How To Quit Smoking

Ready to quit smoking and potentially add years of healthy living to your lifespan? Smoking cessation is an enormously important goal. The links between smoking and cardiovascular disease are strong, and the health benefits of quitting smoking are well documented.

Quitting smoking is not easy. Smoking is a habit that fills many different physical and psychological needs, and nicotine is addicting.¹ This means that you need to develop new habits that rewire your brain. This all takes time, but it is totally doable.

Despite the challenges associated with quitting smoking, many people see how important this goal is.² For example, in 2015, over two-thirds of adult smokers wanted to quit. Over half had attempted to quit smoking in the previous year, but fewer than 10% of people actually succeeded in quitting.³

To achieve your goal to quit smoking, break it down into smaller goals and develop a timeline. A timeline with well-defined steps is a plan. People with plans typically are more successful than those who don’t break down their goals into discrete actionable steps. Make sure your plan notes the challenges you anticipate as you work toward your goal and how you plan to overcome them.

Prepare for Quitting: Common Challenges

As you develop your timeline and plan for quitting smoking, it is important to understand some common challenges people face when trying to overcome their addiction to nicotine and smoking.

Cravings

Nicotine addiction is powerful, and your brain will crave nicotine when you quit smoking. A craving is a strong, distracting urge to smoke. Physical and psychological cravings are most intense right after you quit smoking. Plan for cravings. Take it one day, hour, or even a minute at a time. Plan ahead. Develop a list of activities that can help you distract your mind from its deep desire for nicotine.

Withdrawal symptoms

Nicotine dependence is a change in your brain chemistry after repeated nicotine exposure. Your brain changes its physiology in response to nicotine. When this happens, many people need increased doses to get the same effect. Tolerance is the need for more nicotine to get the same psychological and physical effects. Nicotine-dependent and non-dependent smokers are equally tolerant to nicotine.⁴

Common nicotine withdrawal symptoms include:

• Cravings or urges to smoke
• Increased hunger
• Weight gain
• Mood changes
• Insomnia
• Increased anxiety, restlessness, or tendency to get upset or irritated
• Difficulty sleeping
• Difficulty concentrating

Nicotine replacement therapies can help take the edge off withdrawal symptoms.

Social pressure

Many people who want to stop smoking find that the social pressure from friends and colleagues makes it harder. Social pressure can help people quit but can also sabotage their efforts to quit. If your friends all smoke, they may intentionally or unintentionally increase temptation. Many people also find that they need to smoke to feel accepted in social situations, especially in bars or clubs where smoking is commonplace.

To quit smoking successfully, you may need to distance yourself from those who urge you to continue. At the least, avoid going to settings where smoking is commonplace because the temptation would be too great. Spend time with family and friends who are nonsmokers doing activities that you enjoy.

Triggers

Whether your habit is smoking, overeating, or something else, most people can identify triggers that make it harder to overcome habitual behavior.

Common triggers for smoking include:

• Stress
• Boredom
• Anxiety
• Excitement
• Loneliness
• Fighting
• Watching television
• Talking on the phone
• Waiting in line
• Taking a break
• Going to a bar or club
• Smelling cigarette smoke

When quitting smoking, try to avoid your triggers or at least recognize them for what they are—high-risk situations. Develop a plan for how you can distract yourself from smoking in each situation.

Alternative Methods of Quitting Smoking

Alternative nicotine delivery methods, such as vaping or nicotine replacement therapies, can help people manage nicotine withdrawal symptoms.

Is Vaping Safe?

Vaping changes the way nicotine is delivered to your body. Nicotine is heated to create an aerosol that is inhaled. It is safer than cigarette smoking because it delivers fewer chemicals to the lungs, but not ideal or safe. Vaping products are not as well studied, and the chemicals found in them and their effects on the body are not fully understood.⁵

According to the Centers for Disease Control and Prevention, over 2,800 hospitalizations and 68 confirmed deaths (early 2020) due to vaping product use have occurred.

