Introduction
No two people are alike. This is a reality that just about everyone agrees with. Who we are is dependent upon our upbringing, experiences and even our genes. Why then, are smokers considered alike in terms of what best allows them to quit smoking?
Some view points will argue that quitting smoking cold turkey has the highest success rates, while others have strong evidence that nicotine replacement is effective. Motivational coaching, exercise and other strategies have also been shown to be effective. What all of these methods have in common is that they have been effective at one point or another.
With this in mind, navigating the internet attempting to seek out what might be the best option for quitting tobacco smoking is challenging. The practice has led to mixed attitudes towards assisted and unassisted quitting, and the social stigmas of both methods run very deep [1].
The most important realization you can make is that choosing to quit smoking tobacco deserves a great deal of admiration and praise.
Why should you quit smoking?
Quitting smoking is not easy because addiction is a very real and difficult process to work through. However, it is a lot easier today than it has been in the past. Part of the reason for this is there is less access to smoking areas in communal areas. There are certain fields such as medicine where it is becoming harder and harder to find smoking areas as well. One of the leading reasons that smokers are choosing to quit has been because they are tired of being alienated by those around them.
In addition to reclaiming a social life, quitting smoking will benefit your health by preventing problems like lung and other cancers, heart disease, and stroke [2-6]. For that alone, smoking cessation is a worthy goal.
There will be decreased financial burden as well. Work productivity, sick days, and depression symptoms have all been shown to have less of an impact after smoking cessation [7][8].
Overall, smoking cessation will yield great benefits in your social life, health and financial situation!
How do you quit smoking?
As mentioned previously, different strategies will work for different individuals. As many as three-fourths of smokers will fail and end up utilizing multiple methods. Some gradually cut back on cigarettes or switch to “mild” cigarettes. Others will use e-cigarettes, nicotine patches or nicotine gum in a replacement strategy. Sometimes health professionals become involved and FDA-approved medications such as Zyban or Chantix are utilized. Lastly there are support groups that have been shown to help such as smokefree.gov or telephone quit lines.
Why not quit cold turkey? The majority of smoking cessation attempts are unassisted [9]. In fact, studies have been able to demonstrate that quitting cold turkey leads to higher cessation rates long-term than quitting gradually [10-12]. The fact of the matter is that if you can tolerate it, it may be the best strategy. However, there are many factors that have been shown to make this more difficult such as older age, history of anxiety/depression, or even social factors such as close family members that smoke [13][14].
Quitting cold turkey is not for everyone. There are also certain situations where this can even be harder, such as attempting to make it through long flights or prolonged hospitalization [15]. This is where quitting aids come in.
What can help you be more successful?
There are a variety of questions that come up when first embarking on seeking assistance with smoking. There are programs for smoking cessation available which involve counselors and support groups which can be accessed through your doctor, the health department and/or smokefree.gov. These have been shown to be modestly beneficial in keeping you on track [16][17].
One novel approach has been hypnosis to help with smoking cessation in addition to counseling. There have been mixed results in medical literature. Some studies show that it does not have any additional benefits, [18] while others have found it is useful to help with enhancing motivation [19] and movement through stages of quitting [20][21].
Another approach has been the use of psilocybin, a naturally occurring psychedelic found in mushrooms. This has shown great promise in improving smoking cessation success [22-24]. However, this was only found effective within the context of being enrolled in a structured smoking cessation counselling program.
Inevitably during this process smokers will consider e-cigarettes as a replacement option. This is best reserved as a last resort when all other strategies fail. The long-term side effects are poorly studied and the substances within them have only recently begun being regulated [25-28].
What about nicotine replacement therapy?
In contrast to e-cigarettes, nicotine replacement therapy (NRT) has been very well studied [29][30]. Utilization of NRT has been shown to dramatically increase abstinence rates when beginning the quitting process as well as long-term abstinence [31][32]. It can even be immediately beneficial for smokers that are critically ill in the hospital! [33]
Nicotine gum or patches are also very discreet, which seems to help in the smoking cessation process.
One question that comes up continually with these approaches are the length of time that someone should utilize NRT. Simply stated, it is very dependent on the individual. One study found that most utilized it for less than 4 weeks [34]. NRT has been studied out as far as 2 years as being beneficial, though there is no support past that [35]. The short answer is that NRT is best used in the initial 1-2 months following smoking cessation and then sporadically as an alternative to cigarettes when relapses occur.
What if I fail to quit smoking?
Failure is very common, especially when starting smoking cessation for the first time [36]. The most important tool in failure is forgiving yourself and trying again.
Bouncing back after a slip-up can be difficult. The initial day of smoking cessation is always the worst [37]. On the bright side, starting again is usually a little better than your very first attempt in terms of cravings and physical effects.
When you try again, attempt different strategies and methods to see what works best for you. Also it is important to note potential stressors in your life and things that eroded your self-control, so that you can avoid these in the future if possible or at least be aware of them [38].
Will I gain weight if I quit smoking?
Weight gain is very common in smoking cessation for two primary reasons. First is that generally smoking establishes an oral fixation, or the need to have something in your mouth. When taking this away sometimes additional food becomes the replacement. Second, when ceasing addictions, it is very common to replace it with a new addiction.
The good news is being cognizant that this might occur will make you more likely to recognize it and address it should you start gaining weight. Additionally, the health benefits of smoking cessation far exceed any health risks from weight gain [39][40].
References
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