Ready to quit smoking? Here are some tips to help you succeed

Rohan Arya, MD

Pulmonology

You’ve decided to quit smoking. Congratulations! Quitting is hard, especially if you’ve smoked for a long time, and it can take multiple tries. Pulmonologist Rohan Arya, MD, offered some helpful tips to help you kick the smoking habit once and for all.

Why is it hard to quit smoking?

“People who smoke are dependent on the nicotine in tobacco – it’s very addictive,” Dr. Arya said.

According to the National Institutes of Health, quitting nicotine can cause withdrawal symptoms in as little as three hours after quitting. The symptoms typically peak within the first few days of quitting and subside within a few weeks. For some people, however, the symptoms can go on for months.

Some of these withdrawal symptoms include:

• Irritability
• Craving
• Depression
• Anxiety
• Cognitive and attention decline
• Sleep problems
• Increased appetite

“Smoking is also habitual and intertwined with what you do every day,” Dr. Arya added. “It’s hard to just yank that out of your life.”

What can you do to manage cravings while quitting smoking?

“What I recommend is changing your lifestyle or the things that you associate with smoking,” Dr. Arya said. “If it’s Friday night happy hour, maybe avoid those for a bit so you’re not tempted to smoke.”

Change where and how you smoke. For example, avoid smoking in your car. If you usually have a cigarette in the morning with coffee, have something different so you break the connection to cigarettes.

“I tell patients to smoke by their mailbox,” Dr. Arya said. “If it’s raining, snowing or hot, maybe they’ll think twice and decide to stay inside.”

It also helps to supplement these lifestyle changes with nicotine replacement products, such as chewing gum, lozenges or patches.

Which method of nicotine replacement is most effective?

Dr. Arya said it depends on the person. Some people might not want to use gum because they have poor teeth, but other people prefer the gum because chewing helps satisfy their oral fixation with the cigarette. The key is to try each of the options and see which one you can incorporate into your lifestyle without making it overly complicated.

Is vaping a safer alternative to cigarette smoking?

“The simple answer is we don’t really have enough information to determine how much of a risk vaping will have in terms of developing lung cancer,” Dr. Arya said. “What we do know is the vape products don’t seem to contain the tar, carbon monoxide and some of the other products of combustion that you find in cigarette smoke. But it does have a lot of other chemicals which may potentially lead to cancer. We do know that some of these chemicals cause very high levels of inflammation in the lung, and we need to see if this ongoing inflammation leads to cancerous changes,”

Is it safer to smoke cigars, pipes or hookah?

Cigar and pipe smoking both can increase the risk of lung cancer when compared to people who don’t smoke anything at all. Based on all the research that has been done so far, the more cigarettes or pipes that one smokes and the longer they smoke throughout their lives, the greater their risk of developing lung cancer, as well as cancer of the mouth, throat and esophagus.

When it comes to smoking hookah or shisha, Dr. Arya said it depends on what you’re smoking. If it includes tobacco, then the risk would be the same as if you were smoking cigarettes.

If you have smoked for a long time, can quitting still be beneficial?

“If you can stop smoking, there’s always going to be a benefit, whether it’s for your cardiovascular health, general lung health, or the health of your mouth and teeth and gums,” Dr. Arya said. “Your risk for cancer also will go down. It’ll never go back to the risk that a non-smoker has, but the longer you stay smoke free, the closer it gets to simply age-related risk factors.”

According to the Centers for Disease Control and Prevention, these are the effects quitting smoking has on your body:

• After 24 hours: Nicotine level in the blood drops to zero.
• After 1–12 months: Coughing and shortness of breath decrease.
• After 1–2 years: Risk of heart attack drops sharply.
• After 5–10 years: Risk of stroke decreases; added risk of mouth and throat cancer drops by half.
• After 10 years: Added risk of lung cancer drops by half.
• After 15 years: Risk of coronary heart disease drops to close to that of someone who does not smoke.

How can you help someone who wants to quit?

If you know someone who would like to stop smoking, helping them across the finish line is a lot easier than trying to punish them for failing to quit. if nicotine replacement products aren’t working, have them reach out to their primary care physician. Prescription medication might be helpful. You can also try participating in a smoking cessation program.