Now that you have had a week to consider the reasons to quit smoking that I presented you with in my last article, “Five Good Reasons to Quit Smoking”, you may have decided that you want to quit. The next step in the process is to determine how you are going to stop using a highly addictive substance. Not only will you be battling an extremely strong physical addiction, many of you may also have an equally strong psychological addiction to smoking (Quitnet – Getting Ready). You may find it easier to rid yourself of these types of addictions if you identify the obstacles that you will have to overcome before you attempt to quit and formulate a plan to help you achieve your goal.

Obstacles Along the Way

Physical Obstacles: According to Health Canada, a person who quits smoking may experience any combination of the following symptoms, which are caused by depriving your body of the nicotine it has become addicted to:

• Irritability, frustration, anger or anxiety
• Difficulty in concentrating
• Restlessness
• Increased appetite
• Problems falling asleep or frequent waking
• Slight depression or feeling down

Other physical withdrawal symptoms you may experience are headaches and increased coughing, although these are caused by your lungs trying to clear themselves out and not by a lack of nicotine. These are only possible withdrawal symptoms and some people may not experience any of them. Most people find that the side effects of quitting are the strongest in the first few days after quitting. After 3-4 days the withdrawal symptoms should start to fade and they should be completely gone after 7-10 days (Health Canada – Withdrawal).

Psychological Obstacles: Some people find that the psychological addiction to smoking is harder to deal with than the physical addiction. There are two theories on how people become psychologically addicted to smoking. The first theory is based on the study conducted by Ivan Pavlov where he successfully conditioned dogs to salivate at the ringing of a bell. He achieved this by continually pairing the ringing of the bell with the presentation of food, which naturally caused the dogs to salivate. Over time the dogs learned that the ringing of the bell meant that they would be receiving food. This theory can help us understand why we crave cigarettes at certain times. If you always have a cigarette with your morning coffee your brain eventually associates the morning coffee with smoking and a powerful craving is created. You have successfully conditioned yourself to light up a cigarette with your morning coffee whether your body physically craves it or not (Quitnet – Getting Ready).

The second theory is based on B.F. Skinner’s findings that when behavior is rewarded it is more likely to occur again, while behavior that is punished is less likely to occur again. This theory helps us to understand why it is so hard for some people to quit smoking. When you quit you are likely to start thinking about all the good aspects you think you are losing (the positive reinforcers), and at the same time you are being punished with withdrawal symptoms. These conditions are likely to encourage you to keep smoking and discourage you from quitting (Quitnet – Getting Ready).

Overcoming the Obstacles

Now that you are aware of the obstacles you may encounter when you quit smoking you need to formulate a plan to deal with them. The following are several of the methods available to help you:

The Nicotine Patch: The nicotine patch is a self-adhesive patch that releases nicotine into your blood stream and is worn on your body 24 hours a day. The treatment works by allowing you to put nicotine into your blood without smoking. You can then gradually lower the dosage and wean yourself off of nicotine. It takes 4-10 weeks to quit smoking with this product, and it costs an average of $4/day. Possible side effects of using the patch are skin reactions, vivid dreams and sleep disturbances. These effects can be counteracted by moving the patch to different parts of your body more often and by removing the patch before you go to bed (Quitnet – The Patch).

I highly recommend the patch, but I am a little biased because I finally quit smoking using it. The patch is a great way to overcome the psychological addiction without having to deal with the physical withdrawal symptoms at the same time. After I went 7 days without a cigarette I had overcome most of the psychological need to smoke, which in my case was stronger than the physical addiction. I knew that I still had a strong physical addiction to deal with though because my body had still spent the last 7 days receiving its beloved nicotine. The last thing I wanted to do was wait another 3-9 weeks to see if I could overcome the physical addiction, so I stopped using the patch and decided to deal with the physical addiction “cold turkey.”

The first day I took the patch off was worse than all of the bad days I had ever experienced combined. Each day after that got a little better, though, and eventually I returned to normal. Amazingly, the psychological addiction lingered long after the physical addiction was gone. I thought about having a cigarette every hour of every day for about a month. At first I thought I was destined to live the rest of my life thinking about cigarettes, but, thankfully, I was wrong. Over time I stopped thinking about it and now it seems as though I never was a smoker to begin with.

