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New Year's Resolution to Quit Smoking: Part II

Medicines That Help With Withdrawal

When you quit smoking, you may feel strange at first. You may feel dull, tense, and not yourself. These are signs that your body is getting used to life without nicotine. It usually only lasts a few weeks.

Many people just can't handle how they feel after they quit. They start smoking again to feel better. Maybe this has happened to you. Most people slip up in the first week after quitting. This is when feelings of withdrawal are strongest.

There are medicines that can help with feelings of withdrawal: Bupropion SR pills; nicotine gum; nicotine inhaler; nicotine lozenge; nicotine nasal spray; and the nicotine patch.

Using these medicines can double your chances of quitting for good. Ask your doctor for advice. But remember: Medicine alone can't do all the work. It can help with cravings and withdrawal, but quitting will still be hard at times.

Here is more information about the different medicines.


Nicotine Gum, Patch, Inhaler, Spray, and Lozenge (NRT)

Nicotine gum, patches, inhalers, sprays, and lozenges are called nicotine replacement therapy (NRT). That's because they take the place of nicotine from cigarettes. NRT can help with withdrawal and lessen your urge to smoke.

You need a prescription to buy the inhaler and nasal spray. But you can buy nicotine gum, nicotine patches, and nicotine lozenges on your own.


Other Medicines

Bupropion SR is a medicine that has no nicotine. You need a prescription to get these pills. They seem to help with withdrawal and lessen the urge to smoke.

Some people have side effects when using bupropion SR pills. The side effects include dry mouth and not being able to sleep.

This medicine isn't right for: Pregnant women; people who have seizures; people with eating disorders; or heavy drinkers.

Ask your doctor, dentist, or pharmacist if this medicine is right for you. Make sure to use it the right way if your doctor prescribes it.


Thinking About Using NRT?

  • Ask your doctor, dentist, or pharmacist if nicotine gum, the patch, or some other kind of NRT is right for you. These medicines can cause side effects in some people. Some people should not use NRT without a doctor's help. Pregnant women are a good example.

  • Be patient. Using NRT correctly can take some getting used to. Follow the instructions and give it some time.

  • Don't mix tobacco and NRT. Having one or two cigarettes while you use the gum, patch, nasal spray, inhaler, or lozenge is not dangerous, but your goal is to quit smoking for good. Use NRT only when you are ready to stop smoking. If you do slip up and smoke a cigarette or two, don't give up on NRT. Keep trying.

  • Start out using enough medicine. Use the full amount of NRT in the instructions. Don't skip or forget to use your NRT after you first stop smoking.

  • Slowly use less and less medicine. But don't stop completely until you're ready. You can set up a schedule with your doctor or pharmacist.
  • Keep some of the medicine with you after you stop using it. This way you'll be ready for an emergency.

  • Wait a half hour after using the gum, lozenge, or inhaler before you eat or drink anything acidic. Acidic foods and drinks can keep nicotine gums and inhalers from working. Acidic foods and drinks include tomato sauce, tomatoes, oranges, lemons, grapefruit, coffee, soda, orange juice, and grapefruit juice.

Bottom line: Read the instructions that come with the medicine. Talk to your doctor or pharmacist if you have any questions.

Source: NRT Product User's Guides. GlaxoSmithKline Consumer Healthcare, Pittsburgh, PA, 2002.


Other Support

1. Your state may have a toll-free telephone quitline. Call the quitline to get one-on-one help.

2. Call the National Cancer Institute's Smoking Quitline at 1-800-QUITNOW (1-800-784-8669) TTY 1-800-332-8615. This number works anywhere in the U.S. You can get one-on-one help quitting. Or you can ask where to get help in your state.

3. Visit the National Cancer Institute's SmokeFree Website. This website offers science-driven tools, information, and support that has helped smokers quit. You will find state and national resources, free materials, and quitting advice from the National Cancer Institute and its partners.

4. More and more workplaces have help for workers who want to quit. Some offer quit-smoking clinics and support on the job. Others will pay for outside programs for their workers. Ask at work about the choices open to you.

5. Your doctor may know about a quit-smoking program or support group near you.


Steps to Take on Your Quit Day

Today's the day you start your smoke-free life! Remind your family and friends that today is your quit date. Ask them to support you during the first few days and weeks. They can help you through the rough spots.

Using your support program: If you decided to use a support program, use it fully. Go to the sessions. Call your telephone quitline. Visit your Internet site. The more support you get, the more likely you will quit for good. Are you using medicine to help you quit? If so, follow the directions. If you don't, you're more likely to go back to smoking. Also, don't rush to stop using the medicine. Stick with it for at least 12 weeks. Or follow your doctor's advice.

Keep busy:
  • Keep very busy today.
    • Go to a movie.
    • Exercise.
    • Take long walks.
    • Go bike riding.

  • Spend as much free time as you can where smoking isn't allowed. Some good places are malls, libraries, museums, theaters, department stores, and places of worship.

  • Do you miss having a cigarette in your hand? Hold something else. Try a pencil, a paper clip, a marble, or a water bottle.

  • Do you miss having something in your mouth? Try toothpicks, cinnamon sticks, lollipops, hard candy, sugarfree gum, or carrot sticks.

  • Drink a lot of water and fruit juice. Avoid drinks like wine and beer. They can trigger you to smoke.

Stay away from what tempts you:
  • Instead of smoking after meals, get up from the table. Brush your teeth or go for a walk.

