Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2000;62(6):1419-1420

Why do I need to stop using tobacco?

Cigarettes are the leading cause of preventable deaths in this country. Tobacco is toxic to your body. The nicotine in cigarettes and smokeless tobacco (snuff or chewing tobacco) makes your body release adrenaline. Adrenaline causes your blood vessels to constrict and your heart to beat faster, which raises your blood pressure. This can lead to heart attacks and strokes. The tars and other toxic substances in tobacco can cause cancer of the lung and other organs. Tars also damage the lungs, leading to emphysema (a serious breathing disorder). Cigarette smoke contains carbon monoxide (which interferes with your lungs' ability to get oxygen into the blood), and other chemicals, such as DDT, arsenic and formaldehyde. All of these chemicals are bad for your lungs and body. Smokeless tobacco causes dental problems and can cause cancer of the mouth. That's why quitting tobacco use is so important.

Why is it so hard to stop smoking?

It seems hard to stop smoking because smoking causes changes in your body and in the way you act. The changes in your body are caused by addiction to nicotine. The changes in the way you act have formed over time as you have bought cigarettes, lit them and smoked them. These changes have become your smoking habit.

When you have a smoking habit, many things seem to go along with having a cigarette. These might include having a cup of coffee, being stressed or worried, talking on the phone, driving, taking a break at work, having a drink, socializing with friends or wanting something to do with your hands.

How can I stop smoking?

You'll have the best chance of stopping if you do these four things:

  • Use a nicotine replacement.

  • Get support and encouragement.

  • Learn how to handle stress and the urge to smoke.

  • Use bupropion (brand name: Zyban), if recommended by your doctor.

How do I get ready to stop smoking?

Set a stop date two to four weeks from now. Keep a diary of when and why you smoke to help you better understand your smoking habit. Using the diary, you and your family doctor can develop a plan to help you deal with the things that make you want to light a cigarette.

What will happen when I stop smoking?

How you feel when you stop depends on how much you smoked, how addicted your body is to nicotine and how well you get ready to stop. You may crave a cigarette, and you may be hungrier than usual. You may feel edgy and have trouble concentrating. You also may cough more at first, and you may have headaches. These things happen because your body is used to nicotine. The symptoms are strongest during the first few days after quitting, but most symptoms go away in a few weeks.

What is nicotine replacement?

Nicotine replacement products are ways to take in nicotine without smoking. These products come in several forms: gum, patches, inhalers and nasal spray. (The nicotine gum and the nicotine patch can be bought without a prescription from your doctor.) Nicotine replacement works by lessening your craving for nicotine and reducing the withdrawal symptoms. It allows you to focus on the changes you need to make in your habits and environment. Once you're more comfortable being a nonsmoker, dealing with your nicotine addiction is easier.

People with heart disease may need to stop taking in nicotine altogether. Your family doctor will help you decide if the benefits of using nicotine replacement outweigh the risks. If you have heart disease, do not buy nicotine replacement products unless your doctor tells you to do so, then follow the directions carefully.

What is bupropion (Zyban)?

Bupropion is a prescription medicine that can help people increase their chance of success when they quit smoking. It can be used by itself or in combination with nicotine replacement. Ask your doctor about whether it might help you quit.

How do I get support and encouragement?

Tell your family and friends what kind of help you need. Some people like support from friends and family, while others don't want people to comment. Your family doctor can also recommend stop-smoking programs. These programs are often held at a local hospital or health center.

Support and encouragement don't have to come from just your family and friends, though. Give yourself personal rewards for stopping smoking. Buy yourself something you've always wanted, or treat yourself to an afternoon movie.

What about stress and my urges to smoke?

The first few days after stopping will be the hardest. Look back at your smoking diary and see what triggered you to smoke. Then think of other things to do instead of lighting up at these times, such as walking or simply breathing deeply and slowly. Think of changes in your routine that will help you not smoke, such as drinking hot tea in the morning instead of coffee (if you used to smoke while you had a cup of coffee).

Will I gain weight when I stop smoking?

Most people gain a few pounds (usually less than 10) after they stop smoking. It's important to know that any weight gain is a minor health risk compared to the risks of continuing to smoke. To limit your weight gain, try not to replace smoking with overeating. Find other ways to keep your hands busy instead of picking up food. Make sure you have healthy, low-fat snacks on hand in case you do reach for food. And start exercising or exercise more. Exercise helps burn calories and has the added benefit of keeping you busy so you can't smoke. Your doctor will help you find out how much exercise is right for you.

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