Everyone knows that smoking is bad for you. But we don't all know what smoking does. When you smoke, you're risking your life, especially if you have heart disease, diabetes or any other chronic disease. You also know that there is nothing easy about giving up cigarettes. Yet, as hard as it may be, your life depends on it.

Among other benefits, quitting will lower your risk of further health problems. No matter how much or how long you have smoked, once you quit, your health will improve. You will feel better, look better and have a more active life.

Quitting takes an organized plan that includes changing behaviors, habits and beliefs and, for some people, using medication. Your heart, mind and body will love you for it. Click a link below to learn more about strategies for quitting smoking.

Know Yourself
Find New Habits
Know What to Expect
About Gaining Weight
Treatment Options
Behavioral Methods
Ready, Set, Quit!

Know Yourself

To win the smoking battle, you need to know your own special “triggers” — the times, places and feelings that bring on the urge to light up. Some common triggers include drinking coffee, an alcoholic drink, the end of a good meal, talking on the phone or watching someone else smoke. Make a list of the “triggers” that tempt you and try to avoid them as much as you can.

Find New Habits

Try new pastimes that you don't link with smoking. For instance, if you're feeling tense or angry, instead of reaching for the comfort of a smoke, try to breathe deeply, calm down and relax. Instead of sitting at the table after a meal craving a cigarette, get up and take a walk. Try out new pastimes that make smoking out of the question, like swimming. The key is to keep busy and active. Keep a journal to mark your daily progress.

Know What to Expect

During the first few weeks after quitting, your body and mind may be affected, but those feelings will go away after a while. Since smoking is an addiction, 85 percent of those who quit have some of those bad feelings. You may feel things like headaches, stomach trouble and tiredness. You may also feel jumpy, sad, confused and angry with people. While these feelings are not pleasant, you should know that they are signs that your body is learning to do without smoking. Most symptoms end within two to four weeks.

Nicotine replacement therapy or Zyban helps to control the negative feelings that often occur with quitting.

About Gaining Weight

Quitting smoking does not mean you have to gain weight. It will mean changing eating habits and lifestyle. If you find yourself reaching for snacks to replace cigarettes, make sure you choose healthy food or foods with diet sugars, such as gum or mints. Those kinds of foods can help you get through those between-meal cravings. Drink six to eight cups of water each day. It cuts down on your hunger. Begin a workout program that you can handle. Work your way up slowly, little by little. There is no magic way to keep the pounds off when you quit smoking. But, with healthy eating, working out and a good outlook, you can keep your weight under control. You can find ways to break the link between eating and smoking.

Treatment Options

The combination of behavioral changes and pharmacotherapy leads to higher cessation rates than with either used alone. There are various medications for smoking cessation. Some are available without a prescription; others need a physician’s prescription. Some products have been shown to be even more effective when used in combination (two or more smoking cessation medications taken together). It is important to discuss medication options with your physician or other health care professional to help you design an individual treatment plan. Inform your health care professional of all medication you take, including over the counter medications and herbal products, or if you have heart disease or are pregnant.

Nicotine is addictive, but is otherwise relatively safe. It is the substance in cigarettes and chewing tobacco that keeps the user "hooked." Using nicotine replacement therapy helps the smoker or chewing tobacco user slowly wean off the addition to nicotine while breaking free of the harmful substances in tobacco.

Nicotine replacement therapy helps smokers give up cigarettes by replacing some of the nicotine a smoker usually gets from cigarettes. Using nicotine replacement therapy decreases the withdrawal from nicotine in cigarettes and generally makes the quitting process much easier compared to quitting "cold turkey," which can be uncomfortable. Nicotine replacement is available as a patch, gum, nasal spray, inhaler, and recently approved lozenges, and can also be used for quitting other forms of tobacco, such as chewing tobacco.

Nicotine patches are available both by prescription and over-the-counter. Generic patches are available at most pharmacies and will help to save you some money. Most patches are worn 24 hours a day, but some are removed during sleep. The patches work by allowing nicotine from the patch to be absorbed through the skin into the bloodstream. By wearing the patch all day there is a steady level of nicotine in the blood, helping to decrease cravings for cigarettes and reduce withdrawal symptoms. The strength of patch is based on the number of cigarettes you smoke on a daily basis. If you have heart disease or are pregnant, you should consult with your doctor before using any smoking cessation medication.

