How to Quit Smoking

close up of a hand motioning to refuse a cigarette from someone offering one from a pack

Tobacco use remains the single largest preventable cause of disease and premature death in the United States. Since the release of the Surgeon General’s Report on Smoking and Health 50 years ago, there have been 20 million deaths due to tobacco. Almost half the deaths from 12 different types of cancer combined – including lung, voice box, throat, esophagus, and bladder cancers – are attributable to cigarette smoking alone.

In addition to cancer, smoking greatly increases the risk of debilitating long-term lung diseases like emphysema and chronic bronchitis. It also raises the risk for heart attack, stroke, blood vessel diseases, and eye diseases. Half of all smokers who keep smoking will eventually die from a smoking-related illness.

That’s why it’s so important to quit. And no matter how old you are or how long you’ve smoked, quitting can help you live longer and be healthier. But quitting is hard, mostly because nicotine, a drug found naturally in tobacco, is so addictive. It’s as addictive as heroin or cocaine. Even so, millions of Americans have quit, and you can too. People have used many different methods to quit. Here is what the research tells us about how well they work:

Medications

Research shows that using a medication to help you quit smoking can double your chances of being successful.

The US Food and Drug Administration (FDA) has approved 7 medications to safely and effectively help people quit smoking. Choosing which one to use is often a matter of personal choice and should be discussed with your pharmacist or health care provider.

Three of these medications are available over-the-counter at most pharmacies and can be helpful in easing the symptoms of nicotine withdrawal when used as directed.

  • Nicotine gum
  • Nicotine patches
  • Nicotine lozenges

Four other medications are available by prescription.

  • Nicotine inhalers
  • Nicotine nasal sprays
  • Zyban (bupropion) – an antidepressant
  • Chantix (varenicline) – a drug that blocks the effects of nicotine in the brain

Counseling

Counseling combined with medication makes it even more likely than using medication alone that you can quit smoking and stay away from tobacco for good. Counseling comes in many forms.

  • In-person counseling is available from a doctor, nurse practitioner, pharmacist, or other health care providers.
  • Telephone quitlines: All 50 states and the District of Columbia offer some type of free, telephone-based program that links callers with trained counselors. People who use telephone counseling have twice the success rate in quitting smoking as those who don’t get this type of help. Call us at 1-800-227-2345 to get help finding a phone counseling program in your area.
  • Support groups have helped many smokers quit. Check with your employer, health insurance company, or local hospital to find a support group that fits your needs. Or call us at 1-800-227-2345.
  • Smokers who want to quit can also increase their chances of success by enlisting the help and support of family, friends, and co-workers. Tell your friends about your plans to quit. Try to spend time with non-smokers and ex-smokers who support your efforts. You can also suggest that those in your support system read Helping a Smoker Quit: Do’s and Don’ts.

Apps

Help to quit smoking is as close as your smartphone. But it’s important to choose a program that’s based on quit-smoking recommendations proven through research to be effective.

The Quit For Life® Program, provided by the American Cancer Society and Alere Health, offers a free smartphone app for iPhone and Android that offers daily tips and motivation, a cost-savings calculator, and a calendar to track your success.

The National Cancer Institute also has a quit-smoking app that allows users to set quit dates, track financial goals, schedule reminders, and more. It also offers a text messaging service that provides round-the-clock encouragement and advice to people trying to quit. You can sign up by texting “QUIT” to iQUIT (47848) and entering the date of your Quit Day – the day you will stop smoking.

Cold Turkey

Going cold turkey means that you stop smoking all at once. Even though ex-smokers often say they quit cold turkey, usually they had thought about stopping before they actually did it. It’s easier to quit this way if you smoke fewer than 10 cigarettes a day. Gradual withdrawal – smoking fewer cigarettes each day – can help reduce nicotine withdrawal symptoms and make it easier for some people to quit.

Electronic Cigarettes

Some users of e-cigarettes and other electronic nicotine delivery systems (ENDS) say these products have helped them quit smoking. But the evidence to date is only anecdotal, and it’s not always clear whether they mean they’ve quit all use of tobacco and nicotine, or they’ve simply switched from using conventional cigarettes to ENDS.

Marketers of e-cigarettes and other ENDS claim the ingredients are safe. But these products contain and emit addictive nicotine, flavorings, and a variety of chemicals, some known to be toxic or cause cancer - and research hasn’t yet established the level of potential risk posed by these unregulated and non-standardized products. And the FDA has not approved them as quitting aids.

According to Cliff Douglas, American Cancer Society vice president, tobacco control, the American Cancer Society cannot recommend that people use e-cigarettes, other ENDS, or any product that hasn’t gone through proper review and regulation for health and safety and been approved by the FDA. 

Just this year, the FDA began regulating e-cigarettes. Among the new requirements, manufacturers of ENDS will have to subject these products to the FDA's rigorous testing of proposed quit-smoking devices and medications if they are going to be marketed for this purpose.

Researchers are actively studying the long-term health effects of these devices. In the meantime, there are reasons to be cautious.

  • Many e-cigarettes are not labeled with their ingredients, so the user doesn’t know what’s in them. The amounts of nicotine and other substances a person gets from the wide variety of these devices are known to vary a great deal.
  • Manufacturers claim that the ingredients are safe, but such claims are not proven. Some of the ingredients found in ENDS might be harmful, although, in general, products that are not burned are not as harmful as conventional, combustible tobacco products.
  • E-cigarettes can lead to nicotine addiction, especially in young people who may be experimenting with them. They may lead kids to try other tobacco products, which we know cause life-threatening diseases. This is of particular concern, because the use of e-cigarettes among middle and high school students is rising rapidly, even while use of traditional tobacco products is declining.

Bottom Line

One of the most important things researchers have learned about quitting smoking is that the smoker needs to keep trying. It may take several serious attempts before a smoker can quit forever. Rather than looking at a slip back to smoking as a failure, it should be considered an opportunity to learn from experience and be better prepared to quit the next time.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.