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Am Fam Physician. 2000;62(3):591-592

See related article on assessing nicotine dependence.

How do I feel about giving up smoking?

Check one of the boxes below:

  • I like to smoke, and I'm not planning to quit.

  • I like lots of things about smoking, but I would like to quit.

  • I'm ready to quit smoking now.

If you said, “I like to smoke, and I'm not planning to quit,” ask yourself this question: “Why have so many other people quit smoking?” In fact, 50 million Americans are former smokers. What do you think were their reasons for quitting? Some of those reasons may also apply to you. Do you have problems with breathing, your heart or high blood pressure? Does cancer run in your family? You can lower your chance of having these diseases by quitting smoking.

If you said, “There are lots of things I like about smoking, but I would like to quit,” you are like most smokers. Now ask yourself this question: “How will I be better off after I quit smoking?”

My health will improve.

In what way? ________________________

I'll save money.

How much? _________________________

My house and car will be cleaner.

Why is this important to you? ______________________________________________

My family and friends will be glad.

Why? _________________________________________________________________

I'll feel better about myself.

In what way? ____________________________________________________________

Another reason is: ____________________________________________________________

If you said, “I'm ready to quit smoking,” your doctor wants to help you succeed. Here are some suggestions to help you understand why you smoke. If you know why you smoke, you can make a plan for quitting.

What are my smoking triggers?

Start by listing some of the times when you most want a cigarette (triggers to smoking). Triggers are events that set off your desire to smoke a cigarette. I want a cigarette:

  • When I see someone else smoking.

  • When I see cigarettes in an ashtray.

  • When I am cleaning the house.

  • When the telephone rings.

  • When I am relaxing.

  • When I drink a cup of coffee.

  • With a drink.

  • During or after meals.

  • When I am driving a car.

  • When I am on a coffee break.

  • After leaving work.

  • While I am watching TV.

For each trigger, think of something you could do that makes it impossible to smoke. For example, instead of smoking after meals, you could get right up and brush your teeth.

Do you use cigarettes to relieve uncomfortable feelings?

Smokers often use cigarettes to help them cope with certain feelings. Think about when you do this. “I have smoked cigarettes when I felt”:

  • Angry

  • Disappointed

  • Resentful

  • Ashamed

  • Lonely

  • Abandoned

  • Guilty

  • Sorry for myself

  • Abused

  • Mistreated

  • Hurt

  • Frightened

  • Frustrated

  • Embarrassed

  • Depressed

  • Anxious

  • Bored

  • Worried

Once you know how you use cigarettes to help you cope with stressful times, you will be better able to get through those times without smoking. Breathing exercises, relaxation exercises and guided imagery have helped many smokers quit.

What do I do about nicotine withdrawal?

If you smoke every day, you are probably physically dependent on nicotine. You will have withdrawal symptoms when you stop smoking.

Your body gets rid of half the nicotine in your bloodstream every one to two hours, so it doesn't take long after finishing one cigarette before your body cries out for another. You may become irritable and agitated, have trouble sleeping, have difficulty concentrating or experience mood swings. These withdrawal symptoms are often the reason smokers give up their effort to quit.

There are five kinds of medications doctors use to treat nicotine withdrawal symptoms:

  1. Nicotine gum (brand name: Nicorette)

  2. Nicotine patches (brand names: Habitrol, Nicoderm, Nicotrol, ProStep)

  3. Nicotine nasal spray (brand name: Nicotrol NS)

  4. Nicotine inhaler (brand name: Nicotrol Inhaler)

  5. Bupropion (brand name: Zyban)

One or more of these may be right for you. Your family doctor can tell you about these medicines and how they help people quit smoking.

Where can I get more information?

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