Why is it so hard to quit smoking?
You’ve probably heard this line before from a family member or friend: “Smoking is so bad for you, why do you do it?”
Well, people start smoking for different reasons. They might think it will help calm their nerves, make them look more mature, or maybe, at the time it just seemed sort of adventurous. But looking back, it wasn’t the best choice, and now they really do want to quit. So, why is it so hard?
It is hard to quit smoking because the nicotine in cigarettes, cigars, and other tobacco products gets you hooked. Most people try as many as three times to quit before they are able to resist. Look at smoking cessation as a process as opposed to a one-time event. That way, if you do slip, you can focus on what you can do differently to prevent future slips and relapse. Don’t give up – you’ll get there.
You’ve probably heard a lot about how smoking is harmful, but here are some positive things you can look forward to when you do quit.
If you quit, you will:
- Prolong your life
- Improve your health
- Feel healthier (Smoking can cause coughing, poor athletic ability, and sore throats.)
- Look better (Smoking can cause face wrinkles, stained teeth, and dull skin.)
- Improve your sense of taste and smell
- Save money (Most smokers spend about $90 a month on cigarettes.)
Smoking increases complications for those who have diabetes.
While smoking can increase your chances of getting diabetes, it can also make managing diabetes more difficult for those who already have it. Other complications of smoking on diabetes include retinopathy (eye disease), heart disease, stroke, vascular disease, kidney disease, nerve damage, foot problems, and many others.
What options do people have?
Some people try quitting on their own before they go to their doctor, but your doctor can be very helpful in offering pointers and suggesting medicines, both prescription and over-the-counter, that can help you “kick the habit” with more ease. It is also important to tell your doctor what types of products you might try to help you quit so he or she can make sure they won’t interact with other medicines you are already taking. Remember, there is no “magic bullet” when it comes to quitting smoking. Quitting requires persistent effort. You have to quit totally and permanently.
Over-the-counter medicines
Nicotine-based medicines
It might sound crazy – taking nicotine to help quit using nicotine– but some over-the-counter medicines that contain it can be very helpful in fighting off cravings. It won’t take all the cravings away, but by using some of these products instead of smoking, you can gradually reduce your intake of nicotine and ease off of its addictive effects.
When you give your body a steady dose of nicotine all the time and then stop suddenly, you will have more side effects - called withdrawal symptoms - that usually make quitting a lot harder. They include irritability, headache, and the craving to smoke. Go slow and lower the dose gradually with these products until you feel you are able to resist the cravings on your own. You will still have them, but they will be reduced. No matter how you quit or what type of product you use, if any, it is extremely important to have some form of social support – either from your doctor, counselor, support group, close friend, or a family member.
When considering a nicotine-based product to help you quit, be sure to tell your doctor about any conditions you might have, especially:
- Asthma or breathing problems
- Heart or blood vessel disease
- High blood pressure
- Stomach ulcer
- Type 1 diabetes mellitus
- Liver disease
- Overactive thyroid
- Pheochromocytoma (PCC)
Over-the-counter treatments are typically used for up to 12 weeks as part of a smoking cessation program.
Additional things to consider when taking nicotine-based medicines
- Do not smoke while you are using the nicotine-based medicines. You could risk overdosing on nicotine.
- Tell your doctor about any medicines you are taking or any allergies you have.
- Do not use the nicotine-based medicines if you are breastfeeding, are pregnant, or think you might be pregnant.
- Keep this and all medicines out of the reach of children and pets.
Common brand names of the nicotine patch and gum include:
- Habitrol
- Prostep
- Nicotrol
- Nicorette
- NicoDerm CQ
- Commit
Nicotine patch
The patch is worn directly on the skin. Nicotine passes through the skin into your blood stream. Some brands have patches with different strengths so you can gradually reduce your dosage. Nicotine patches are available with and without a prescription. If you are not sure what kind of patch to use, ask your doctor.
Always follow the instructions on the box, but here are some things to remember when using the nicotine patch:
- Find a clean, dry part of the skin to apply it. Somewhere on your upper arm or torso usually works best. Try to find an area that has little hair and is without scars, cuts, burns, or rashes.
- Always wash your hands with water only. Do not use soap after applying the patch. Using soap can increase the amount of nicotine that can pass through the skin of your hands.
- Do not try to adjust the dosage by cutting the patch into sections.
- Leave the patch on - even while bathing or swimming. If it falls off, do not try to re-apply it. Use a new one.
- Remove the patch according to the instructions on the box (usually after 16 to 24 hours).
- When applying a new patch, choose a different place than before. Do not use the patch in the same place for at least a week.
- Do not leave the patch on for longer than directed.
- Remove the patch if you are going to do rigorous exercise. This might cause more nicotine to pass into your bloodstream.
- If you are unsure how to use the product, be sure to ask your doctor or pharmacist to explain.
Common side effects of the nicotine patch:
- Increased appetite
- Mild headache
- Irritation at the site of the patch
There are other common or more serious side effects. Please read the information that comes with the product carefully and be sure to contact your doctor if you have any questions.
Nicotine gum
Nicotine gum, like the patch, is a systemic way to receive nicotine. This means that the nicotine in the gum passes from the lining of your mouth right into your bloodstream. Like the patch, you will decrease the dosage during the recommended time (usually 12 weeks or sooner) if you are able to resist cravings on your own. Nicotine gum is available without a prescription.
