Contents
Understand Your Smoking Habit
Reasons to Quit Smoking
How to Get Emotional Support Before Quitting Smoking
How to Get Medical Support Before Quitting Smoking
Alternative Methods for Quitting Smoking
How to Choose a Quit Date
How to Stay Quit
How to Deal with Regression
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Previous: How to Get Emotional Support Before Quitting Smoking |
Next: Alternative Methods for Quitting Smoking |
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How to Get Medical Support Before Quitting Smoking
When you quit smoking, you deny your body a drug to which it has become addicted. As a result, you go through withdrawal, which can cause anxiety, depression, and irritability, among other symptoms. Many quitters relapse within three days of quitting because withdrawal is so uncomfortable. The most effective way to break your physical
addiction to smoking is to use nicotine replacement therapy, medication, or a combination of these two approaches (see below). Some people also use alterative smoking cessation treatments (see Alternative Methods for Quitting Smoking). Confer with your physician and make a specific plan about the methods you intend to use before attempting to quit.
Nicotine Replacement Therapy (NRT)
Nicotine replacement therapy (NRT) refers to a number of quitting aids that ease withdrawal symptoms by delivering nicotine to your body in amounts you can regulate. Over time, you can reduce the nicotine dose, thus weaning your body from the addiction. Using NRT doubles your chances of quitting successfully and definitively. According to the U.S. Agency for Healthcare Research and Quality (AHRQ), anyone trying to quit smoking can benefit from NRT except:
- Pregnant or nursing women
- People with heart or circulatory diseases
Even if you fall into the latter two categories, check with your physician about NRT. He or she may advise you that the benefits of quitting smoking with the help of NRT outweigh the risks of continuing to smoke.
There are five different NRT products on the market: the nicotine patch, gum, nasal spray, inhaler, and lozenges.
Nicotine Patch
The nicotine patch—often called simply the patch—is an adhesive square that you stick to a clean, dry, hairless part of your body above your waist and below your neck. The patch releases nicotine, which is absorbed through your skin into your bloodstream. Some brands are available over the counter, while others require a prescription. Over-the-counter patches cost about $4 a day.
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Dosage
The nicotine patch is sold in two forms:
- 16-hour patch: Worn during the day but removed at night, this patch is less likely to cause side effects but won’t get rid of morning cravings. The 16-hour patch is best for those who smoke 20 or fewer cigarettes a day. It comes in 5-, 10-, and 15-mg dosages.
- 24-hour patch: Worn for an entire day and changed every day at a regular time, the 24-hour patch is more likely to cause side effects but minimizes morning cravings. Smokers of more than 20 cigarettes a day should consider using this patch. It comes in 7-, 14-, and 21-mg dosages.
Whether using the 16- or 24-hour patch, most smokers should use a higher-dosage patch for a month and then switch to a lower-dosage patch for another month. Some smokers may be able to stop using the patch after two months, while others may need to use it for three to five months. Don’t use the patch for more than five months. Always consult your physician and the instructions that come with the patch you’re using to determine the proper dosage regimen.
Side Effects
The patch may cause any of the following side effects:
- Dizziness
- Headache
- Nausea
- Insomnia
- Aches and pains
- Skin irritation
- Racing heart
- Nightmares
- Vomiting
You may be able to ease most side effects by switching to a lower-dosage patch or another brand. If your skin becomes irritated, switch the patch to a new place on your body each day. If you begin having nightmares, wait a few days to see if they go away. If they don’t, switch to a lower-dosage patch. If side effects are persistent, consult your doctor.
Nicotine Gum
Over-the-counter nicotine gum releases nicotine when chewed. The nicotine is absorbed into the lining of your mouth and then into your bloodstream. Nicotine gum ranges in cost from $4.50–13.50, depending on the number of pieces you chew.
Using Nicotine Gum
You should not chew nicotine gum as you would a regular piece of gum. Instead, follow the instructions that come with the particular brand of nicotine gum you buy. A few general guidelines apply:
- Chew the gum softly a few times until your mouth tingles, then stop chewing until the tingling subsides.
- Continue with this pattern and move the gum around in your mouth between chews.
- Don’t eat or drink for 15 minutes before and after chewing the gum.
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Dosage
Nicotine gum comes in two dosages:
- Low-dosage (2 mg): Best for people who smoke 20 or fewer cigarettes a day
- High-dosage (4 mg): Best for people who smoke more than 20 cigarettes a day
Try to use the gum on a schedule, which often means chewing one piece every 1–2 hours. Never chew more than 20 pieces a day. One piece of gum should last about half an hour. Your goal should be to taper off your usage of the gum over the course of about three months. While chewing nicotine gum is safer than smoking cigarettes, you still should not use the gum for longer than six months. Always consult your physician and the instructions that come with the gum to determine the proper dosage regimen.
Side Effects
Nicotine gum may cause any of the following side effects:
- Hiccups
- Bad taste
- Irritation of the throat
- Nausea
- Racing heart
- Mouth sores
You may be able to alleviate side effects by chewing the gum less vigorously or avoiding excessive swallowing while chewing. If side effects are persistent, consult your doctor.
