Quit Smart 

Nicotine is highly addictive. It works powerfully on the reward centres in our brains. Withdrawal can be unpleasant, so it pays to have a strategy worked out before quitting.

Accept you may need help

Some people quit cold turkey with no treatment or support, but the long term success rate of this method is only around 3%⁽¹⁾. Needing help doesn’t mean you lack will power. You are still doing all the work, treatments just aid your efforts.

Get motivated

Why do you want to quit? Write down your reasons. These may include better health, improved fitness, a healthier pregnancy or wanting to set a good example for your kids. Put your list where you will see it frequently.

Set goals

Do you want to stop today? Or next Monday? Do you want to cut down first, then stop later? Choose a quit date and mark it on the calendar.

Gather supports

Friends or family can be positive supports, unless they have a vested interest in you not quitting (e.g. you’re their smoking buddy). If all your friends smoke, you could find support from your GP, pharmacist or a service like Quitline.

Choose your treatment

If you are nicotine dependent, you can double your chance of success by using NRT or other medication⁽¹⁾. (Find out if you are nicotine dependent here: http://www.quit.org.au/quitting-tools/nicotine-addiction-test). Read about treatment options below.

Meet cravings head on. Acknowledge them, then put them aside. Have some nicotine gum or a lozenge (if you are using them). Try one of the four Ds:

• Delay having a smoke (wait twenty minutes then see how you feel),
• Distract yourself (e.g. with breathing exercises),
• Do something else (e.g. exercise, which can reduce cravings⁽²⁾,
• Drink water.

Find more ideas here (http://www.quit.org.au/staying-quit/craving-a-cigarette-right-now).  

Treatments and Tools

Treatment improves abstinence rates. It is best to combine medication (pills or NRT) with counselling⁽¹⁾. Talk to your doctor about treatment options.

Nicotine Replacement Therapy⁽¹⁾. Using more than one type at once (e.g. patches plus gum) is even better. NRT is safe for most people and compared to cigarettes the addictiveness is low (the nicotine release is much slower). Side effects include skin irritation, unusual dreams, and nausea.

Varenicline (brand names Chantix or Champix): this medication is prescription only. It more than doubles your chance of quitting long term. It works by blocking nicotine receptors in the brain, relieving withdrawal symptoms and reducing the pleasure you get from a cigarette if you lapse and smoke one. Side effects include: mood changes, nausea, and abnormal dreams. [If you experience persistent low mood or thoughts of suicide, stop taking varenicline and see your doctor]. 

Bupropion (brand names Welbutrin, Zyban, or Aplenzin): If you are unable to take varenicline, your doctor may recommend bupropion, another prescription only medication. Side effects include insomnia, headache, dry mouth, nausea, dizziness, anxiety and a 0.1% risk of seizures. 

Counselling: individual or group counselling can increase success rates. Counselling can be with your GP, another trained health professional (e.g. a psychologist), or a telephone service like Quitline.

Staying Quit

Most smokers don’t quit for good after just one try⁽¹⁾, so don’t be too hard on yourself if you have relapsed. Your previous attempts weren’t for nothing; you can learn something from them. Think about why you started smoking again. Were you stressed out, or were the withdrawal symptoms unbearable? What could help next time? Here are some ideas for avoiding relapse:

Avoid cues such as cigarette displays and social settings where you used to smoke. Temporarily changing your routine can avoid people and places linked in your mind with smoking⁽²⁾.

Surround yourself with positive support people who want to help you stay off cigarettes⁽²⁾.

Avoid drinking alcohol in settings where you used to smoke (as becoming uninhibited and more impulsive leaves you vulnerable to relapse).

Manage stress in positive ways to ensure you don’t respond by relapsing. Stressful situations can trigger a return to smoking for some people. 

Remember the withdrawal symptoms are temporary and you’ll feel better in the long run. Withdrawal symptoms range from irritability, insomnia and nausea to mood changes. Using treatment to reduce cravings can help your mood and in the long term; quitting leads to better mood and lower stress⁽¹⁾.        

Keep up the counselling. Continuing for a while after quitting can help prevent relapse⁽²⁾.

Reinforce your knowledge about the benefits of quitting⁽²⁾. Revisit your motivations and goals.

Avoid or address weight gain: quitting can cause a small amount of weight gain, which puts many people off quitting. NRT(particularly using higher dose gum) may help⁽²⁾. Eating well, exercising regularly and learning to manage stress without comfort eating can also limit weight gain.

Remember: One lapse doesn’t have to mean relapse. If you have a puff or two, or a cigarette, forgive yourself, but don’t give up on quitting! Read your list of motivations and get back on board. What triggered the lapse? How can you prevent it happening again? Touch base with your counsellor or other support person and keep trying.

Next steps

If you want to quit smoking but aren’t sure how, or you would like to discuss medication options, book an appointment with your GP through HealthEngine now. Your pharmacist may offer additional guidance, or you can phone Quitline on 137 848.

References

1. RACGP; Support for Smoking Cessation; http://www.racgp.org.au/your-practice/guidelines/smoking-cessation/; accessed 17/8/15.
2. Cancer Council Victoria; Tobacco in Australia: Facts and issues, Chapter 7; http://www.tobaccoinaustralia.org.au/chapter-7-cessation; accessed 17/8/15.    

Disclosure: The author has received no funding from any company that makes smoking cessation aids or medications.

This article is for informational purposes only and should not be taken as medical advice. If in doubt, HealthEngine recommends consulting with a registered health practitioner.

This article is for informational purposes only and should not be taken as medical advice. If in doubt, HealthEngine recommends consulting with a registered health practitioner.