Quitting Tobacco Use

Strategies and Skills for Quitting

When you plan your strategy for quitting tobacco, use the U.S. Surgeon General's five keys to quitting: get ready, get support, learn new skills and behaviors, get and use medicine, and be prepared for relapse.

1. Get ready

Contact your doctor or local health department to find out the kinds of medicines and help available in your area for people who want to quit smoking. Telephone help lines operated by your state can also help you find information and support for quitting tobacco use.

Check with your insurance provider to find out if medicines or counseling are covered under your plan.

Prepare your body and mind for the stress that comes with quitting.

• Set a quit date and stick to it. This is an important step toward becoming tobacco-free. Choosing a good time to quit can greatly improve your chances of success. For example, avoid setting your quit date on high-stress days, such as holidays.
• Make some changes. Get rid of all ashtrays and lighters after your last cigarette. Throw away pipes or cans of snuff. Also, get rid of the smell of smoke and other reminders of smoking by cleaning your clothes and your house, including draperies, upholstery, and walls. Don't let people smoke in your home. Take the lighter out of your car. Try some methods to reduce smoking before your official quit date. Use a smoking journal to record what triggers urge you to use tobacco. This gives you important information on when it's toughest for you to resist.
• If you have tried to quit in the past, review those past attempts. Think of the things that helped in those attempts, and plan to use those strategies again this time. Think of things that hindered your success, and plan ways to deal with or avoid them.
• Once you quit, don't even take a puff. After your quit date, don't smoke at all—not even a puff.

2. Get help

You will have a better chance of quitting successfully if you have help and support from your doctor, family, friends, and coworkers.

• A doctor, nurse, or mental health professional can help you tailor an approach to quitting smoking that best suits your needs. These people are also good sources of motivation and support during the quitting process.
• Tell your friends that you are quitting, and talk to ex-smokers about their experiences during and after quitting. Have a friend or ex-smoker check in with you once in a while to ask how you are coping.
• If you live with someone who smokes, let that person know how he or she can support you. Be specific. Talk with him or her about not smoking in front of you. Better yet, ask that person to quit smoking with you. That way you can support each other through the quitting process. Also, family and friends can help support and encourage you while you are quitting.
• Join a support group for people quitting smoking. People who have quit smoking may be particularly helpful, because they know what you are going through.
• Get counseling (telephone, individual, or group). The more counseling you get, the better your chances of quitting. Counseling may help you learn to recognize and cope with situations that tempt you to smoke. Counseling sessions can also offer comfort if you have a relapse.
• You may want to attend a program to help you quit smoking. When choosing a smoking cessation program, look for one that has proven success. Ask your doctor for ideas. You can also check with your local health department or call the national quit line at 1-800-QUITNOW for help.
• Children and teens may respond well to community and school programs based on the social and self-image aspects of smoking.
• Use the Internet. The Internet allows round-the-clock access to information about quitting smoking and to chat rooms that can provide support. These programs are good for people who can't get to a stop-smoking meeting. They also work well for people who don't like group meetings.

3. Learn new skills and behaviors

Since you won't be using tobacco, decide what you are going to do instead. Make a plan to:

• Identify and think about ways you can avoid those things that make you reach for a cigarette (smoking triggers), or change your smoking habits and rituals. Think about situations in which you will be at greatest risk for smoking. Make a plan for how you will deal with each situation.
• Change your daily routine. Take a different route to work or eat a meal in a different place. Every day, do something that you enjoy.
• Cut down on stress. Calm yourself or release tension by reading a book, taking a hot bath, or digging in your garden. See the topic Stress Management for ways to reduce stress in your life.
• Hang around nonsmokers and people who have stopped smoking.

4. Get and use medication

The U.S. Food and Drug Administration (FDA) has approved several medications to help people quit smoking. You will double your chances of quitting even if medication is the only treatment you use to quit, but your odds get even better when you combine medication and other quit strategies, such as counseling.¹

These medications also may help you if you use spit tobacco (chewing tobacco and snuff), pipes, or cigars every day.

If you are trying to quit (unless you only use tobacco occasionally), try one or more of these medications. Using these medications along with learning new behaviors further increases your likelihood of success.

The first-choice medicines are:⁴

• Nicotine replacement therapy (NRT). Nicotine replacement products include nicotine gum, patches, lozenges, and inhalers. You can buy gum, patches, and lozenges without a prescription. See a picture of how to use patches to help you quit smoking or stop using spit tobacco.
• Bupropion SR (Zyban), a non-nicotine prescription medicine that you can use by itself or along with nicotine replacement products.
• Varenicline (Chantix), a prescription medicine that helps withdrawal and reduces the effects of pleasurable smoking.

Take this new medicine information form(What is a PDF document?) with you when you talk to your doctor.

Should I take medicine to quit smoking?

Should I use nicotine replacement therapy to quit smoking?

Other medicines you can try if the above medications do not work or you cannot take them are:

• Nortriptyline (Aventyl, Pamelor).
• Clonidine (Catapres).

Your doctor will prescribe these medicines and explain how to use them. It is very important to take the medicines for a long-enough time.

Remember, taking medicines and using counseling or a cessation program at the same time greatly increases your chances of success.

5. Be prepared for relapse

Most people are not successful the first few times they try to quit smoking. Don't beat yourself up. Make a list of things you learned, and think about when you want to try again, such as next week, next month, or next spring.

You might try something new next time, such as a new medicine or program. You might try combining tools, such as counseling and medicine. Keep trying, and don't be fooled by light cigarettes, or reducing your smoking. Neither one appears to make smoking safer.

Quitting tobacco use when you have other medical conditions

If you have depression, anxiety, or a similar problem, or if you have had an alcohol or drug use problem, try to care for that problem before you try to stop smoking.

Some people who have had one of these medical problems find that the problem returns when they try to quit smoking. If you have any of these problems, talk to your doctor before you quit. After you quit, seek help right away if you see signs that the problem is returning.

Smoking can also affect the level of several medicines in your blood. If you take medicines for a health problem, talk with your doctor before you quit smoking to see whether you should alter the dose.

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Author:	Debby Golonka, MPH Caroline Rea, RN, BS, MS	Last Updated: July 24, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine John Hughes, MD - Psychiatry
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