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Clearing the Air: How to Quit Smoking...and Quit for Keeps
From the National Cancer Institute

Prepare for quitting
  • Ways of quitting
  • Just before quitting
  • Just after quitting
  • About gaining weight
  • What happens after you quit smoking
  • Withdrawal symptoms
  • Quitting for keeps
  • Keep your guard up
  • How to dampen that urge
  • Not smoking is habit-forming
  • Relapse: If you smoke again
  • Marking progress
  • Common rationalizations
  • Further information
  • Non Smoking Is Habit Forming

    Good for you! You have made a commitment not to smoke, and by using this booklet, you know what to do if you are tempted to forget that commitment. It is difficult to stay a nonsmoker once you have had a cigarette, so do everything possible to avoid it.

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    If you follow the advice in this booklet and use at least one coping skill whenever you have an urge to smoke, you will have quit for keeps!


    Relapse: If You Do Smoke Again

    If you slip and smoke, don't be discouraged. Many former smokers tried to stop several times before they finally succeeded. Here's what you should do:

    • Recognize that you have had a slip. A slip means that you have had a small setback and smoked a cigarette or two. But your first cigarette did not make you a smoker to start with, and a small setback does not make you a smoker again.
    • Don't be too hard on yourself. One slip doesn't mean you're a failure or that you can't be a nonsmoker, but it is important to get yourself back on the nonsmoking track immediately.
    • Identify the trigger: Exactly what was it that prompted you to smoke? Be aware of the trigger and decide now how you will cope with it when it comes up again.
    • Know and use the coping skills described above. People who know at least one coping skill are more likely to remain nonsmokers than those who do not know any.
    • Sign a contract with yourself to remain a nonsmoker.
    • If you think you need professional help, see your doctor. He or she can provide extra motivation for you to stop smoking. Your doctor may also prescribe nicotine gum or a nicotine patch as an alternative source of nicotine while you break the habit of smoking.


    Marking Progress

    • Each month, on the anniversary of your quit date, plan a special celebration.
    • Periodically, write down new reasons you are glad you quit, and post these reasons where you will be sure to see them.
    • Make up a calendar for the first 90 days. Cross off each day and indicate the money you saved by not smoking.
    • Set other, intermediate target dates, and do something special with the money you have saved.


    Common Rationalizations*

    Rationalization: I'm under a lot of stress, and smoking relaxes me.

    Response: Your body is used to nicotine, so you naturally feel more relaxed when you give your body a substance upon which it has grown dependent. But nicotine really is a stimulant; it raises your heart rate, blood pressure, and adrenaline level. Most ex-smokers feel much less nervous just a few weeks after quitting.


    Rationalization: Smoking makes me more effective in my work.

    Response: Trouble concentrating can be a short-term symptom of quitting, but smoking actually deprives your brain of oxygen.


    Rationalization: I've already cut down to a safe level.

    Response: Cutting down is a good first step, but there's a big difference in the benefits to you between smoking a little and not smoking at all. Besides, smokers who cut back often inhale more often and more deeply, negating many of the benefits of cutting back. After you've cut back to about seven cigarettes a day, it's time to set a quit date.


    Rationalization: I smoke only safe, low-tar/low-nicotine cigarettes.

    Response: These cigarettes still contain harmful substances, and many smokers who use them inhale more often and more deeply to maintain their nicotine intake. Also, carbon monoxide intake often increases with a switch to low-tar cigarettes.


    Rationalization: It's too hard to quit. I don't have the willpower.

    Response: Quitting and staying away from cigarettes is hard, but it's not impossible. More than 3 million Americans quit every year. It's important for you to remember that many people have had to try more than once, and try more than one method, before they became ex-smokers, but they have done it, and so can you.


    Rationalization: I'm worried about gaining weight.

    Response: Most smokers who gain more than 5-10 pounds are eating more. Gaining weight isn't inevitable. There are certain things you can do to help keep your weight stable. (See Tips To Help You Avoid Weight Gain.)


    Rationalization: I don't know what to do with my hands.

    Response: That's a common complaint among ex-smokers. You can keep your hands busy in other ways; it's just a matter of getting used to the change of not holding a cigarette. Try holding something else, such as a pencil, paper clip, or marble. Practice simply keeping your hands clasped together. If you're at home, think of all the things you wish you had time to do, make a list, and consult the list for alternatives to smoking whenever your hands feel restless.


    Rationalization: Sometimes I have an almost irresistible urge to have a cigarette.

    Response: This is a common feeling, especially within the first 1-3 weeks. The longer you're off cigarettes, the more your urges probably will come at times when you smoked before, such as when you're drinking coffee or alcohol or are at a cocktail party where other people are smoking. These are high-risk situations, and you can help yourself by avoiding them whenever possible. If you can't avoid them, you can try to visualize in advance how you'll handle the desire for a cigarette if it arises in those situations.


    Rationalization: I blew it. I smoked a cigarette.

    Response: Smoking one or a few cigarettes doesn't mean you've "blown it." It does mean that you have to strengthen your determination to quit and try again–harder. Don't forget that you got through several days, perhaps even weeks or months, without a cigarette. This shows that you don't need cigarettes and that you can be a successful quitter.


    *Adapted from Clinical Opportunities for Smoking Intervention–A Guide for the Busy Physician. National Heart, Lung, and Blood Institute. NIH Pub. No. 86-2178. August 1986.


    For More Information

    The Cancer Information Service, a program of the National Cancer Institute, is a nationwide telephone service for cancer patients and their families and friends, the public, and health care professionals. The staff can answer questions (in English or Spanish) and can send free National Cancer Institute materials about cancer. They also know about support groups and other resources and services. One toll-free number, 1-800-4-CANCER (1-800-422-6237), connects callers with the office that serves their area.

    The following organizations also can help you. Contact them to learn more about quitting for keeps.

    American Cancer Society *
    1599 Clifton Road, NE
    Atlanta, GA 30329
    (404) 320-3333

    The American Cancer Society (ACS) is a voluntary organization composed of 58 divisions and 3,100 local units. Through "The Great American Smokeout" in November, the annual Cancer Crusade in April, and the numerous educational materials, ACS helps people learn about the health hazards of smoking and become successful ex-smokers.

    American Heart Association *
    7272 Greenville Avenue
    Dallas, TX 75231
    (214) 373-6300

    The American Heart Association (AHA) is a voluntary organization with 130,000 members (physicians, scientists, and laypersons) in 55 state and regional groups. AHA produces a variety of publications and audiovisual materials about the effects of smoking on the heart. AHA also has developed a guidebook for incorporating a weight-control component into smoking cessation programs.

    American Lung Association *
    1740 Broadway
    New York, NY 10019-4374
    (212) 315-8700

    The oldest voluntary health agency with 57 state associations and 60 affiliates throughout the United States, the American Lung Association (ALA) provides help for smokers who wish to quit through their Freedom From Smoking® self-help smoking cessation program. The organization actively supports legislation and information campaigns for nonsmokers' rights and conducts public information programs about the health effects of smoking.

    Office on Smoking and Health
    Centers for Disease Control
    Mail Stop K-50
    4770 Buford Highway, NE
    Atlanta, GA 30341-3724
    (404) 488-5705

    The Office on Smoking and Health (OSH) is the Department of Health and Human Services' lead agency in smoking control. OSH sponsors distribution of publications on smoking-related topics, such as free flyers on relapse after initial quitting, helping a friend or family member quit smoking, the health hazards of smoking, and the effects of parental smoking on teenagers.

    *Consult your local telephone directory for listings of local chapters.




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