Staying Tobacco-free After You Quit

Nicotine is the main addictive substance in tobacco. When a person uses tobacco, many parts of the body get used to having nicotine in them. When a person quits tobacco, they also quit nicotine and will likely have withdrawal from it. This is because the body has to get used to not having nicotine.

Dealing with withdrawal

Withdrawal can be uncomfortable. Withdrawal from nicotine has 2 parts – the physical and the mental. The physical symptoms are annoying but not life-threatening. Still, if you’re not ready to resist them, they can tempt you to go back to smoking or chewing. Nicotine replacement and other medicines can help reduce many of these symptoms. Most people who use tobacco find that the mental part of quitting is the bigger challenge.

If you’ve been using tobacco for any length of time, it has become linked with a lot of the things you do – waking up in the morning, eating, reading, watching TV, and drinking coffee, for example. It will take time to “un-link” tobacco from these activities. This is why, even if you’re using nicotine replacement therapy, you may still have strong urges to smoke or chew.

Rationalizations are sneaky

One way to overcome urges or cravings is to notice and identify rationalizations as they come up. A rationalization is a mistaken thought that seems to make sense at the time, but isn’t based on reality. If you choose to believe in such a thought even for a short time, it can serve as a way to justify using tobacco. If you’ve tried to quit before, you might recognize many of these common rationalizations:

• “I'll just do it once to get through this rough spot.”
• “Today isn’t a good day. I’ll quit tomorrow.”
• “It’s my only vice.”
• “How bad is smoking/chewing, really? Uncle Harry smoked/chewed all his life and he lived to be over 90.”
• “Air pollution is probably just as bad.”
• “You’ve got to die of something.”
• “Life is no fun without tobacco.”

You may be able to add more to the list. As you go through the first few days without tobacco, write down rationalizations as they come up and recognize them for what they are – messages that can trick you into going back to smoking/chewing. Look out for them, because they always show up when you’re trying to quit. After you write down the thought, let it go and move on. Be ready with a distraction, a plan of action, and other ways to re-direct your thoughts.

Use these ideas to help you stay committed to quitting

• Avoid temptation. Stay away from people and places that tempt you to smoke or chew. Later on you’ll be able to handle these with more confidence.
• Change your habits. Switch to juices or water instead of alcohol or coffee. Choose foods that don’t make you want to smoke or chew. Take a different route to work. Take a brisk walk instead of a tobacco break.
• Choose other things for your mouth: Use substitutes you can put in your mouth like sugarless gum or hard candy, raw vegetables such as carrot sticks, or sunflower seeds. Some people chew on a coffee stirrer or a straw.
• Get active: Do something to reduce your stress. Exercise or do something that keeps your hands busy, such as needlework or woodworking, which can help distract you from the urge to use tobacco. Clean out a closet, vacuum the floors, go for a walk, or work in the yard.
• Breathe deeply: When you were smoking, you breathed deeply as you inhaled the smoke. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remind yourself of your reasons for quitting and the benefits you’ll gain when you do. Deep breathing may help you also remember that you’re cleaning the toxins from tobacco out of your body.
• Delay: If you feel that you’re about to light up, hold off. Tell yourself you must wait at least 10 minutes. Often this simple trick will allow you to move beyond the strong urge to smoke. This works for smokeless tobacco too: wait 10 minutes until the urge lessens.
• Reward yourself. What you’re doing isn’t easy, and you deserve a reward. Put the money you would have spent on cigarettes or tobacco in a jar every day and then buy yourself a weekly treat. Buy a book or some new music, go out to eat, start a new hobby, or join a gym. Or save the money for a major purchase.

You can also reward yourself in ways that don’t cost money: Visit a park or go to the library. Check local news listings for museums, community centers, and colleges that have free classes, exhibits, films, and other things to do.

Staying tobacco-free

Maybe you’ve quit many times before. If so, you know that staying quit is the final, longest, and most important stage of the process. You can use the same methods as you did to help you through withdrawal. Think ahead to those times when you may be tempted to smoke or chew, and plan on how you’ll use other ways to cope with those situations.

More dangerous, perhaps, are the unexpected strong desires to smoke or chew that can sometimes happen months or even years after you’ve quit. Rationalizations can show up then, too. To get through these without relapse, try these:

• Remember your reasons for quitting and think of all the benefits to your health, your finances, and your family.
• Ask your tobacco-using friends for support. Tell them to NOT share their cigarettes or tobacco with you – no matter what!
• Remind yourself that there is no such thing as just one dip or one cigarette – or even just one puff.
• Ride out the desire to smoke or chew. It will go away, but don’t fool yourself into thinking you can have just one.
• Avoid alcohol. Drinking lowers your chance of success.
• If you’re worried about weight gain, put some energy into planning a healthy diet and finding ways to exercise and stay active.
• Keep getting the counseling and support that’s helped you so far.

