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Quitting smoking (smoking cessation) is one of the most important things you can do to improve your health and well-being. People who stop smoking decrease their risk of cancer, heart disease, stroke, and early death. Women who stop smoking before or during pregnancy reduce their risk of infertility or having a low-birth-weight baby. Most smokers in the United States report that they want to stop smoking, but kicking the smoking habit can be difficult. Most ex-smokers try several times, often as many as 8 to 10 times, before they are able to quit for good. The results are definitely worth those efforts. The December 12, 2007, issue of JAMA includes a review article reporting that smoking increases the risk of type 2 diabetes. This Patient Page is based on one previously published in the July 5, 2006, issue of JAMA.
How to quit smoking
Be committed. Keep in mind why you want to quit and stay motivated.
Get help from your doctor and continue to follow up with your doctor, especially during the first month.
Choose a firm date to quit and mark your calendar. Choose a time that is not particularly stressful and that does not involve situations associated with smoking.
Begin to cut back prior to your quit date.
Consider joining a stop-smoking program such as the free program offered by the National Cancer Institute at 1-800-QUITNOW (784-8669).
Tell friends, family, and coworkers that you are quitting smoking so that they can offer motivation and support.
Remove smoking from your environment. Avoid places where people congregate to smoke. Remove cigarettes from your car, home, and work.
Anticipate that you may experience withdrawal symptoms, such as cigarette cravings, anxiety, irritability, and restlessness, even with nicotine replacement or drug treatment. These symptoms usually peak at 1 to 3 weeks after quitting but generally become manageable within a few weeks.
Eat a healthy diet and stay active to help with stress and to minimize weight gain.
Nicotine replacement therapy
Nicotine replacement therapy helps relieve the withdrawal symptoms that many smokers say prevent them from quitting. It contains nicotine but without the harmful substances found in cigarettes. Nicotine gum, patches, and lozenges are available over the counter. Nicotine inhalers and nasal sprays are available by prescription.
Non-nicotine drug therapy
Bupropion and varenicline are approved prescription drugs to help patients stop smoking. Both medications are generally well tolerated. The most common adverse effects are insomnia from bupropion and nausea from varenicline.
Most smokers trying to quit need drug therapy or nicotine replacement therapy. Talk with your doctor about the therapy appropriate for you.
For more information
National Cancer Institute 800/QUITNOW (784-8669)http://1800quitnow.cancer.gov
American Lung Associationhttp://www.ffsonline.org
Centers for Disease Control and Preventionhttp://www.cdc.gov/tobacco
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: American Cancer Society, American Lung Association, National Center for Chronic Disease Prevention and Health Promotion
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
Brender E, Lynm C, Glass RM. Smoking Cessation. JAMA. 2007;298(22):2700. doi:10.1001/jama.298.22.2700
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