Smoking - how to stop

Written by: 
Dr Sarah Brewer

Exactly why is giving up smoking so important and how do you go about it?

This page covers:

Within seconds of inhaling tobacco smoke, nicotineAn addictive substance found in tobacco and nicotine replacement therapies. affects your heart, brain and hormoneA substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect. levels, and more than 60 different cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body.-causing chemicals are deposited in your lungs

It is notoriously difficult to quit smoking. Surveys indicate that between 60 and 70 per cent of tobacco smokers have tried to give up the habit, but many relapse.

Smokers find quitting so difficult because they become dependent on nicotineAn addictive substance found in tobacco and nicotine replacement therapies., an organic compound in tobacco that produces physiological effects: when inhaled in brief puffs, nicotineAn addictive substance found in tobacco and nicotine replacement therapies. acts as a stimulant, but when inhaled more deeply it can have a tranquillising effect.

Smoking cigarettes is the leading cause of preventable premature death in modern societies. Within seconds of inhaling tobacco smoke, nicotineAn addictive substance found in tobacco and nicotine replacement therapies. affects your heart, brain and hormoneA substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect. levels, and more than 60 different cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body.-causing chemicals are deposited in your lungs.

Poisonous carbon monoxide also enters your circulation, reducing the amount of oxygen your bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. cells can carry.

What are the usual reasons for trying to stop smoking?

People often want to quit smoking tobacco because:

  • They are worried about current or future health problems caused by smoking
  • A health professional advises them to quit
  • Smoking is too expensive.

Some people are encouraged to give up by the availability of relatively inexpensive medication.

What are the health dangers of smoking?

Smoking tobacco is linked with the development, or worsening, of a number of serious illness, including:

  • Cancer of the lung, throat, oesophagusThe gullet, the part of the gastrointestinal system that extends down from the mouth cavity to the stomach., bladderThe organ that stores urine., kidney, stomach, pancreas and white bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. cells (myeloidDerived from or relating to bone marrow. leukaemiaA malignant condition in which increased numbers of white blood cells, leucocytes, are produced in an immature or abnormal state.)
  • Asthma, pneumoniaInflammation of one or both lungs. and other respiratory tractThe parts of the body that are involved in respiration. The respiratory tract includes the nasal passages, throat (pharynx), windpipe (trachea), bronchi and lungs. infections such as acuteHas a sudden onset. and chronicA disease of long duration generally involving slow changes. bronchitis
  • Hardening and furring up of the arteries (atherosclerosisDisease leading to fatty deposits in the inner walls of the arteries, which reduce and may eventually obstruct blood flow.) that can reduce bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. supply to the brain, heart and legs
  • Angina (information coming soon), heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. (mini-site coming soon) and heart failureFailure of the heart to pump adequately.
  • Impotence or 'erectile dysfunction' and infertility
  • Loss of sight from eye diseases such as macular degeneration and diabetic retinopathy
  • Osteoporosis (brittle bones).

Men who smoke throughout their adult lives die on average 10 years earlier than those who have never smoked

Smoking while pregnant increases the chance of serious complications such as miscarriageThe spontaneous loss of pregnancy., low birthweight, premature birth and stillbirth.

When you smoke, you endanger the health of people around you through the effect known as 'passive smoking'. Each time you smoke a cigarette, you inhale around 15 per cent of the smoke and 85 per cent is released and inhaled by other people if you are in an enclosed space.

Each inhalation of smoke deposits tar in your lungs; some cigarette brands contain less tar than others.

You can experience significant harm to your health from smoking, even if you only smoke a few cigarettes a day and even if you select low-tar brands

What are the health benefits of stopping smoking?

When you stop smoking, you gain health benefits almost immediately. These include:

  • Within 12 hours, bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. carbon monoxide levels fall and oxygen levels return to normal, improving your exercise capacity
  • Within 2 weeks, bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. circulation in your gums has improved
  • After 4 weeks, skin brightness and hydration shows visible improvements
  • Within 3-9 months, your lung function improves, so that, provided you have not already developed smoking-related lung disease, you should no longer experience coughing or wheezing caused by smoking
  • After 1 year, your risk of a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. (mini-site coming soon) is halved, and after 10 years your risk of lung cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. is halved, compared with the risk of continuing to smoke
  • After 15 years, your chance of a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. (mini-site coming soon) is the same as it would have been if you had never smoked at all.

