Smoking Cigarettes: How Do I Quit?

Am Fam Physician. 2012;85(6):599-600

See related article on smoking cessation.

What can I do to quit smoking?

Quitting smoking can improve your health, but it can be hard. There are nicotine replacement therapies, medicines, and counseling that can make it easier. Talk to your doctor about which option is best for you.

What are nicotine replacement therapies?

Nicotine replacement therapies, or NRTs, contain less nicotine than cigarettes. Replacing cigarettes with an NRT can help lessen cravings and ease withdrawal symptoms. NRTs are available as skin patches, chewing gum, nasal sprays, inhalers, and lozenges. You can buy some of them over the counter.

If you smoke more than 15 cigarettes per day, an NRT may be a good option for you. It is important to follow the package directions to make sure you are using the right amount. If you are a heavy smoker (more than two packs per day), talk to your doctor about how to combine more than one type of NRT.

If you are a teenager, are pregnant or breastfeeding, or have a serious health condition (for example, diabetes or heart, lung, kidney, or liver disease), you should talk to your doctor about the safety of using an NRT.

What medicines can I take to help me stop smoking?

The prescription pills bupropion (brand name, Zyban) and varenicline (brand name, Chantix) do not contain nicotine, but they have been shown to help people quit smoking. Both of these medicines should be started a week or two before you try to quit.

Will there be side effects when I stop smoking?

Withdrawal: Withdrawal is your body's reaction to not getting nicotine after it has become used to it. Symptoms of withdrawal vary in different people. You may feel irritable, nervous, jittery, or sleepy. You may have trouble concentrating or feel more hungry than usual. These symptoms are usually worst during the first week after you quit. They may last two weeks to one month.

Nervousness: Nervousness is one of the most common side effects, but you may also become nervous because you know you are tackling a difficult habit. The effects of caffeine, including nervousness, are more severe after you stop using nicotine.

Depression: Some people feel down because they miss smoking. If you have had depression in the past, quitting smoking may trigger it again. If you feel depressed, you should talk to your doctor about your symptoms.

Weight gain: Many people gain a small amount of weight when they quit smoking (usually no more than 10 lb). You may eat more than usual as a substitute for smoking. Planning out healthy meals and exercising can help prevent weight gain.