This pamphlet will:

Help you take the steps to quit Show you how to beat the cravings Tell you what to expect when you quit

Your decision to quit smoking is one of the best things you can do for yourself and your family.

About Cigarettes and Smoking

With each puff of a cigarette, a smoker's body is exposed to more than 2,500 chemicals. Many of these chemicals are known to cause cancer. For instance, cigarettes contain:

• Nicotine—a highly addictive drug
• Carbon monoxide—the poisonous gas in car exhaust fumes
• Tar—a gummy substance used to pave roads

Smoking is the most preventable cause of illness and death. It doubles the risk of heart disease and cancer of the cervix in women. Women who smoke are 12 times more likely to get lung cancer than women who have never smoked. Smoking increases the risk of many other cancers as well.

Smoking is linked with reproductive problems such as infertility and early menopause. Also, people (especially children) around smokers suffer health problems from being exposed to second-hand smoke.

How Can I Quit?

Here are some ways to help you quit smoking for good. No matter how long you have been smoking, quitting has benefits.

Getting Started

Follow these steps to help you get started:

• Decide that you want to quit. Try to avoid thinking about how hard it might be. Instead, imagine your life smoke-free.
• 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.
• Know what to expect when you quit. Learn how to handle urges to smoke and the stress that comes along with quitting.
• Set a target date for quitting. This may make it easier to keep your promise. Your target date can be your birthday, an anniversary, or any other day. Mark the date on your calendar. This also will help you keep track of the exact day you became a nonsmoker—a date you can celebrate each year.

Nicotine Replacement Products

To help you quit, you may want to try nicotine replacement products. Using one of these products almost doubles your chances of quitting.

Nicotine replacement products release nicotine into your body. This can provide relief of cravings and withdrawal symptoms while you get used to life without smoking. They are available in a special chewing gum, skin patch, nasal spray, or inhaler.

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

You should never smoke when using nicotine replacement products. It could cause a stroke or heart problems.

If you smoke and are pregnant or breastfeeding, ask your doctor to help you quit smoking. You should not use nicotine replacement products unless your doctor says they are safe for you and your baby.

Nicotine Replacement Products One of the nicotine replacement options listed here may help you quit smoking. Discuss your dosage level with your doctor. Patch The patch method can be used for up to 8 weeks. As soon as you wake up each morning, place a new patch on a smooth, flat place on your body between your waist and your neck. Each day, place the patch on a new spot on this area of your body. This will help prevent a rash. There are a number of types of patches. Some can only be bought with a prescription. Others can be bought over-the-counter. Talk to your doctor about which one is best for you. Gum You should never smoke when using nicotine replacement products. It could cause a stroke or heart problems. Chew at least one piece of nicotine gum every 1–2 hours for at least 1–3 months for the best results. Following a schedule will help you get the most benefit out of nicotine gum. The gum must be chewed slowly, until a "peppery" taste comes out. You should then "park" it between your cheek and gum. You should chew and "park" off and on for about 30 minutes. Side effects of the gum include hiccups, upset stomach, or sore jaw. In most cases, these side effects go away if the gum is used the right way. You do not need a prescription to buy this gum. Inhaler The inhaler is shaped like a cigarette holder. When you inhale, nicotine is absorbed through the tissues of your mouth. It can be used up to 16 times each day for 3 months. The dosage then should be decreased. It should not be used longer than 6 months. Side effects of the inhaler include a cough and mouth and throat irritation. The inhaler must be prescribed by a doctor. Nasal Spray Nicotine nasal spray must be prescribed by a doctor. The inhaled spray sends nicotine through the nasal passages into the bloodstream. The nasal spray should be used no longer than 6 months. Side effects of nasal spray include nasal and sinus irritation.

Other Products

Another product your doctor may suggest to help you quit smoking is bupropion hydrochloride tablets. These tablets are antidepressants and must be prescribed by your doctor. This medication helps reduce the urge to smoke and withdrawal symptoms (such as feeling nervous and getting angry over little things). The treatment begins 2 weeks before your quit date. Treatment lasts about 7–12 weeks.