  • If you always smoke while driving, try something new: Listen to a new radio station or your favorite music. Take a different route. Or take the train or bus for a while, if you can.

  • Stay away from things that you connect with smoking. Do it today and for the next few weeks. These may include:
    • Watching your favorite TV show
    • Sitting in your favorite chair
    • Having a drink before dinner

  • Do things and go places where smoking is not allowed. Keep this up until you're sure that you can stay smoke-free.

  • Remember, most people don't smoke. Try to be near non-smokers if you must be somewhere you'll be tempted to smoke, for example at a party or in a bar.


Managing Cravings When you really crave a cigarette...

Remember: The urge to smoke will come and go. Try to wait it out. Or look at the plan you made last week. You wrote down steps to take at a time like this. Try them! You can also try these tips:
  • Keep other things around instead of cigarettes. Try carrots, pickles, sunflower seeds, apples, celery, raisins, or sugarfree gum.

  • Wash your hands or the dishes when you want a cigarette very badly. Or take a shower.

  • Learn to relax quickly by taking deep breaths.
    • Take 10 slow, deep breaths and hold the last one.
    • Then breathe out slowly.
    • Relax all of your muscles.
    • Picture a soothing, pleasant scene.
    • Just get away from it all for a moment.
    • Think only about that peaceful image and nothing else.

  • Light incense or a candle instead of a cigarette.

  • Where you are and what is going on can make you crave a cigarette. A change of scene can really help. Go outside, or go to a different room. You can also try changing what you are doing.

  • No matter what, don't think, "Just one won't hurt." It will hurt. It will undo your work so far.

  • Remember: Trying something to beat the urge is always better than trying nothing.


Withdrawal: How You May Feel When You Quit

Common feelings of smoking withdrawal include:
  • Feeling depressed
  • Not being able to sleep
  • Getting cranky, frustrated, or mad
  • Feeling anxious, nervous, or restless
  • Having trouble thinking clearly
  • Feeling hungry or gaining weight

Not everyone has feelings of withdrawal. You may have one or many of these problems. And they may last different amounts of time. The medicines described in this guide can help.

Source: Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed. (1994). American Psychiatric Association. Washington, D.C.


What To Do If You Do Slip

Don't be discouraged if you slip up and smoke one or two cigarettes. It's not a lost cause. One cigarette is better than an entire pack. But that doesn't mean you can safely smoke every now and then…no matter how long ago you quit. One cigarette may seem harmless, but it can quickly lead back to one or two packs a day.

Many ex-smokers had to try stopping many times before they finally succeeded. When people slip up, it's usually within the first three months after quitting. Here's what you can do if this happens:
  • Understand that you've had a slip. You've had a small setback. This doesn't make you a smoker again.

  • Don't be too hard on yourself. One slip up doesn't make you a failure. It doesn't mean you can't quit for good.

  • Don't be too easy on yourself either. If you slip up, don't say, "Well, I've blown it. I might as well smoke the rest of this pack." It's important to get back on the non-smoking track right away. Remember, your goal is no cigarettes - not even one puff.

  • Feel good about all the time you went without smoking. Try to learn how to make your coping skills better.

  • Find the trigger. Exactly what was it that made you smoke? Be aware of that trigger. Decide now how you will cope with it when it comes up again.

  • Learn from your experience. What has helped you the most to keep from smoking? Make sure to do that on your next try.

  • Are you using a medicine to help you quit? Don't stop using your medicine after only one or two cigarettes. Stay with it. It will help you get back on track.

  • Know and use the tips in this booklet. People with even one coping skill are more likely to stay non-smokers than those who don't know any. START to stop again!

  • See your doctor or another health professional. He or she can help motivate you to quit smoking.


Sticking With It

Beating an addiction to nicotine takes a lot of will power and determination. You should feel great about yourself for making it so far. Now's the time to focus on sticking with it.
  • Keeping your guard up:

    Your body has changed since you began to smoke. Your brain has learned to crave nicotine. So certain places, people, or events can trigger a strong urge to smoke, even years after quitting. That's why you should never take a puff again, no matter how long it has been since you quit.

    At first, you may not be able to do things as well as when you were smoking. Don't worry. This won't last long. Your mind and body just need to get used to being without nicotine.

    After you've quit, the urge to smoke often hits at the same times. For many people, the hardest place to resist the urge is at home. And many urges hit when someone else is smoking nearby. Look at your Craving Journal to see when you might be tempted. Then use the skills you've learned to get through your urges without smoking.

  • Fighting urges: Review the tips in this article to help you fight the urge to smoke. These tips are meant to help you stay a non-smoker.

  • Staying upbeat: As you go through the first days and weeks without smoking, keep a positive outlook. Don't blame or punish yourself if you do have a cigarette. Don't think of smoking as "all or none." Instead, take it one day at a time. Remember that quitting is a learning process.

  • Keep rewarding yourself for not smoking

    Now that you aren't buying cigarettes, you probably have more spending money! Think about starting a "money jar" if you haven't already. Put your cigarette money aside for each day you don't smoke. Soon you'll have enough money to buy a reward for yourself.


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    *Copyright © Smokefree.gov provides accurate, up-to-date information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking. Any information obtained in this article should not be construed as medical or legal advice. The above information is presented for educational purposes only, and it is not a substitute for informed advice or training. Please do not copy or use this information to diagnose or treat any problems without consulting a qualified professional. Reprinted with permission.


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