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- Pulmonary Introduction
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What is your Snore Score?- Quit Smoking
Prepare to quit
Using Medications
Staying Smoke Free- Asthma
Kinds of Medicines
Special Hints
Quit Smoking
The American Lung Association, with the guidance of a team of experts on cigarette smoking has developed specific recommendations for selecting a personalized Quit Smoking Action Plan to free yourself of cigarettes and stay that way. To help you understand your options, there are three steps in the Quit Smoking Action Plan:
Step 1 - Preparing to Quit
Step 2 - Using Medications
Step 3 - Staying Smoke-FreeA Deadly Combination: Addiction and Behavior
Nicotine is a powerful drug that raises mood, reduces anxiety, and, in those accustomed to it, increased alertness. Over time, it causes changes in smokers' brains that make them need nicotine. Then, when they try to quit, smokers have unpleasant symptoms such as irritability, craving for cigarettes or difficulty concentrating.
An additional obstacle to quitting is the many daily behavior patterns that smokers may not even realize they have, such as morning or before-bed cigarette routines, or smoking with friends, coworkers or spouses. Each person's smoking behavior is different, but these established patterns link smoking to many activities of daily life. People who are fairly dependent on cigarettes need to incorporate multiple sources of help in their quitting plan to maximize their odds of success. Those who are less dependent on cigarettes may be successful by using only a few sources of help. However, the more help you have, the better your chances of quitting and staying smoke-free.
Be a Smart Quitter!
There are many programs to help you quit smoking. The cost of these programs may vary from almost nothing to hundreds of dollars. A higher cost does not guarantee success. Many health plans and worksites provide free quit-smoking programs and some health plans cover the cost of medications to help you quit. Check with your insurance carrier or employer for more information. Before investing your time or money in a program, ask questions such as:
- Is there a cost to you?
- Is the program convenient for you?
- Is the staff well trained and professional?
- Does the program meet your needs?
- What is the success rate of this program?
A program representative should be able to answer your questions. If they can't, keep looking. There are no tricks or magic bullets to make you stop smoking. If a program seems too easy, guarantees you will quit, or claims a success rate that sounds unrealistic, look elsewhere.
Examining Your Options
The information below outlines your options for each of the three steps of your Quit Smoking Action Plan. Although there are many sources of help available, it's best to choose what feels right to you. The more comfortable you are with the methods you use, the better the chances that you will stick with them.
Step 1: Preparing to Quit
Group Programs
Pros: Supportive, encouraging environment; Opportunity for building skills needed to quit smoking.
Cons: Meeting schedule may not be flexible enough for some; a group may not be available when you need it. Comments: Best for those who work well with others. The groups focus on helping you change your smoking behaviors. May also be helpful for those whose family or friends are unlikely to provide support. Usually meets for four to seven sessions with each session lasting one to two hours.
Individual Counseling from Healthcare Provider
Pros: Flexible; personalized to your needs; opportunity for building skills needed to quit smoking.
Cons: No opportunity for peer support; usually requires an appointment. Comments: This may be best if you have a good relationship with your healthcare provider. Best for people who prefer to work independently rather than in group settings. The more counseling sessions you attend, the better your chances of staying smoke-free.
Books, Manuals, Audiotapes, Videotapes, Internet Resources
Pros: Convenient; private; may be especially appropriate for those who like to work on their own or enjoy "do-it-yourself" projects.
Cons: Success depends on continued use; many are superficial and do not provide needed key elements. Comments: Although you may prefer to quit on your own, quitting without preparing an action plan is unlikely to be successful.
Telephone Counseling
Pros: Convenient; flexible; personal and private; useful in rural areas or anywhere access to counseling services is limited.
Cons: Phone counselor may change from contact to contact; lack of fixed schedule may be discouraging for some. Comments: Telephone counseling services are also sometimes used to help you stay smoke-free. Ask your healthcare provider or check your phone book for availability of these services to your area.
Step 2: Using Medications
Nicotine patch
Pros: Easy to use; only needs to be applied once a day; some available without prescription; few side effects.