Nicotine Gum: Nicotine gum works the same way as the patch except for the fact that you have more control over the amount of nicotine that enters your body. Instead of having a constant flow of nicotine administered through a patch you decide when you need nicotine and give yourself a piece of gum. This method is not the same as normal chewing gum, however, and if you continually chew the gum the treatment will not work. What you must do is chew the gum for a little while at first to activate the nicotine, and then place it between your cheek and gums and leave it there to do its job. (Quitnet – Gum Use) It takes an average of 12 weeks to quit smoking with this product, and it costs an average of $5/day. Possible side effects include soreness in the gums, teeth and jaw (Quitnet – Gum).

Nicotine Lozenge: The nicotine lozenge works the same way as nicotine gum, except it comes in the form of hard candy that is dissolved in the mouth (Quitnet – Lozenge). It takes an average of 12 weeks to quit smoking with this product, and it costs an average of $6/day. Possible side effects of using the lozenge are sore gums and teeth, irritated throat, hiccups and heartburn/indigestion (Quitnet – Lozenge Specifics).

The Nicotine Inhaler: The nicotine inhaler works the same way as nicotine gum and lozenges except for the fact that the nicotine is administered by puffing on a plastic cartridge containing nicotine. 80 puffs on the cartridge is equivalent to smoking one cigarette. Some people prefer the inhaler because the inhaling aspect resembles the act of smoking a cigarette. The nicotine inhaler is only available with a prescription (Quitnet – Inhaler). It takes an average of 6-16 cartridges for 12-24 weeks to quit smoking with this product, and it costs $45.00 for a package of 42 cartridges. Possible side effects are irritated mouth and throat and upset stomach (Quitnet – Inhaler Specifics).

Nicotine Nasal Spray: Nicotine nasal spray works the same way as the other self administered products listed above, except it comes in an aerosol spray bottle and nicotine is administered by spraying it into your nose. This method may be preferred by highly addicted smokers because the nicotine makes its way into your system much faster than it does with the other products. The nasal spray is only available with a prescription (Quitnet – Nicotine Nasal Spray). It takes an average of 12-14 weeks to quit smoking with this product, and it costs an average of $5/day. Possible side effects of using the nasal spray are irritated nose and throat, watering eyes, sneezing and coughing. These symptoms usually subside after the first week (Quitnet – Nasal Spray Specifics).

Bupropion/Zyban: Zyban is an anti-depressant drug that makes some of the physical withdrawal symptoms of quitting disappear. It is not known how the drug achieves this, but studies have shown that the drug helps some people to quit. Zyban is only available with a prescription. It takes an average of 7-12 weeks to quit smoking with this product, and it costs an average of $2.50/day. Possible side effects are dry mouth, insomnia, shakiness and skin rash (Quitnet – Zyban).

Support Groups and Programs: Many people find it useful to quit with other people, so they can support and encourage each other. If you do not know anyone who wants to quit right now there are still resources available that can give you the same kind of support. Health Canada has an online program, called On the Road to Quitting, that will help you formulate a plan to quit smoking and guide you along that plan (Health Canada – On the Road to Quitting). Another Health Canada program, called E-quit, will send you an e-mail each day while you are quitting. The e-mails will contain encouraging messages and tips on how to quit smoking (Health Canada – E-quit). If you are the type that would benefit more by talking to someone on the phone or in person you can phone one of the toll-free quit smoking lines in your area. These lines are manned by trained specialists who will help you develop a plan to quit smoking, refer you to services in your area that can help you quit smoking and answer any questions you have about smoking and quitting. The lines listed below are free for everyone.

