Quit Smoking Treatment and Support Options

All smoking cessation treatment and support options attempt to ease the symptoms related to quitting. These symptoms include: Depressed

Irritability
Depression
Restlessness
Sleeping difficulties
Anxiety
Increased appetite
Poor concentration
Cigarette craving

These symptoms start to appear within 24 hours of quitting. The most important part of your smoking cessation effort will be to abstain from smoking through the first week. After the first week, the symptoms being to become less intense and your likelihood for long term success improves.

If you resume smoking during the first week it is very likely that you will permanently return to your regular smoking patterns. Your effort during the first week of your smoking cessation effort are the most important efforts you can make.

If you can refrain from smoking on the fist day and then for the first week of your quit smoking effort you will have about a 10 times better chance of remaining smoke free after 6 months. It's going to be hard, but it's worth it.

You should understand that every quit smoking program claims to be successful. Here is How to Comapre Quit Smoking Program Options.

Self Help Methods

Smokers who want to quit often do so without assistance. Typical methods of quitting include:

Cold Turkey Here you simply throw your cigarettes away and stop smoking. But, you must have the right attitude. You can't simply quit and maintain your current thinking about cigarettes.

For example, here is Allen Carr discussing his change in attitude that made him go from 100 cigarettes a day addiction to zero cigarettes overnight. With his tips, you too may be able to quit "cold turkey".

For more information, read Allen Carr's The Easy Way to Stop Smoking book.

Tapering Here you slowly reduce the number of cigarettes you smoke each day.

Fading Changing brands periodically to reduced tar and nicotine cigarettes. This can work, provided you do not compensate for lower tar and nicotine by taking deeper puffs, puffing more frequently, or covering the vent holes on the low tar cigarettes. All these ways help keep the amount of nicotine you get from each cigarette nearly constant--regardless of the advertised levels.

If you are a smoker who didn't know about the vent holes in low tar and nicotine cigarettes, you should take a look at our page: Are Low Tar and Nicotine Cigarettes Healthful?

An alternative way to reduce nicotine is to use NicoBloc. This product actually captures nicotine as it travels through the filter of your cigarette. You will taper your intake of nicotine and reduce the number of cigarettes.

For additional information about NicoBloc please visit NicoBloc.

Self Monitoring Recording the number of cigarettes smoked per day and plotting the total amount of nicotine and tar consumed per day.
Using graph paper or a spreadsheet, you can multiple the nicotine and tar content of each cigarette by the number of cigarettes you smoke each day. Construct a chart showing your total nicotine and tar input per day. This chart will help motivate you to reduce your daily intake.

These techniques are effective, especially with those whose dependence on tobacco is low. Those who smoke 10 or more cigarettes a day, however, find it more difficult to overcome the symptoms of smoking cessation. For them, additional methods will likely be required to reduce cravings for cigarettes.

Combining fading and self monitoring has been very effective. One study found a success rate of 50% for self reporting abstinence. And, subject who continued to smoke at least consumed less tar and nicotine.

Coping Options

Coping is a way of dealing with problems, including the symptoms of smoking cessation. It does not mean simply ignoring the problems, but it involves preparing for them. So, you must learn to cope by anticipating ways in which you can reduce the impact of the symptoms of smoking cessation.

Here are a few ways you can cope with the inevitable symptoms you will experience. You should make a list of the symptoms and include your own ideas about ways to reduce or avoid the pressure to return to smoking.

Putting on Weight
Many people are worried about putting on weight when they quit smoking. This worry causes many people to relapse and return to smoking. But, by anticipating an increased hunger you can take steps to reduce its effect.

You can snack on healthful, low calorie items like vegetables. Carry a small bag of carrots you can munch on during the day. A full cup of chopped carrots adds only about 52 calories to your diet.

Drink plenty of water or other low calorie drinks. This will keep you feeling full.

Take appetite suppressors. These can be found in most health food stores.

Accept the idea that you may put on a few pounds. But, with increasing health, you'll be more able to exercise to reduce your weight and feel better in the long run.
Cigarette Cravings
Cigarette cravings come and go. You need to remember that the cravings are temporary.
Distract yourself with another activity. Get you mind on something else.