Always follow the instructions on the box, but here are some things to remember when using nicotine gum:
- Use nicotine gum only when you feel the urge to smoke.
- Slowly chew the gum until you begin to taste it. Then stop chewing and park it between your cheek and gum. This helps release the nicotine. When the taste is almost gone, repeat these two steps for 30 minutes.
- Use only one piece at a time.
- Do not drink acidic beverages (soft drinks, tea, coffee, and fruit juices) 15 minutes before or while chewing the gum.
- Gradually decrease the number of pieces of gum you chew per day, until you reach three to six pieces per day. Some people can do this in under 12 weeks. Do not chew more than 24 pieces in one day.
- Try to have the nicotine gum handy at all times. You might try hard candy or using regular gum, if the nicotine gum is not available.
Common side effects of nicotine gum:
- Belching (burping)
- Increased appetite
- Mild headache
- Watery mouth
- Jaw or muscle pain
- Sore mouth or throat
There are other common or more serious side effects. Please read the information that comes with the product carefully and be sure to contact your doctor if you have any questions.
Nicotine pill/lozenge
Nicotine pill/lozenge, like the patch and gum, is a systemic way to receive nicotine. This means that the nicotine in the lozenge passes from the lining of your mouth right into your bloodstream.
Always follow the instructions on the box, but here are a few things to remember when using the nicotine pills or lozenges:
- Place the pill in your mouth, wait until it dissolves completely, move it around from time to time without chewing it. It takes around 20-30 minutes to dissolve.
- Do not eat or drink 15 minutes prior to, during, or after use. This might cause hiccups, heartburn, or nausea.
- Do not use more than 5 pills in 6 hours or more than 20 pills in 24 hours.
Prescription medicines
Nicotine nasal spray
Nicotine that can help you stop smoking also comes in the form of a nasal spray, available only by prescription. Like the patch and the gum, the amount taken is gradually decreased during a period of 12 weeks. It is to be used, like the gum and the patch, as part of a program that also includes support, education, and counseling.
Nicotrol NS is one brand name of nicotine nasal spray.
Always follow the instructions on the prescription label. Here are some other things to remember when using nicotine nasal spray:
- You may gradually reduce your dose of nasal spray by skipping doses or using only half the usual amount.
- Writing down the time you take the nasal spray and how much you take might be very useful when reducing your dose.
Common side effects of nicotine nasal spray:
- Back pain
- Constipation
- Coughing
- Indigestion or nausea
- Runny nose
- Sneezing
- Watery eyes
- Headache
- A burning feeling in the back of the throat or nose
There are other common or more serious side effects. Please read the information that comes with the product carefully and be sure to contact your doctor if you have any questions.
Nicotine inhalant
A nicotine inhalant – available only by prescription - can be used for up to six months as part of a smoking cessation program. When the inhaler is used, nicotine passes from the lining of the mouth and throat (not the lungs) into the bloodstream. Like other nicotine products, you will decrease the dosage during the recommended time (usually several weeks) or until you are able to resist cravings on your own.
Nicotrol Inhaler is one brand name of nicotine inhalant.
Always follow the instructions on the box, but here are some things to remember when using a nicotine inhalant:
- Store the inhaler in a dry area at or above room temperature (60° F or 16° C).
- Write down the time you take the inhalant and how much you take. This might be very useful when reducing your dose.
- The normal first dose is between six and 16 cartridges per day.
Common side effects of nicotine inhalants:
- Coughing
- Indigestion
- Mouth and throat irritation
- Stuffy nose
There are other common or more serious side effects. Please read the information that comes with the product carefully and be sure to contact your doctor if you have any questions.
Bupropion
Bupropion is more commonly seen under the brand names of Wellbutrin or Zyban. It is not a nicotine-based medicine; it is an antidepressant that is only available by prescription.
It is prescribed along with counseling and support to aid in smoking cessation. Bupropion might also be used to treat major depressive disorders.
Bupropion comes in tables that are to be swallowed whole, not crushed, divided, or altered in any other way. Individual prescription strengths might vary, so if you are taking bupropion, be sure to follow the directions on the label and ask your doctor or pharmacist any question you have about how to take it, when to take it, any potential side effects, and the duration of treatment.
Common side effects of bupropion:
- Dry mouth
- Sweating
- Insomnia
- Rash
- Headache
- Dizziness
- Anxiety
- Restlessness
- Irritability
- Indigestion
- Decreased appetite
There are other common or more serious side effects. Please read the information that comes with the product carefully and be sure to contact your doctor if you have any questions.
Do not take bupropion if you have taken an MAOI (monoamine oxidase inhibitor) within the last 14 days. MAOIs are sometimes used to treat depression. Some examples include: tranylcypromine (Parnate), phenelzine (Nardil), and isocarboxazid (Marplan). There are other drugs that might interact with bupropion so be sure to tell your doctor about any over-the-counter or prescription medicines you are taking.
Varenicline (Chantix)
Veranicline is a prescription medication that does not contain nicotine. This medicine helps to reduce the reinforcing effects of nicotine and can minimize the withdrawal effects from nicotine. Typically, this medication is recommended for a minimum of 12 weeks and in concert with smoking cessation counseling.
How could research benefit smokers who want to quit?
Researchers are testing a vaccine that could make quitting a lot less difficult. This type of treatment could potentially be used in a program, along with bupropion (Zyban) and counseling, to significantly reduce withdrawal symptoms.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/15/2006…#9960