Side effects of this medication include dry mouth, trouble sleeping, feeling shaky, and skin rash. If you are taking another antidepressant, you should not use these tablets to help you quit smoking.

Quitting Day

When the target date comes, throw away all your cigarettes. Clean your clothes to get rid of the cigarette smell.

Try to keep busy on your quitting day—exercise, go to the movies, or take long walks. It may help to spend most of your free time in places where smoking is not allowed, such as a library, store, or museum. Remind your family and friends that this is your quitting day. Ask them to help you through the first week or so—it is the hardest.

After You Quit Smoking

Once you stop smoking, there will be times when you feel you must have a cigarette. When you feel these urges, take steps to control them. Intense cravings only last a short time. By thinking about something else, you can keep your mind away from the cravings. Try using substitutes to keep the cravings down (see box).

Cigarette Substitutes When you miss having a cigarette, resist the temptation by trying these instead: Put something else in your mouth: Carrot sticks Sugarless gum Sunflower seeds Hard candy Keep your hands busy by playing with a: Pencil Paper clip Small rubber ball Computer mouse Rubber band Do activities that make smoking hard: Take a shower Exercise Clean the house Wash the car Paint your nails Focus on something else: Do crossword puzzles Take 10 slow deep breaths

If you have a cigarette, don't be too hard on yourself. One slip doesn't mean you've failed. It takes time and patience to quit a habit. Many people have to try more than once—and try more than one method—before they become ex-smokers. Find out what set you back, and try again.

If you feel you need extra help, ask for it. Your doctor can offer support and medical advice. Many people who can't stop smoking on their own get help by joining special programs. You can contact the local chapter of the American Lung Association, the American Cancer Society, or other local groups to help you quit. The groups are listed in the phone book.

Rewards of Quitting

When you quit smoking, the benefits start right away. Quitting reverses much of the damage caused by smoking. The odor of stale cigarette smoke will begin to fade from your clothes, car, and home. The smoke stains on your fingernails will go away. A person who stops smoking can reduce the risk of heart disease to the same level as someone who has never smoked at all. You'll also have the bonus of not spending your money on cigarettes. Reward yourself by buying something special with your savings.

Effects of Quitting

The Rewards of Quitting As soon as you stop smoking you will notice a change in your health: Within 12 hours of quitting Levels of carbon monoxide and nicotine in your system decrease quickly. Your heart and lungs begin to repair the damage caused by cigarette smoke. Within a few days of quitting Your sense of smell and taste may improve. Within 3 months of quitting Your circulation improves. You breathe easier. Your voice sounds less hoarse. Within 1 year of quitting Your risk of suffering a heart attack decreases by 50%. Within a few years of quitting Your risk of getting life-threatening diseases (for instance, lung cancer, cancer of the mouth, and heart disease) is reduced to nearly that of a nonsmoker.

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 feelings are known as withdrawal symptoms. Withdrawal symptoms may begin within a few hours, peak in 2–3 days, and last up to a month.

Your doctor can suggest ways to help you get through the withdrawal stage. Nicotine replacement products may help.

What About Weight Gain?

Many people who are thinking about quitting worry about gaining weight. Keep in mind that the benefits of quitting far outweigh the drawbacks of gaining a few pounds.

If you're concerned about gaining weight after you quit, make sure you eat right. It is also good to start a regular exercise program. Exercise helps you feel better, keeps your weight down, and may help ease any withdrawal symptoms. Using nicotine gum also may help delay or prevent weight gain.

Finally...

Tips to Keep Your Weight Down When You Quit Follow a regular exercise program. Make sure you have a well-balanced diet with the right amounts of protein, carbohydrates, and fat. Drink a glass of water before each meal. Have low-calorie foods for snacks—fruits and vegetables, fruit juices, or Plan menus with care and count calories.

Your decision to quit smoking is one of the best things you can do for yourself and your family. Talk to your doctor—he or she can help you live tobacco-free.

Glossary

Cervix: The lower, narrow end of the uterus, which protrudes into the vagina.

Infertility: A condition in which a couple has been unable to get pregnant after 12 months without the use of any form of birth control.