Perhaps, you have used cigarettes as a way of coping with stress. Try breathing deeply and feeling the stress leave you as you exhale.

Note where and when you normally smoke. You may need to change some of your habits to avoid situations you associate with smoking. Don't tempt yourself when your resistance is low. Make plans to do other activities or be in other places you don't associate with smoking.
Concentration Problems
When you have trouble focusing on a problem or task, take a short break. Go outside for an invigorating walk. Then come back to the task.

If you can, take a few days away from situations that demand concentrated attention. You will feel less pressure and anxiety.
Irritability
Adding the loss of the pleasurable effects of smoking with the uncomfortable feelings of urges and depression, you can become short tempered and irritable. You can yell at someone or "kick the cat" because you just are quite yourself. You are annoyed and "you just can't take it any more!"

Planning how to deal with unpleasant situations, anger management, is a big and growing business. Most family and work related problems relate to uncontrolled anger.

By anticipating ways of dealing with symptoms of smoking cessation you can feel prepared when the symptoms do appear. You will have confidence you can handle them.

Pharmacological Options

While pharmacological options can often double the chance of successfully quitting, only about a fifth of the smokers who attempt to quit make use of them. And, combining several of these options together can often quadruple your chances of success.

Pharmacological options actually help reduce the severity of the symptoms of smoking cessation. They can help you by allowing you to cope with mild rather than severe anxiety, depression, or cravings.

The following are approved by the U.S. Food and Drug Administration (FDA) for treatment of tobacco dependence. They include varenicline, bupropion and five forms of nicotine replacement therapy (NRT).

Varenicline
Varenicline stimulates the release of dopamine to reduce craving for nicotine. It also blocks the binding of nicotine to nicotinic receptors which reduces the reinforcing effects of smoked nicotine.

Though only recently released for sale in the United States in May of 2006, clinical studies have shown varenicline to be highly effective. In trials of varenicline vs. bupropion, varenicline showed more than 1.5 times the number of successful quitters after 12 months.

Varenicline is sold in 0.5 and 1.0 mg tablets and is taken twice daily for 12 weeks. If you successfully quit you can continue taking varenicline for an additional 12 weeks. It is sold as Chantix by Pfizer.

You can now order Chantix online: Chantix by Pfizer
Bupropion
Bupropion sustained release formula is an antidepressant medication. It does not contain nicotine. It works by reducing the attachment of neurotransmitters dopamine, serotonin, and norepinephrine to the neurons that created them. This inhibition of "reuptake" allows more of these neurotransmitters to remain available to move to nearby neurons. This increases the transmission of signals between neurons. This helps decrease the feelings of depression.

Bupropion significantly decreases the cravings for cigarettes. Common brand names are Wellbutrin and Zyban.
You normally start using bupropion two weeks before your target quit date. Bupropion can be used with nicotine replacement therapy to further decrease smoking cessation symptoms.

You can now order Bupropion online: Zyban Brand
Nicotine Patch (transdermal)
Nicotine patches contain varying amounts of nicotine, usually 21, 14, or 7 mg. A cigarette delivers approximately 1 mg of nicotine. So, someone smoking a pack of cigarettes a day will normally start with a 21 mg patch. After 6 weeks, you would use the next smaller patch. Then 6 weeks later the next smaller patch.

Different brands of the nicotine patches are intended to be worn from 18 to 24 hours a day. It takes several hours for the patch to reach the intended transmission rate. Because of this, heavy smokers who feel an urgent need for a cigarette in the morning should use the 24 hour patches so nicotine will be available to the body throughout the night as well as in the morning.

Since the adhesives on the patch can cause skin irritation, each day a new patch should be applied to a different area of your body.
Nicotine Nasal Spray
Each spray delivers about half a mg of nicotine. So, one spray in each nostril gives a full does of 1 mg, the equivalent of one cigarette.

