Most Smokers Want to Quit – So Why Don’t They?


Tobacco use is the number one cause of preventable disease and death in the United States, and it can harm nearly every part of a person’s body. The majority of adult smokers want to quit. So why don’t they just do it? Simple – it’s really hard to do sometimes. Nicotine is very addictive, and the withdrawal and cravings can be overpowering. More than half of adult smokers have tried to quit in 2018, but only 7.5% of them succeeded. ¹


If you or a loved one smoke, it’s important to understand the risks associated with tobacco use to you and those around you. We are here to help educate you on the risks as well as the benefits of quitting and to provide resources to help you on your journey to a tobacco-free life.


What are the risks associated with smoking? ²

First and foremost, smoking is the leading cause of cancer in the United States. Lung cancer is especially common and is the foremost cause of cancer death in the United States. Not only does it increase a person’s risk for lung cancer, it can also increase the risk for cancer of throat, mouth, stomach, kidney, bladder, cervix, and more. Depending on how long someone has smoked, this risk can be 2 to 10 times higher than if they never smoked a cigarette.


The health risk to a smoker is not limited to cancer. Smoking is associated with other diseases such as heart disease and stroke, may be linked to developing cataracts or a bone disease, and can even cause problems in getting pregnant. Smoking during pregnancy may also be associated with low birth weight in the baby.


Smoking doesn’t affect just the smoker, either. Those around smoke can inhale the smoke or exhalations of smokers nearby, which is called secondhand smoke. The amount of chemicals and toxins inhaled from secondhand smoke is less than what the smoker is breathing in, but it is still dangerous and can increase their chances of developing cancer or other diseases as well. Secondhand smoke can cause additional problems in children especially, including lung infections, asthma, and even sudden infant death syndrome (SIDS).


Are e-cigarettes safe to use? ³

E-cigarettes (also known by e-cigs, vape pens, and many other names) deliver the nicotine or other drug as an aerosol vapor rather than the traditional smoke. These products are generally less toxic than a traditional cigarette, but they are still harmful. Most contain nicotine (often even those marketed to be nicotine-free), which is toxic and addictive itself. They can also have other cancer-causing chemicals, heavy metals, harmful flavoring, and more.


As a cigarette substitute, studies have mixed results on the efficacy. They may help cigarette users quit, but what often happens is “dual-use” – adding vaping into the routine in addition to regular cigarettes instead of in replacement of them. E-cigarettes are not an FDA-approved smoking cessation aid.


E-cigarettes are relatively new, and studies are still being conducted – but the short conclusion so far is that they are still harmful and it’s better to never start than to use this less harmful alternative. There is no tobacco product that is harmless, nor is there a safe level of smoking.


What are the benefits of quitting smoking?

While smoking increases a person’s risk of developing health concerns, quitting can help lower that risk. Some of the health benefits of quitting are immediate while some take longer to manifest. Within minutes of a person’s last cigarette, the heart rate drops to a healthier level; within a day, the nicotine in the blood is gone. Within a year, coughing will decrease; risk of cancers and stroke decreases in the years following. ⁴



Even if already diagnosed with cancer, it’s not too late to benefit from quitting. For patients with some cancers, quitting smoking at the time of diagnosis may reduce the risk of dying by 30 to 40 percent. Quitting also helps the body heal better from surgery and respond better to therapy, and it lowers the risk of cancer coming back or that another cancer will develop. ⁵

I’m ready to quit – where should I start?

Reach out to your healthcare team.

According to the National Cancer Institute, those who have counseling from their doctor, pharmacist, or other healthcare professional are more likely to actually quit smoking – even one session can increase your likelihood of succeeding. ²


Your healthcare team can help you on your journey to quitting by:

· Asking about your smoking history so you both have a good understanding of where you’re starting.

· Helping you plan the journey by setting goals and providing support materials.

· Following up regularly to support you and help you stay accountable.

· Offering options for group or peer counseling.

· Recommending nicotine replacement therapy or other treatment options


There are also other means of support available outside of visiting a doctor. You can get confidential coaching through 1-800-QUIT-NOW or join a free messaging program like SmokefreeTXT. There are even mobile apps like quitSTART that can help support you while and after you quit. ⁶


Set yourself up for success.