• Newfoundland residents: 1-800-363-5864
• New Brunswick and Nova Scotia residents: 1-877-513-5333
• Prince Edward Island residents: 1-888-818-6300
• Quebec residents: 1-888-768-6669 (Quebec Lung Association) or 1-888-853-6666 (Canadian Cancer Society)
• Ontario residents: 1-877-513-5333
• Manitoba and Saskatchewan residents: 1-877-513-5333
• Alberta residents: 1-866-332-2322
• British Columbia residents: 1-877-455-2233
  (Health Canada – Lines)

Acupuncture, Hypnosis and Herbal Remedies: These methods have become quite popular in quitting smoking, but they are not recommended as effective ways to quit smoking by the Surgeon General. Any positive effects gained by these treatments are more likely caused by positive expectations – the person believes that the treatment will work and wants it to work so much that he/she will actually make the treatment work to avoid being wrong. Furthermore, treatments such as herbal cigarettes contain just as many harmful chemicals as normal cigarettes (Quitnet – Getting Ready). I can personally attest to the uselessness of replacing real cigarettes with herbal cigarettes because I actually tried this method of quitting once. Not only did herbal cigarettes make me feel like I was smoking the air freshener from my bathroom they did not make my psychological or physical cravings for cigarettes go away at all.

Other Useful Tips: In addition to the quit smoking products and programs there are also several things you can do on your own to make the process easier. When I quit smoking I found the following helpful:

• Keep yourself busy so you do not have time to think about smoking.
• Find something else to do when you would normally smoke. During my breaks at work and school I started getting a coffee instead of having a cigarette.

Consequently, I am now addicted to coffee, but I figure it is better than smoking.

• Find something to simulate the action of having a cigarette. This is where people’s fear of gaining weight when they quit comes in because instead of sticking a cigarette in their mouth they stick a piece of cake in instead. I found that weight gain could be avoided by using chewing gum and licorice. Every time I couldn’t get rid of a craving for a cigarette I would eat a piece of licorice or chew on gum, which is not as fattening as cake.
• Once you feel confident enough keep hanging out in the smoking area. One of my fears was that I would lose the interaction I had of going to the smoking area with my friends. I found that it didn’t bother me to keep going out and I ended up having more social interaction by hanging around with the smokers and the non-smokers. This act also tested the strength of my commitment to quit smoking.

Now that you are equipped with the information you need to quit smoking what you do with it is up to you. Everyone is different and the tips and treatments in this article will work differently for each person. In order to successfully quit smoking you need to formulate a plan that you think will work the best for you.

Sources

Health Canada: On The Road to Quitting – http://www.hc-sc.gc.ca/hecs-sesc/tobacco/quitting/road/index.html

Withdrawal – http://www.hc-sc.gc.ca/hecs-sesc/tobacco/quitting/road/withdrawal.html
On the Road to Quitting – http://www.hc-sc.gc.ca/hecs-sesc/tobacco/quitting/road/about.html
E-quit – http://www.hc-sc.gc.ca/hecs-sesc/tobacco/quitting/e-quit/index.html
Lines – http://www.hc-sc.gc.ca/hecs-sesc/tobacco/quitting/index.html#lines

Quitnet: Quit All Together – http://www.quitnet.com/

Getting Ready – http://www.quitnet.com/library/guides/Quitnet/B/getting_ready.jtml
The Patch – http://www.quitnet.com/library/guides/NRT/ThePatch_specifics.jtml
Gum Use – http://www.quitnet.com/library/guides/NRT/NRT_Gum_Use.jtml
Gum Specifics – http://www.quitnet.com/library/guides/NRT/gum_specifics.jtml
Lozenge – http://www.quitnet.com/library/guides/NRT/lozenge.jtml
Lozenge Specifics. http://www.quitnet.com/library/guides/NRT/lozenge_specifics.jtml
Inhaler – http://www.quitnet.com/library/guides/NRT/inhaler.jtml
Inhaler Specifics – http://www.quitnet.com/library/guides/NRT/Inhaler_specifics.jtml
Nasal Spray – http://www.quitnet.com/library/guides/NRT/nasalspray.jtml
Nasal Spray Specifics – http://www.quitnet.com/library/guides/NRT/nasalspray_specifics.jtml
Zyban. quitnet.com – http://www.quitnet.com/library/guides/NRT/bupropion.jtml

All files retrieved on September 26, 2003.