By Thomas J. Glynn, PhD
"I think I can. I think I can. I know I can. I know I can." These words are a familiar refrain to the millions of Americans who want to quit smoking. We promise ourselves that this is the year that we are going to get healthier, to save more money, or to be nicer to our friends and family. But there are so many challenges - it's too cold or rainy to exercise, I need that dress or that app, and who could be nice to Uncle Jack?
Yet there is good news if you are among the 45 million American adults who is still a smoker. You can become healthier, save more money, and do something wonderful for your friends and family- you can stop smoking.
How can stopping smoking make you healthier? Short-term, the effects of stopping are immediate - your blood pressure drops, your blood begins to flow more smoothly, and your lungs begin to clear out. Long-term, your risk of 15 types of smoking-related cancers is reduced, and your risk of a variety of smoking-related heart and lung diseases begin to resemble those of a nonsmoker.
How can stopping smoking save you money? The average pack-a-day smoker in the U.S. spends more than $2000 a year on cigarettes (and double that in many states with higher taxes), and has significantly higher medical and dental bills -- even higher dry cleaning bills -- than a nonsmoker.
And how can stopping smoking make you nicer to your family and friends? Breathing in others' cigarette smoke - secondhand smoke - kills nearly 50,000 Americans each year and makes millions, including vulnerable children, sick. By not exposing your friends and family to your cigarette smoke, you are enabling them to be healthier, as well.
So there are plenty of reasons to make a resolution to stop smoking. But the question for many smokers is how do I stay away from cigarettes? We have all heard Mark Twain's observation that "Quitting smoking is easy - I've done it a thousand times" and most smokers just shake their heads ruefully and agree. Quitting smoking is hard and it takes time and effort. But think about the following:
• 70% of smokers say they want to quit
• More than 48 million Americans already have quit smoking
• At any given time, 1 out of 5 smokers is suffering from a tobacco-related illness such as chronic bronchitis, emphysema, or asthma, and
• Consider the alternative - not quitting can cost you a decade, 10 years, of life
Deciding to quit smoking seems easy, then - it can make you and loved ones healthier, it can save you money, and it can give you the precious gift of life - but actually doing it is where the real challenge begins. Fortunately, scientists, doctors, and other health care professionals have been studying for some time the best ways to help smokers stop and stay stopped - in other words, how to help them make and keep that vow to quit.
Smokers are certainly presented with a wide array of choices when it comes to quitting - cold turkey, stopping gradually, using approved medications, or a variety of other approaches such as hypnosis, acupuncture and even laser therapy. The U.S. Public Health Service, the U.S. Preventive Services Task Force, the U.S. Surgeon General, and many other experts have examined all of these choices and developed guidelines and advice about which of them are most likely to be effective in helping someone quit and stay quit - and which ones are not effective (hint: there is no scientific evidence that methods such as hypnosis, acupuncture, and laser therapy are effective ways of quitting). So the American Cancer Society has studied all of the scientific evidence and suggests the following approach to quitting and staying quit:
1) Think of your resolution to stop smoking as a project, a process that will take some time, and not one that is a snap decision or that will take only a few days. Remember, you are starting on a journey to health and greater prosperity, but also undoing a psychological and physiological habit that took many years to develop. It won't take that long to undo it, but it will take some time and effort. And you can do it.
2) Make a list of all the reasons you want to stop smoking - health, cost, family/friends, longer life, etc. - and keep that list (even laminate it) in your pocket at all times and take it out and review it whenever you are tempted to smoke.
3) Decide on a quit date - maybe a birthday (yours, or your spouse or partner's, or your child's) or an anniversary, maybe 3 or 4 weeks from the time you decide to become a nonsmoker (so you have time to prepare).
4) Enlist the help of your family (even Uncle Jack), friends, and co-workers in your project. Warn them that you will likely be cranky for a few weeks - after all, nicotine has been your friend for a long-time and friends like that are hard to give up - and ask them if you can call on them for support when you slip back to smoking or are tempted to do so. Share your list of reasons for quitting with them - it will help them support you.
5) Speak with your physician or your pharmacist about your plan - ask them for their advice and support and discuss with them whether one of the seven FDA-approved medications for quitting smoking (i.e. nicotine replacements, such as the gum or patch; Zyban, an antidepressant; or Chantix, which helps to block the effects of nicotine in your brain) might be useful for you. Alternatively, you can call the American Cancer Society toll-free information line at 1-800-227-2345 to be connected with a telephone quitline. You can ask their trained counselors for advice. And remember that science shows that the most successful quitters use a combination of advice and medications.
6) In the days just before your quit date, remove all smoking paraphernalia from the house and your workplace - extra packs of cigarettes, lighters, ashtrays, etc. - anything that would tempt you to slip.
7) Quit on the big day, and be sure to let your support group know. Use your medications, if you are using any, exactly as directed and for as long as directed.
8) Be prepared for some of the immediate, and often unpleasant, side effects of quitting - e.g. stomach upset, irritability, sleep disruption, coughing (as your lungs clear themselves out) - and understand that these are good signs, that your body is repairing itself and making adjustments as the toxins from your years of smoking begin to go away.
9) If you slip - as most smokers do, given that it usually takes 3, 4, 5, or even more attempts to fully quit - just analyze the situation in which your slip took place (e.g. a cigarette after dinner that you just had to have, a drink with friends after work on Friday night) - and adjust your routine for a couple of months to avoid the situations in which you are in danger of slipping.
10) Start thinking of yourself as a nonsmoker who is on the journey of a lifetime, one that certainly has its unexpected twists and turns, but with great rewards at the end.
Following these steps, challenging as they may be at times, will be the best thing you could do for yourself and your family - even Uncle Jack.
For more information, visit our guide to quitting smoking.
Thomas J. Glynn, MA, MS, PhD, is director of Cancer Science and Trends and director of International Cancer Control for the American Cancer Society.