoking at an increased level. This medication is available only by prescription from your doctor. Side effects may include headache, trouble sleeping and/or dry mouth. People who have had a seizure in the past, have a history of eating disorders, are taking medications known as MAO Inhibitors (such as phenelzine, tranylcypromine, moclobemide, selegiline) or who are pregnant or breastfeeding should not take this medication.
Champix (varenicline tartrate)
Champix (varenicline tartrate) is thought to help control cravings and withdrawal symptoms in two opposite ways: it acts as a weaker version of nicotine at the same receptor sites, and because it binds more strongly to those sites, it essentially blocks the effects of nicotine. This medication is only available with a doctor's prescription and common side effects include nausea/vomiting, gas, constipation, trouble sleeping, abnormal dreams and headache. In rare instances, severe effects on mood may occur. Please discuss with your doctor if Champix is right for you.
Medication does increase the chances of quitting and remaining smoke free. Studies have shown that:
- 3 to 4% quit successfully without aids
- 6 to 8% quit with brief counseling
- 12 to 16% quit with intensive counseling
- Adding medication doubles each of the above
Getting Ready to Quit
In preparing for your quit date, it is important to plan ahead for possible barriers that might cause you to relapse
Understand Why You Smoke
People smoke for a variety of reasons (social, reduce stress, routine, addiction, coping mechanism) but may differ in how large a role certain factors play. A quit smoking counselor can help you better understand these reasons so you can better prepare for handling smoking triggers after quitting.
How Addicted Are You?
If you smoke more than one pack of cigarettes a day and/or if you need a cigarette within 30 minutes of waking up in the morning, you are likely highly addicted. Your Sobeys Pharmacist and/or smoking cessation counselor can recommend strategies such as nicotine replacement therapy for helping you to deal with the urge to smoke once you have quit.
Plan for Dealing with Triggers
Techniques used to deal with situations or urges that prompt you to want to smoke include:
- Avoiding or leaving the situation completely.
- Using distraction techniques -- do something else.
- Delay -- tell yourself that you are going to wait five minutes before smoking. The craving will likely have passed by then.
- Use positive self-talk -- you are the one in control, and if others can do it so can you!
- In addition, changing your daily routine to remove the common daily triggers that spark the desire for a cigarette.
- Remove items such as ashtrays from the house that will remind you about smoking.
Weight Gain Concerns
Some smokers don't want to quit because of the fears of weight gain. Using nicotine replacement therapy or bupropion to help quit smoking has been shown to reduce the amount of weight gained after quitting to about 1.5 kg or less. Exercise programs and healthy eating will help you to keep weight gain to a minimum.
Smoking Deterrent Products
- NicodermTM Patch
- HabitrolTM
- NicoretteTM Gum
More Information About Quitting Smoking
Canadian Cancer Society
Smoker's Helpline 1-877-513-5333
Lung Association of Canada
National Office:
1750 Courtwood Crescent, Suite 300
Ottawa, Ontario K2C 2B5
Phone: (613) 569-6411
Web site: www.lung.ca/smoking
Do you want to quit booklet available online
Ottawa, Ontario K2C 2B5
Phone: (613) 569-6411
Web site: www.lung.ca/smoking
Do you want to quit booklet available online
Canadian Health Network
Physicians for a smoke-free Canada
Web site: www.smoke-free.ca
Your Sobeys Pharmacist has many resources for health care education and is always available to discuss your health concerns!