Nicotine Nasal Spray
Nicotine nasal spray is a liquid you spray into each nostril. The nicotine attaches to the nasal lining and is absorbed into the bloodstream. This product is available by prescription only. Nicotine nasal spray can range in cost from $5–15, depending on how many doses you take each day.
Using Nicotine Nasal Spray
Always follow the instructions that come with the particular brand of nicotine nasal spray you buy. A few general
guidelines apply:
- Do not inhale as you spray. Inhaling will cause the product to wind up in your throat and stomach, which will stop the absorption of nicotine.
- People with asthma, allergies, or sinus problems should not use the nicotine nasal spray.
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Dosage
Nicotine spray comes in one dosage only. You can use the product up to five times an hour and up to 40 times a day. As with the gum, it helps to use the spray for about three months, tapering off over time. Do not use the spray for more than six months. Always consult your physician and the instructions that come with the spray you’re using to determine the proper dosage regimen.
Side Effects
Nicotine nasal spray may cause any of the following side effects:
- Sneezing
- Runny nose
- Watery eyes
- Irritation of the throat
- Cough
You may be able to alleviate these side effects by making sure you’re not inhaling as you use the spray. If side effects are persistent, consult your doctor.
Nicotine Inhaler
The nicotine inhaler is a small device that’s shaped like a cigarette. When you suck on the inhaler, nicotine vapor from a cartridge in the inhaler enters your mouth and lungs and is absorbed into the bloodstream. Inhalers are available by prescription only. Depending on the number of cartridges you use daily, inhalers can range in cost from $6–17 a day.
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Dosage
Nicotine inhalers are currently available in one dosage only. Each cartridge lasts about 20 minutes. Puff on the inhaler until the craving has passed. If possible, stop before consuming the entire cartridge. You can use between six and 16 cartridges a day for six to 12 weeks, tapering off your use as time passes. Do not use the product for more than six months. Always consult your physician and the instructions that come with the inhaler you’re using to determine the proper dosage regimen.
Side Effects
Nicotine gum may cause any of the following side effects:
- Cough
- Irritation of the throat
- Upset stomach
If you’re at the upper limit of the recommended number of cartridges, you may be able to relieve side effects by reducing the number of cartridges you use per day. If side effects persist, consult your doctor.
Nicotine Lozenges
Over-the-counter nicotine lozenges release nicotine into the lining of your mouth as you suck on them. Don’t eat or drink for about 15 minutes before and after consuming a lozenge.
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Dosage
Nicotine lozenges comes in two dosages:
- Low dosage (2 mg): Recommended for light or moderate smokers
- High dosage (4 mg): Recommended for heavy smokers
Do not consume more than 20 lozenges a day, and try to stick to a schedule. For six weeks, consume one lozenge every 1–2 hours. For the following 2–3 weeks, consume one lozenge every 2–4 hours. For the final 2–3 weeks, consume one lozenge every 4–8 hours. Do not use the product for more than three months. Always consult your physician and the instructions that come with the lozenges you’re using to determine the proper dosage regimen.
Side Effects
Lozenges may cause any of the following side effects:
- Hiccups
- Cough
- Headache
- Sleeplessness
- Nausea
- Heartburn
- Gas
How to Use NRT
- Choosing the best NRT for you: All FDA-approved NRT products are equally effective: each product just about doubles your chances of quitting smoking successfully. The best product for you is the one that makes it easiest for you to quit. Always consult a physician when selecting a type of NRT.
- When to start using NRT: Start using NRT as soon as you quit smoking. Do not use NRT if you plan to continue smoking at all. It’s dangerous to combine the nicotine in NRT with the nicotine in cigarettes.
- Combining two types of NRT: For some heavy smokers, the combined use of NRT products (the patch and gum, for example) might be appropriate. Never combine products without first consulting your physician, though.
NRT may help you manage your physical addiction to cigarettes, but it won’t do anything about your psychological addiction. You’ll get the best results by combining NRT with quitting programs, meditation, or another quitting technique (see Alternative Methods for Quitting Smoking).
Smoking Cessation Medication
A number of medications have been shown to help people quit smoking. For heavy smokers, doctors may recommend one of these medications in conjunction with a nicotine replacement product. The two medicines that doctors prescribe most often to help patients quit smoking are:
- Bupropion (marketed as Zyban® or Wellbutrin®)
- Varenicline (marketed as Chantix®)
Both of these medications require a prescription and can have significant side effects. Bupropion should never be taken by anyone with a history of seizures, weight-loss disorders, alcoholism, or head trauma. Varenicline should not be taken by pregnant or breastfeeding women or by anyone with a kidney disorder. Never take either of these drugs without first consulting your doctor.
Atropine and Scopolamine
Some smoking cessation clinics provide the drugs atropine and scopolamine as part of their treatment program. These drugs were not developed for smoking cessation purposes, and do not have FDA approval for use as smoking cessation tools. Until formal studies can prove the effectiveness of these drugs, it is best to avoid atropine and scopolamine and the smoking cessation programs that use them. Never use these drugs under any circumstances without first consulting your doctor.
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