Nicotine nasal spray is used only after quitting. The nicotine nasal spray is very effective at supplying your body with nicotine. It is very effective at reducing cigarette cravings and has one of the highest success rates for keeping people smoke free. Because of its efficient delivery of nicotine, the nicotine nasal spray can itself become addicting.
Nicotine Gum
Nicotine gum is available in 2 and 4 mg doses. Smokers who used more than 15 cigarettes a day should use the gum in the 4 mg dose. After chewing for about 20 minutes about 90% of the nicotine is released from the gum.

While nicotine gum delivers higher does than the nasal spray, the effectiveness of nicotine gum seems to be no better than a placebo when comparing success rates at 6 months after the target quit date. In fact, no benefits have been documents beyond 8 weeks.
Nicotine Inhaler
The nicotine inhaler is a cigarette like dispenser. You insert a nicotine cartridge into the inhaler. By taking "puffs" on the cigarette like dispenser nicotine vapor is deposited in your mouth. About 80 puffs draws 4 mg of nicotine from the dispenser, of which about 2 mg enters your blood stream. The equivalent of smoking 2 cigarettes.

Each cartridge is used up after about 20 minutes of active puffing.

The advantage of the nicotine inhaler is that its action is similar to a cigarette. You use your hands and mouth just as if you were smoking. This may reduce your hunger.
Nicotine Lozenge
The nicotine lozenge is a hard candy that you place in your mouth. It lasts about 20 minutes. Each lozenge contains 2 or 4 mg of nicotine. The 4 mg dose is recommended for more addicted smokers who strongly desire a cigarette within 30 minutes after awakening in the morning.

The lozenge is easy to use and almost unnoticeable by those around you. It is easily used in the workplace where an inhaler would draw attention.

Counseling Options

Within counseling options we include various smoking cessation programs in which you work with other people. Sometimes this involves one-on-one sessions, but most people opt for group sessions.

Verbal Support
Brief advice given by a medical professional can get a patient thinking about quitting. By itself, advice is not effective, but it is the most cost effective way to communicate concern. Medical professionals are advised to follow the "Five A's" to facilitate smoking cessation:
- Ask about smoking at each patient consultation
- Advise every smoker to quit
- Assess the patient's willingness to quit
- Assist the patient to quit with information, counsel, and tips
- Arrange follow-up to encourage or congratulate
Verbal support from a trusted source can help the smoker to prepare for the time he or she will set a target quit date and make an attempt to quit.
Behavioral Support
Support options include group sessions or private consultations with trained professionals experienced in helping people quit smoking. In addition, numerous organizations provide self-help resources to assist your efforts to quit. Some of these organizations include:
In addition, there are many commercial organizations that provide individual and group counseling as well as other therapies. Some of these therapies are described below.
Rapid Smoking Aversion Therapy
This is usually done in a group setting. Smokers are required to smoke by taking a puff of their cigarette every 6 to 10 seconds until the cigarette is finished or the smoker is nauseated. Rapid smoking has helped reduce cravings for a least a week.
Electric Shock Aversion Therapy
The concept of shock therapy is that habits reside in the subconscious mind. The subconscious mind associates pleasant feelings with smoking. To counter this, "mild" electric shocks are administered when you think about, reach for, or smoke a cigarette. Shock therapy is supposed to block the pleasant association of smoking and replace it with more disturbing and unpleasant associations.

In one study participants selected the strength of electric shock to a painful but tolerable level given on the upper arm. As the subjects smoked the researcher tapped a pencil on a desk and a shock was administered 3 out of 4 times. The subjects were to quickly stub out and discard the cigarette. If the subject appeared to delay stubbing out the cigarette another shock was administered. In addition, subjects were asked to imagine activities related to smoking; when they imagined themselves lighting up they were to say "Now" and a shock would be administered. Subjects attended a varying number of sessions, but in most cases they changed their attitude about smoking and reduced their consumption of cigarettes. After one year, 43% of the subjects were still abstinent.

