Women's Health
FAQ065, June 2014



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It's Time to Quit Smoking

What are the dangers of smoking?

Smoking is a leading cause of death in women. Lung cancer causes more deaths in women than any other type of cancer, including breast cancer and ovarian cancer. Another smoking-related disease, heart disease, is currently the number one killer of women in the United States. Death occurs earlier in women who smoke. On average, female smokers die 12 years earlier than female nonsmokers.

How does smoking affect the body?

With each puff of a cigarette, your body is exposed to more than 7,000 chemicals. Hundreds of these chemicals are toxic. About 70 are carcinogens. The chemicals in cigarette smoke move from your lungs to your blood. The blood in your arteries carries these chemicals to every organ in your body. When you smoke, it damages your body right away. Smoking even one cigarette is not safe.

Can smoking affect my appearance?

Smoking can make you look and feel older. Smokers tend to develop wrinkles earlier than nonsmokers. A smoker’s teeth, fingers, and nails may be stained from tobacco smoke. Because smoking depletes the body of oxygen, a smoker’s skin may appear pale or gray. Smokers tire easily and are not able to be as physically active as nonsmokers. All of these factors can make smokers look years older than they actually are.

How is secondhand smoke harmful?

People who are around smokers may develop health problems from being exposed to secondhand smoke. In children, secondhand smoke has been linked to asthma, lung infections such as bronchitis and pneumonia, and middle ear infections. Infants exposed to secondhand smoke are at increased risk of sudden infant death syndrome (SIDS).

What are some reasons to quit smoking?

Quitting smoking is one of the best things you can do for your health and your family’s health. Additional reasons to quit include the following:

  • You will look better and have more energy.
  • Tobacco stains will fade from your teeth, nails, and hands.
  • You will have more money in your pocket.
  • You will be free from having to find a place to smoke.
  • You will never have to worry about running out of cigarettes.
  • The smell of cigarettes will fade from your clothes, car, and home.
  • You will set a good example for your children and others.

How do I begin to quit smoking?

Some people quit smoking without planning. Others need to plan to quit smoking. Follow these steps to help you get started:

  • Decide that you want to quit. Avoid thinking about how hard it might be. Instead, imagine your life free of cigarettes.
  • Find a support group. People who get support from others online, on the phone, with a counselor, or in groups have a better chance of success.
  • Focus on your reasons for quitting—to improve your health, protect your family, or save money. These reasons will help keep you going.
  • Tell your family and friends that you plan to stop smoking. Get their support. If they smoke, you may want to ask them to quit too. It may help to have a friend quit with you.
  • Find out about products that are available to help you quit smoking.
  • Know what to expect when you quit. Learn how to handle urges to smoke and the stress that comes along with quitting. Know what your “triggers” to smoke are and think about the ways you will deal with these triggers when you no longer smoke.
  • Set a target date for quitting. Choose a date that is in the near future—a few days or weeks. Mark the date on your calendar.  Setting a date will help you keep track of the exact day you became a nonsmoker—a date you can celebrate each year.
  • Tell your health care provider that you are quitting smoking. Smoking is a physical addiction. Your health care provider can help you design a quit plan that has the best chance of working for you.

What withdrawal symptoms should I expect when I quit smoking?

The first week after quitting is the hardest time. You may feel irritable, anxious, and hungry. You may have trouble sleeping. You may feel dizzy or drowsy and have headaches. These withdrawal symptoms may begin within a few hours, peak in 2–3days, and last up to a month.

What are nicotine replacement products?

Nicotine replacement products release nicotine into your body, but without the harmful chemicals found in tobacco. These products help relieve cravings and withdrawal symptoms while you get used to life without smoking. They are available in a special chewing gum, lozenge, skin patch, nasal spray, or inhaler.

Do I need a prescription for nicotine replacement products?

You can buy some of these products over the counter. Others require a prescription. Certain health insurance plans cover the cost of nicotine replacement products. Your health care provider can help you decide which product is right for you.

Can I use nicotine replacement products if I am pregnant?

Nicotine replacement products have not been adequately studied in pregnant women. If you are pregnant, you should use these products only with the close supervision of your health care provider.

What is bupropion?

Bupropion is an antidepressant. It helps reduce both the urge to smoke and withdrawal symptoms. It must be prescribed by your health care provider. The treatment begins 2 weeks before your quit date. Treatment usually lasts about 7–12 weeks, but it can last longer if necessary. Bupropion can be used with nicotine replacement therapy. Possible side effects include dry mouth, difficulty sleeping, dizziness, headaches, and skin rashes.

What is varenicline?

Varenicline is another drug that is prescribed to people who are trying to quit smoking. This drug blocks the pleasant effects of nicotine on the brain, which can help break the addiction cycle. The treatment begins 1 week before your quit date. Treatment lasts 12 weeks. Possible side effects include unusual dreams and stomach upset.

Are there any serious side effects of using buproion or varenicline?

Both bupropion and varenicline have been linked to depression, changes in behavior, hostility, agitation, and thoughts of suicide. If you experience changes in behavior or suicidal thoughts while taking either drug, stop taking the medication and report your symptoms to your health care provider.

Are bupropion and varenicline safe to use during pregnancy?

Varenicline has not been studied in pregnant women. Information about bupropion is limited but it does not appear to cause problems in pregnancy. Both drugs can be passed to your baby in breast milk. Most experts recommend using these drugs during pregnancy only if the benefits of quitting outweigh their possible risks to your pregnancy.

Is it normal to feel depressed once I have quit smoking?

Quitting smoking can unmask undiagnosed depression. Many smokers are unaware that they have depression and that they are using nicotine as a self-treatment. Signs and symptoms of depression include feeling sad, lack of interest in activities you used to enjoy, and sleeping too much or having trouble falling asleep. These feelings happen nearly every day and last for at least 2 weeks. If you think you have depression, contact your health care provider. There are treatments that can help you feel better. If you have thoughts of suicide, seek help right away.

Glossary

Antidepressant: A medication that is used to treat depression.

Carcinogens: Substances that promote cancer.

Depression: Feelings of sadness for periods of at least 2 weeks.

Sudden Infant Death Syndrome (SIDS): The unexpected death of an infant in which the cause is unknown.

If you have further questions, contact your obstetrician–gynecologist.

FAQ065: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright June 2014 by the American College of Obstetricians and Gynecologists