Smoking cessation

Smoking is linked to many preventable diseases, both fatal (e.g., heart disease, lung disease, cancer) and non-fatal (e.g., osteoporosis, skin aging, peptic ulcers, erectile dysfunction, pregnancy complications). Exposure to secondhand smoke can also lead to major health problems.

Cigarette smoke contains thousands of chemicals, including tar, benzene, and formaldehyde. The one responsible for cigarette cravings is nicotine.

The benefits of smoking cessation

Smoking cessation has major and immediate health benefits for men and women of all ages. The earlier you quit, the greater the benefits. It's never too late to quit smoking.

Smoking cessation has both short- and long-term benefits on heart and lung health. Quitting smoking before age 50 reduces the risk of dying over the next 15 years by half. After just one year, the risk for heart disease decreases by half compared to the risk for someone who still smokes. Quitting smoking also benefits those around you, as exposure to secondhand smoke is harmful. In addition to having a positive effect on your health and that of your loved ones, quitting smoking also allows you to save money.

Smoking dependence

Smoking leads to two types of dependence: psychological or behavioural dependence, and physical dependence.

Smokers associate the act of smoking with pleasant moments during the day where they experience less anxiety, stress, and boredom. The psychological pleasure associated with smoking makes the habit all the more difficult to break.

It's common to experience withdrawal symptoms when attempting to stop smoking. They tend to be most severe in the first 3 days after quitting, and then decrease over the next 3-4 weeks. Below are some of the most common symptoms:

Preparing to quit

Different people experience different levels of nicotine dependence, but all smokers must be well prepared if they want to quit for good. It can help to take the following steps:

Get as much information as you can about the various resources at your disposal, including through consultation with your health care provider. Support groups and pharmacological smoking cessation aids may be good options. It's also possible to use several different aids at the same time.

Ideally, choose a day when you can relax and focus on not smoking.

Tell your family, friends, and coworkers about your plan to quit and ask for their support.

Proper preparation involves identifying your smoking triggers (e.g., people, places, activities, states of mind). For example, if you tend to smoke at work, consider choosing a day off as your quitting date. Keeping a smoking journal can help you identify triggers. You can use it to track your current habits and get a better sense of when cravings hit (e.g., when you feel stressed, when you drink alcohol).

Exercise, relaxation, deep breathing, low-calorie snacks, and proper hydration are just some of the tricks that can help ease withdrawal symptoms. Take some time to consider what strategies might work for you. Keep reminding yourself of why you want to quit.

Most smokers don't quit on their first attempt. If you've tried to quit in the past, try to figure out why you weren't successful. What worked? What didn't work? What caused you to relapse? Exploring these questions may help you be better prepared and avoid certain pitfalls this time around.

It's important to reward yourself when you make progress. Whereas smoking provides instant gratification, quitting is about long-term benefits. Treating yourself on a regular basis can help you stay motivated.

Treatment

The purpose of the following medications is to reduce nicotine withdrawal symptoms and the desire to smoke. Certain products are available over the counter, while others require a prescription. Talk to your health care provider for more details on available treatments.

These products are designed to replace the nicotine in cigarettes. Nicotine substitutes do not contain the thousands of chemicals found in cigarettes, making them a less harmful alternative. They come in the form of transdermal patches, gum, lozenges, inhalers, and sprays. Using a combination of nicotine substitutes (e.g., patches and gum) is acceptable and may be more effective than employing one at a time. Your health care provider can help you choose the most suitable product and dosage.

Bupropion is a prescription medication that is usually taken for 7-12 weeks. It can be combined with a nicotine substitute to improve treatment efficacy. This medication reduces smoking cessation symptoms and is usually well tolerated.

Varenicline is a prescription medication that acts on the brain to reduce cravings and withdrawal symptoms. Treatment usually lasts 12 weeks.

There is currently no consensus on the benefits of vaping on smoking cessation. While e-cigarettes do appear to be less harmful than traditional cigarettes, they still contain potentially toxic chemicals. Some ingredients are considered safe to ingest, but little is known about their effects on the body when inhaled. E-cigarettes contain varying concentrations of nicotine.

A number of cases of severe pulmonary illness, including several deaths, have been associated with the use of e-cigarettes. Health Canada recommends that e-cigarette users monitor themselves for symptoms of pulmonary illness (e.g., coughing, shortness of breath, chest pain). It's important to remember that, even with vaping, the goal should be complete smoking cessation. Traditional cigarettes should not be replaced with products that could maintain nicotine addiction.

Perseverance

Remember that the road to becoming a non-smoker is a long one. For most smokers, quitting doesn't happen overnight, and it takes more than one attempt. If you manage to quit but one day succumb to the temptation of smoking a cigarette or two, don't worry. You can use that experience to move closer to your goal by learning how to avoid giving in to your cravings. Picture your future as a non-smoker and take things one day at a time.

Maintain a positive attitude about your progress and take pride in being a non-smoker. This will help you get through the tougher times. If you've started smoking again, think about how you'll succeed on your next try. Don't lose hope - regroup and set a new quitting date. You have what it takes to become a non-smoker.

For more information:

• Canadian Lung Association