Cons: Less flexible dosing; slow onset of delivery; mild skin rashes and irritation. Comments: Patches vary in strengths and the length of time over which nicotine is delivered. Depending on the brand you use, may be left on for anywhere from 16 to 24 hours. Some smokers who use these products can stop them abruptly, while others prefer to reduce their dosage slowly.
Nicotine Polacrilex (nicotine gum)
Pros: Convenient; flexible dosing; faster delivery of nicotine than the patches.
Cons: May be inappropriate for people with dental problems and those with temporomandibular joint syndrome (TMJ); cannot eat or drink while the medication is in your mouth; frequent use during the day required to obtain adequate nicotine levels. Comments: Many people use this medication incorrectly. Most of the time the gum is in your mouth, it should be "parked" between your cheek and gum. Read package directions carefully for a full explanation. To achieve greatest benefit, you generally should chew nine or more pieces per day.
Nicotine Nasal Spray
Pros: Flexible dosing; can be used in response to stress or urges to smoke; fastest delivery of nicotine of currently available products; reduces cravings within minutes.
Cons: Nose and eye irritation is common, but usually disappears within one week; frequent use during the day required to obtain adequate nicotine levels. Comments: Unlike nasal sprays used to relieve allergy symptoms, the nicotine spray is not meant to be sniffed. Rather, it is sprayed once into each nostril once or twice an hour. Take a deep breath, hold it, spray once into each nostril and exhale through the mouth. Ask your physician for help in using the product correctly.
Nicotine Inhaler
Pros: Flexible dosing; mimics the hand-to-mouth behavior of smoking; few side effects; faster delivery of nicotine than the patches.
Cons: Frequent use during the day required to obtain adequate nicotine levels; may cause mouth or throat irritation. Comments: Puffing must be done frequently, far more often than your cigarette. Each cartridge lasts for 80 long puffs; each cartridge is designed for 20 minutes of use. A minimum of six cartridges per day is needed for three to six weeks, then the patient starts tapering off. You do not need to inhale deeply to achieve an effect. Small doses of nicotine provide a sensation in the back of the throat similar to cigarette smoke.
Non-Nicotine Medication (Zyban Sustained-Release tablets)
Pros: Easy to use; pill form; few side effects; can be used in combination with nicotine patches.
Cons: Should not be used by patients with eating disorders, seizure disorders or those taking certain other medications; lack of flexibility of use.
Comments: This is the first medication to help quit smoking that is available in tablet form. Its primary role is to act on brain chemistry to bring about some of the same effects that nicotine has when people smoke. A small risk of seizure is associated with use of this medication. The main ingredient in Zyban has been available for many years as a treatment for depression under the trade name Wellbutrin. However, it works well in people with no depression as an aid to quit smoking.
Step 3: Staying Smoke-Free
Prevent Relapse:
The group program, individual counseling from a healthcare provider, telephone counseling or self-help materials you choose should include information on how to prevent a relapse and what to do if a relapse occurs.
Encouragement from Family and Friends
Pros: Convenient/available; understand you well and can anticipate your needs; reinforce your desire to quit when you feel tempted to smoke again.
Cons: May become overly critical if your quit attempt fails; if they try to quit for you instead of for themselves, they may relapse and undermine your efforts.
Worksite & Community
Many worksites and communities offer quit-smoking programs. These often include group programs such as those offered by the American Lung Association or support programs such as Nicotine Anonymous. Smoke-free worksite and community promotional campaigns may also include "buddy systems" and other activities to help people stay smoke-free.
Pros: Helpful to have encouragement in the places – your job or community – where you spend most of your time; helpful – and healthful – to work in smoke-free workplace.
Cons: Programs may not be available or may be hard to find; worksite may not be smoke-free or may not encourage nonsmoking.
Telephone Encouragement or "Health Lines"
In addition to telephone counseling for developing a Quit Smoking Action Plan, many employers, HMOs, communities, and makers of nicotine and non-nicotine medications offer ongoing telephone counseling to encourage staying smoke-free.
Pros: Convenient; private; provides support when family and friends do not or cannot.
Cons: May not be available in your health plan, company or community.
Pulmonary Introduction | Sleep Disorders
Sleep Apnea (What is your Snore Score?)
Quit Smoking (Prepare to quit, Using Medications, Staying Smoke Free)
Asthma (Kinds of Medicines, Special Hints)