In a study of over 880 smokers trying to quit, the success rate at one year was 18% in the e-cigarette group and 9.9% in the nicotine replacement group (combined with behavioral support).⁶

Nicotine Replacement Therapies (NRTs)

A wide range of nicotine replacement therapies (NRTs) are available. These products deliver a small amount of nicotine without the toxins in cigarettes and vaping. The most effective way to use NRTs is to combine a long-acting nicotine patch with a shorter-acting product such as a lozenge, gum, inhaler, or nasal spray and to plan to extend treatment over 12 weeks.⁷

Finding Support When Struggling with Addiction

Nicotine withdrawal causes physical and psychological symptoms, including depression, anxiety, weight gain, and cravings. Support groups and online communities bring together many people facing a common challenge and support them as they work to overcome their challenges. They also celebrate successes and provide encouragement!

Support groups

Support groups bring together those who are working toward a common goal. When you join a support group, you can be mentored by people who have overcome the same challenges you are working to overcome, and you can provide support and advice to people who are not as far along on their smoking cessation journey as you are.

Online support

Telemedicine provides an accessible and easy way to seek advice, receive an online diagnosis, get treatment, and ask questions. Most telemedicine platforms have resources available to discuss potential treatment options. Online social forums can also be a great place to seek advice and guidance from people who have faced similar challenges.

Counseling

Smoking cessation and withdrawal from nicotine have both physical and psychological effects. If you are struggling with anxiety, depression, stress management, or dealing with difficult relationships, counseling or therapy can help.

Research suggests that behavioral interventions, such as cognitive-behavioral therapies, when combined with medications, can be effective in helping adults quit smoking. In an analysis of over 52 clinical studies and almost 20,000 patients, smoking cessation was more successful when using a combination of behavioral therapy and medication use compared than with minimal support alone.⁸  

Telehealth can make access to specialists easier and more affordable. It is a great way to receive care when in-person appointments are not possible.

Family or friend support

When you are working hard to achieve a goal that has tremendous health implications, you need the support of your family and friends. It will be challenging to quit smoking, but once you succeed, your friends and family will have a healthier version of you and an increased likelihood that you will have a longer, healthier life with them.

The Psychological Aspect of Smoking Cessation

Take care of yourself while you work on smoking cessation. Learn about cognitive reframing and self-care practices that can reduce stress. Distraction and mindfulness can help manage cravings. Family and friends can support you along your journey, and on-call support from online doctors and internet support provides an easier and more convenient way to meet your smoking cessation healthcare needs.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. McLaughlin I, Dani JA, De Biasi M. Nicotine withdrawal. Curr Top Behav Neurosci. 2015;24:99-123. doi:10.1007/978-3-319-13482-6_4
2. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
3. Centers for Disease Control and Prevention. Smoking cessation: fast facts.
4. Perkins KA. Chronic tolerance to nicotine in humans and its relationship to tobacco dependence. Nicotine Tob Res. 2002 Nov;4(4):405-22. doi: 10.1080/1462220021000018425. Erratum in: Nicotine Tob Res. 2003 Aug;5(4):603. PMID: 12521400.
5. Bhatnagar A, Whitsel LP, Blaha MJ, et al. New and Emerging Tobacco Products and the Nicotine Endgame: The Role of Robust Regulation and Comprehensive Tobacco Control and Prevention: A Presidential Advisory From the American Heart Association. Circulation. 2019;139(19):e937-e958. doi:doi:10.1161/CIR.0000000000000669
6. Hajek, P., Phillips-Waller, A., Przulj, D., Pesola, F., Myers Smith, K., Bisal, N., Li, J., Parrott, S., Sasieni, P., Dawkins, L., Ross, L., Goniewicz, M., Wu, Q., Mcrobbie, H.J., 2019. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. New England Journal of Medicine 380, 629–637.. https://doi.org/10.1056/nejmoa1808779
7. Rigotti NA. Strategies to Help a Smoker Who Is Struggling to Quit. JAMA. 2012;308(15):1573–1580. doi:10.1001/jama.2012.13043
8. Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2016 Mar 24;3(3):CD008286. doi: 10.1002/14651858.CD008286.pub3. PMID: 27009521; PMCID: PMC10042551.