Shock therapy is used in the Schick Shadel treatment program for addictions.
Hypnosis
Hypnotherapy appears to be most effective in combination with other support and treatment options. Hypnotherapy can often help with pain control and in overcoming habits, such as smoking or overeating. It also might be helpful for people whose symptoms are severe or who need crisis management.

Few rigorous studies with control groups have been done to validate the effectiveness of hypnotherapy. Most studies reported in the literature are comprised of relatively few subjects; real hypnotherapy is often done one-on-one, not on stage in a public performance. And, most results use subject statements of abstinence rather than biochemical measures of smoking cessation.

Discovery Channel Program on Hypnosis: Open to Suggestion - Part 1

To see the rest of the Discovery program visit Open to Suggestion.
For more information on a successful quit smoking hypnosis program with no withdrawal symptoms and no weight gain please visit Quit Smoking In A Flash.
Acupuncture
Acupuncture traditionally involved inserting needles in the body for about 20 minutes several times a week. Various points on the body are claimed to be related to internal organs and areas of the mind. Sometimes a small electrical current is applies to the needles.

In some settings needles are replaced by applied pressure and even laser light. The theory is that acupuncture helps release endorphins and enhance neurotransmitters so your smoking cessations symptoms are reduced.

The latest Cochrane Review of acupuncture (October 24, 2005) indicates that this therapy does "not appear to help smokers who are trying to quit."

Now Let's Quit Smoking

Overall, there are many techniques you can use to help you quit smoking. Many people use several methods during a quit attempt. Most all prepare for their target quit date by planning coping strategies to deal with symptoms of cessation. They also enlist a support network of family and friends who can encourage them and celebrate their success.

Some combinations of methods may include:

Fading then Pharmacologicals: Reduce nicotine and tar by weekly switching brands to one with about 20% lower levels of tar and nicotine; this reduces your level of addiction. When you feel you cannot reduce nicotine any further, begin a program with varenicline or bupropion along with the nicotine patch or nicotine inhaler.
Pharmacologicals: Depending on your level of dependence, you may need to combine several pharmacological options. Many people succeed with Varenicline or Bupropion alone. If you are more dependent, you can also use the nicotine patch or the nicotine inhaler.
Behavioral Support and Pharmacologicals: Attending aversion therapy sessions or using hypnosis in conjunction with the nicotine patch or other pharmacologicals can be helpful.

References

Hayden McRobbie, Peter Hajek, Effects of rapid smoking on post-cessation urges to smoke, Addiction 102 (3), 483-489.
Danaher, Brian G., Rapid Smoking and Self-control in the Modification of Smoking Behavior, Journal of Consulting and Clinical Psychology, 45, 6, 1068-74, Dec 77
E. J. Houtsmuller, M. L. Stitzer, Manipulation of cigarette craving through rapid smoking: efficacy and effects on smoking behavior,Psychopharmacology Volume 142, Number 2 / February, 1999
Foxx RM & Brown RA, Nicotine Fading and Self-Monitoring for Cigarette Abstinence or Controlled Smoking, Journal of Applied behavior Analysis 12(1) 111-125
Hughes JR & Carpenter MJ, The feasibility of smoking reduction: an update, Addiction 100(8), 1074,1089
Coleman T, ABC of smoking cessation: Use of simple advice and behavioural suport, BMJ 328, February 2004.
Wu P, Kumanan W, Popey D & Mills EJ, Effectiveness of smoking cessation therapies: a systematic review and meta-analysis, BMC Public Health December 11, 2006
Okuyemi KS, Nollen NL & Ahluwalia JS, Interventions to Facilitate Smoking Cessation, American Family Physician 74(2) 262-271
Green J & Lynn SJ, Hypnosis and Suggestion-Based Approaches to Smoking Cessation: An Examination of the Evidence, The International Journal of Clinical and Experimental Hypnosis, 48(2) 195-224
Villano LM & White RA, Alternative therapies for tobacco dependence, Medical Clinics of North America 88 (2004) 1607-1621
M. A. Hamilton Russel, Effective of Electric Aversion on Cigarette Smoking, British Medical Journal, 1, 1970, 82-86.

How to Quit Smoking