Habitrol® is worn for 24 hours – By prescription only
>100 lbs., >10 cigarettes/day and no cardiovascular disease:	<100 lbs., <10 cigarettes/day or cardiovascular disease:
21 mg x 4-6 weeks 14 mg x 2-4 weeks 7 mg x 2-4 weeks	14 mg x 4-6 weeks 7 mg x 2-4 weeks
Nicoderm® is worn for 24 hours – Available without a prescription
>10 cigarettes/day 14 mg x 2 weeks 21 mg x 4-6 weeks 7 mg x 2 weeks Same as Nicoderm® patch	<10 cigarettes/day 14 mg x 4-6 weeks 7 mg x 2 weeks
Nicotrol® is worn for 16 hours, removed during sleep – Available without a prescription
>10 cigarettes/day 6 weeks: 15 mg patch 2 weeks: 10 mg patch 2 weeks: 5 mg patch
Nicotine gum is available without a prescription as Nicorette® gum. There is also a generic nicotine gum. The strength of gum that’s right for you is based on the number of cigarettes you smoke on a daily basis.
<25 cigarettes/day 2mg 6 weeks: 1 piece Q 1-2 hours 3 weeks: 1 piece Q 2-4 hours 3 weeks: 1 piece Q 4-8 hour	>25 cigarettes/day 4mg
Nicotine nasal spray is available by prescription as Nicotrol® NS. Nicotine is absorbed through the nasal passages into the blood. The nasal spray delivers a large amount of nicotine is would be appropriate for a heavy smoker (2-3 packs/day). The nasal spray should not be used more than three months.
1 to 2 sprays in each nostril/hour Gradually decrease rate over 6-8 weeks
Nicotine inhaler is available by prescription as Nicotrol® inhaler. The nicotine is a small hand-held device that resembles a cigarette. The inhaler provides the user with nicotine when the device is "puffed" on. The inhaler should not be used more than 6 months.
6 to 16 cartridges/day Must use minimum of 6 cartridges/day for at least 3 to 6 weeks, then continue for 3 months & taper for next 6 to 12 weeks
Nicotine lozenges have recently been approved by the FDA and will soon be available over-the-counter (no prescription needed) as Nicorette® Commit. The lozenge dissolves in the mouth over 20 to 30 minutes. There are 2 strengths available; 2mg for those who smoke greater than 30 minutes after waking up or 4mg for those who smoke less than 30 minutes after waking up.
Smoke > 30 min. after waking 2mg	Smoke within 30 min. of waking 4 mg
Follow dosing schedule for Nicorette® gum

Zyban® is available by prescription to help with the behavioral changes (i.e., anxiety, depression, and anger) that may occur when you quit smoking. Zyban® is available as a 150 mg tablet initially taken 2 times per day then after a few days just once a day. Zyban® is not nicotine replacement therapy and may be started while you are still smoking and is taken for up to 12 weeks. Zyban® has been shown in studies to be very effective when used in combination with nicotine replacement therapies such as nicotine patches. The most common adverse events with Zyban® include dry mouth and trouble sleeping. To avoid having trouble sleeping it is suggested to take Zyban® early in the day.

There are several other medications that have been studied to help people quit smoking. These include nortriptyline and clonidine; both are prescription medications. Although these drugs have not been approved by the FDA for smoking cessation, your physician may prescribe them for you.

For a complete list of over-the-counter products along with cost and dosing information,  click here.

Behavioral Methods

There are many programs that can help smokers adjust to life without cigarettes. These programs have experts who will talk to you one-on-one or in a group to help you make lifestyle changes that will keep you from smoking. The experts can also teach you about other methods like hypnosis and acupuncture. Also, as of 2002, Pennsylvanians can use the toll-free Quitline: 1-877-724-1090.

Freedom From Smoking Group Clinic Program is an eight-session group program offered by the American Lung Association. Led by experts who understand why you smoke, the program will teach you how to become a non-smoker for good. Also available are Freedom From Smoking support tools such as books and videotapes. Call 1-800-LUNG-USA to learn more about Freedom From Smoking Programs.

A free educational program for smoking cessation meets on the first Tuesday of each month at 4 p.m. at Albert Einstein Medical Center, 5501 Old York Road, Philadelphia. The program is open to Einstein patients, staff and community members. Meetings are held at Albert Einstein Cancer Center, first floor, conference room. For more information, call 215-456-6487.

What Smoking Does

SMOKING kills close to half a million people in the USA each year. Almost 50 percent of those deaths are due to heart disease. In fact, more smokers die from heart disease than from lung cancer.

SMOKING one pack of cigarettes a day doubles the risk of a heart attack. Smokers have less chance of living through a heart attack and people who keep smoking after a heart attack increase their chances for a second attack.

SMOKING reduces the amount of oxygen to the heart. At the same time, it makes the heart beat faster, so that the heart needs more oxygen. This can lead to angina, or chest pains.

SMOKING can make your arteries harden – a major cause of heart attack and stroke. Smokers have hardening of the arteries more often than non-smokers do.

SMOKING can also cause smaller arteries that carry blood to the arms and legs to narrow. Blockage in those pathways could mean the loss of an arm or leg.

SMOKING greatly increases the risk of heart disease in people with high blood pressure or high cholesterol levels.

SMOKING around children can make them sick. Second-hand smoke causes about 300,000 breathing illnesses per year in children under 18 months of age. Up to 15,000 of these children end up in the hospital with serious problems. Mothers who smoke up to 10 cigarettes a day cause up to 26,000 new cases of asthma among their children every year.

SMOKING low-tar and low-nicotine cigarettes will not reduce your risk of heart disease.

SMOKING is a major cause of cancers (lung, bladder, pancreatic), chronic obstructive airway disease (emphysema), asthma and other diseases.

What Quitting Smoking Can Do For You

QUITTING will make you feel better. You will have a more active life, you will need less sleep, and your health will improve right away.

QUITTING will lower your risk of heart disease, cancer and other chronic diseases. No matter how much or how long you have smoked, once you quit your risk will start to drop.

QUITTING before you have heart disease will greatly improve your odds for heart health. Once you have symptoms, even if you quit smoking, your risk factors, although reduced, will not be normal.

QUITTING will give you back your sense of smell and your sense of taste. Your skin will look better, your clothes and hair will smell better and you will probably get sick less often.

QUITTING does not mean you have to gain weight. It will mean changing eating habits and avoiding places and things that tempt you.

QUITTING is the best thing you can do for your health! You can do it. Your heart, mind and body will love you for it. Back to Top