Prepare for the side effects. ⁷

Nicotine withdrawal is different for every person, but most people do have some symptoms of it. These symptoms can be unpleasant, but you can get through them. The thing that will hurt you the most is if you give into the withdrawal and smoke again.


As you try to quit smoking, you may experience one or more of these temporary withdrawal symptoms:

· Nicotine cravings

· Anger, frustration, or irritability

· Jumpiness or restlessness

· Trouble concentrating or sleeping

· Anxiety or depression

· Hunger or weight gain


Know the common triggers.

Experiencing cravings as part of withdrawal is bad enough – having reminders of smoking in your day-to-day life can make it even harder to stay committed to quitting. Triggers don’t have to be just seeing a pack of cigarettes out on the table – they can be a mood or a feeling, or even just a normal part of the day when you usually would have a cigarette. These triggers can be different for each person, so taking the time to identify your triggers is crucial to staying in control.


Some triggers for smoking may include:

· Being around smokers

· Your morning or evening routine

· Stress

· Driving or riding in a car

· Eating or drinking

· Boredom


Once you can recognize the triggers, the next step is avoid them in your life. Some tips for removing triggers and for dealing with them if they do happen are:

· Remove tobacco products and things associated with smoking, like ash trays.

· Avoid spending time with other people while they smoke and ask them to not smoke around you.

· Ask for help you keep on this path. This can include asking that they not buy cigarettes for you – or that they don’t ask you to buy cigarettes for them.

· Stay busy. When you have something to distract yourself, you will be less focused on satisfying the craving for a cigarette.

· Exercise! Not only is it a good distractor as well, but it can also help alleviate withdrawal symptoms. Staying active can also help lift your mood, which can help with side effects as well. Any exercise is better than no exercise, so do what you can!

Cancer.gov and the CDC are great resources for dealing with different withdrawal symptoms as well as addressing health concerns where smokers may normally turn to a cigarette to cope.


Try cutting back instead of going “cold turkey.”

If drug therapy or nicotine replacement products aren’t the right fit for you, try limiting how many cigarettes you smoke to try to slowly eliminate nicotine. Many people think they could quit at anytime, but the addictiveness of nicotine is often underestimated. When you cut out nicotine all at once – “cold turkey” style – it can be harder than you may expect to withstand the cravings and withdrawal symptoms. ⁸


Consider treatment. ⁷

Managing withdrawal symptoms sometimes takes outside help. Medications can make the cravings and withdrawal symptoms easier to bear, which can make it easier to stick to your goal of quitting.

Using a type of drug treatment, regardless of type, can increase a person’s chances at successfully quitting. There are several options when looking at drug treatment:


1. Nicotine replacement therapies (NRTs)

Nicotine replacement therapies are products that work to slowly cut back a person’s use and dependence of nicotine. These products do have nicotine in them, but they are much safer to use these products than smoking a cigarette.

The over the counter (OTC) options available are:

· Nicotine patches

· Nicotine gum (available in two strengths)

· Nicotine lozenge (available in two strengths)

The prescription NRT options are:

· Nicotine nasal spray

· Nicotine inhaler

The nicotine patch can be combined with another NRT to increase your chances of successfully quitting. Different products work better for different people and situations. It’s best to check the precautions and side effects of each product and discuss your plans with a healthcare professional before beginning, especially if you plan to use the combination therapy method.


2. Non-nicotine medications

There are two non-nicotine prescription medications that a doctor can prescribe. There are side effects associated with both, so discussing the pros and cons with your doctor is an important step.

· Bupropion (Zyban®) is an antidepressant that has been approved to treat nicotine addiction since 1997. This can be used safely with other NRTs. Bupropion works by reducing the withdrawal symptoms and the cravings for a cigarette.

· Varenicline (Chantix®) has been approved to help people stop smoking since 2006. This medication works by reducing cravings for a cigarette as well as by blocking the pleasurable feelings felt if the person does have a cigarette.

Many treatments may be covered by your insurance. Talk to your healthcare team and insurance to see what coverage you have.

Quitting is hard, and it can take a long time to achieve. But it is doable, and it starts with that first step of wanting to stop. Remember that your friends, family, and healthcare team are here to support you. If you have any questions, please reach out to our staff.


Sources:

¹ https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html

² https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/quit-smoking-pdq

³ https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm

https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm

https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet

https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/

https://www.quit.com/quit-smoking-faqs.html