In addition, quitting means that you protect those around you from the harmful effects of passive smoking.

How can I quit?

The physical cravings caused by nicotineAn addictive substance found in tobacco and nicotine replacement therapies. usually disappear within 7 days, but the psychological need lasts longer. Even so, most people are able to become a non-smoker within 3 months and often sooner.

Consider drawing up a quit plan - a timetable for quitting. Those who make such a plan are twice as likely to succeed as those who attempt to stop without doing this

Making a 'quit plan'

Name the day to quit and get into the right frame of mind beforehand. Throw away all smoking-related items such as cigarettes, rolling-papers, matches, lighters and ashtrays. It helps to cut back on the number of cigarettes you smoke in the lead up to your quit day.

Find support - it's easier to quit together with a friend or relative who also wants to give up smoking.

Putting aside the money you save by not smoking can pay for a holiday after as little as six months

Take it one day at a time. Think positively and concentrate on getting through each day without relapsing. Try not to focus on the weeks and months ahead, which is daunting. Keeping a quit chart and ticking off each cigarette-free day can help.

Keep your hands busy. Try using a stressRelating to injury or concern.-relief ball, or consider taking up model-making, painting, origami, knitting or DIY home repairs. These activities help to overcome the psychological hand-to-mouth habit that makes quitting so difficult.

Exercise regularly. This increases the production of endorphins in your brain to help to curb withdrawal symptoms. As a bonus, it helps to improve your heart and lung fitness, too.

Reward yourself at the end of the first day, the first week, the first month - and so on.

Putting aside the money you save by not smoking can pay for a holiday after as little as six months.

Think smart. Try to avoid situations where you used to smoke. Learn to say 'No thanks, I've given up', 'No thanks, I'm cutting down', or even 'Why not join me and try giving up smoking, too?'

Overcoming cravings

The first three to four days after you quit will probably be the hardest. When you have a strong urge to smoke a cigarette:

  • Try putting something more healthy in your mouth. You could chew sugar-free gum, or eat an apple. Another tactic might be to suck on carrot and celery sticks or use the artificial cigarettes that are available from pharmacies
  • Take a few deep breaths, and occupy your mind with something else to stop focusing on the urge to smoke. The craving will usually pass within a few minutes
  • Take a fast walk or go for a run. Brisk exercise can reduce cravings.

It often helps to brush your teeth with strongly flavoured toothpaste - especially if you also have an urge to snack.

Nicotine replacement therapy (NRT) reduces cravings, but carries a risk of continuing your addiction to nicotineAn addictive substance found in tobacco and nicotine replacement therapies.. A large analysis of 132 trials, involving 40,000 smokers, suggested that using NRT increases the chances of success by 50 to 70 per cent.

There appears to be no difference in effectiveness between the different types of NRT products. Using NRT for longer than the recommended period of 8 weeks equally appears to make no difference to how effective it is.

It is possible that using a combination of a nicotineAn addictive substance found in tobacco and nicotine replacement therapies. patch and a faster-acting form such as gum, spray, inhaler or lozenge may increase your chances of success.

Smoking while using an NRT product may lead to a harmful nicotineAn addictive substance found in tobacco and nicotine replacement therapies. overdose. It is important not to use NRT while still smoking

Hypnotherapy has helped some people to quit, though not everyone is susceptible to hypnotic suggestion.

Antidepressant drugs only available through prescription such as bupropion or nortriptyline are sometimes used to help people quit smoking. Their effectiveness appears to be similar to that of nicotineAn addictive substance found in tobacco and nicotine replacement therapies. replacement therapy. SSRI (selective serotonin reuptake inhibitor) antidepressants have shown inconsistent results for people giving up smoking.