Recovering from slips

What if you do smoke or chew? Here’s the difference between a slip and a relapse: A slip is a one-time mistake that’s quickly corrected. A relapse is going back to using tobacco. You can use the slip as an excuse to go back, or you can look at what went wrong and renew your commitment to staying away from cigarettes and/or smokeless tobacco for good.

Even if you do relapse, try not to get too discouraged. Very few people are able to quit for good on the first try. In fact, it takes most people several tries. What’s important is figuring out what helped you when you tried to quit and what worked against you. You can use this information to make a stronger attempt at quitting the next time.

Weight gain after quitting smoking

Some people who smoked cigarettes gain weight when they quit. For some, this is enough of a concern to make them decide not to quit. But the weight gain that follows quitting is usually small. Even when nothing is done to try to prevent it, the average gain is less than 10 pounds in most studies. Remember that it’s much more dangerous to keep smoking than it is to gain a small amount of weight.

You’re more likely to quit tobacco for good if you deal with the smoking first, and then later take steps to lose weight. While you’re quitting, try to focus on ways to help you stay healthy, rather than on your weight. Stressing about your weight may make it harder to quit. Get regular physical activity. Try to follow a healthy eating pattern, which includes a variety of colorful fruits and vegetables and whole grains, and which avoids or limits red and processed meats, sugar-sweetened beverages, and highly processed foods. Be sure to drink plenty of water and get enough sleep.

Try walking. Walking is a great way to be physically active and increase your chances of not smoking. Walking can help you by:

• Reducing stress
• Burning calories and toning muscles
• Giving you something to do instead of thinking about smoking

All most people need for walking is a pair of comfortable shoes is, and most people can walk pretty much anytime. You can use these ideas as starting points and come up with more of your own:

• Walk around a shopping mall
• Get off the bus one stop before you usually do
• Find a buddy to walk with during lunch time at work
• Take the stairs instead of the elevator
• Walk with a friend, family member, or neighbor after dinner
• Push your baby in a stroller
• Take your dog (or maybe a neighbor’s) out for a walk

The American Cancer Society recommends getting 150-300 minutes of moderate intensity or 75-150 minutes of vigorous physical activity each week. Getting more is even better. But if you don’t already exercise regularly, check with your health care provider before you start.

Managing stress after quitting tobacco

Tobacco users often mention stress as one of the reasons for going back to using. Stress is part of life for people who use tobacco and for those who don’t. The difference is that people who use tobacco use nicotine to help cope with stress and unpleasant emotions. When quitting, you have to learn new ways of handling stress. Nicotine replacement can help for a while, but over the long term you’ll need other methods.

As mentioned before, physical activity is a good stress-reducer. It can also help with the short-term sense of depression or loss that some people have when they quit. There are also stress-management classes and self-help books. Check your community newspaper, library, or bookstore.

Spirituality can give you a sense of purpose and help you remember why you want to stay tobacco-free. Spiritual practices involve being part of something greater than yourself. For some, this includes things like religious practices, prayer, or church work. For others, it may involve meditation, music, being outside in nature, creative work, or volunteering to help others.

Think about how you can deal with stress and not use tobacco. Look at the resources around you and plan on how you will handle the stressors that will come your way.

Taking care of yourself

It’s important for your health care provider to know if you use any type of tobacco now or have in the past, so that you’ll get the preventive health care you need. It’s well known that using tobacco puts you at risk for certain health-related illnesses, so part of your health care should focus on related screening and preventive measures to help you stay as healthy as possible.

For instance, regularly check the inside of your mouth for any changes. Have your doctor or dentist look at your mouth, tongue, gums, and throat if you have any changes or problems. This way, you may find changes such as leukoplakia (white patches on the mouth tissues) early, and maybe prevent oral cancer or find it at a stage that’s easier to treat.

Smokers should also be aware of any of these changes:

• Change in cough
• A new cough
• Coughing up blood
• Hoarseness
• Trouble breathing
• Wheezing
• Headaches
• Chest pain
• Loss of appetite
• Weight loss
• General tiredness
• Frequent lung or bronchial infections

Any of these could be signs of lung cancer or a number of other lung problems and should be reported to a health care provider right away.

Lung cancer screening is recommended for people at high risk due to smoking history. ACS recommends that adults aged 50-80 receive annual screening with a low-dose computed tomography (LDCT) scan if they currently smoke or used to smoke in the past and have a smoking history of 20 or more pack years. If this describes you, talk with your health care provider about your lung cancer risk and the potential benefits and risks of lung cancer screening. You can learn more about the ACS guideline for early detection of lung cancer to prepare you for a discussion with your health care provider.

Remember that tobacco users have a higher risk for many cancers, not only lung cancer. If you have any health concerns that may be related to your tobacco use, please see a health care provider as soon as possible. Taking care of yourself and getting treatment for problems early on will give you the best chance for successful treatment. But the best way to take care of yourself and decrease your risk for life-threatening health problems is to quit using tobacco.