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Tips & strategies for quitting smoking (plain-text)

Presented by the Sunnybrook Health Sciences Centre Interprofessional Smoking Cessation Team

This is a plain-text version of our smoking cessation module. Click here to view the interactive version.

Quitting: the basics

  • If you smoke, chances are you’ve tried to quit in the past
  • You have probably tried several times
  • Quitting is challenging; starting again is NOT a failure
  • Making a "quit plan" can help you quit for good

Why do people smoke?

".. to relax; for the taste; to fill the time; something to do with my hands...."

But, for the most part, people continue to smoke because they find it too uncomfortable to quit.

Tobacco addiction

  • Nicotine reaches the brain in 15-30 seconds
  • Heroin (smoked) reaches the brain in 10-15 minutes
  • When nicotine reaches the brain it releases dopamine
  • Dopamine causes a feel good sensation
  • Nicotine is a very addictive drug

Self-check #1

Is the following statement true or false?

"Tobacco is addictive, but NOT as addictive as heroin or cocaine."

That statement is false. Tobacco is more addictive than heroin and cocaine.

About the chemicals in tobacco

Tobacco smoke contains over 4,000 chemicals, including 70 cancer-causing agents.

Cigarettes contain chemicals found in:

  • Insecticide
  • Toilet cleaner (ammonia)
  • Paint
  • Rocket fuel (methanol)
  • Carbon monoxide
  • Poison (arsenic)
  • Vinegar (acetic acid)
  • Lighter fluid (butane)
  • Batteries (cadmium)
  • Candle wax (stearic acid)
  • Industrial solvent (toluene)
  • Barbeque lighter (hexamine)

Products that contain tobacco include:

  • Cigarettes
  • Cigars
  • Bidis
  • Hookah
  • Snuff
  • Smokeless tobacco
  • Cigarillos

Self-check #2

Which of the following chemicals can be found in cigarettes?

  • Batteries
  • Insecticide
  • Sewer gas
  • Rat poison
  • The correct answer is "All of the above of chemicals are found in cigarettes"

What are the benefits of quitting?

Living tobacco free is the most important thing you can do for your health

  • Save money
  • Enhance sense of taste
  • Look and feel younger
  • Increase energy
  • No more yellow teeth
  • Be a good role model
  • Be free

Health benefits of quitting

Within minutes:

  • After 20 minutes:
    • Blood pressure drops and pulse returns to normal.
    • Temperature of hands and feet stabilize.

Within hours:

  • After 8 hours: Carbon monoxide level in blood drops
  • After 24 hours: Your chance of having a heart attack decreases
  • After 48 hours: The amount of air your lungs can take in increases and breathing becomes easier

Within months:

  • 2 weeks to 3 months:
    • Your circulation improves
    • Walking and breathing becomes easier
  • 1 to 9 months:
    • Coughing, sinus infection, fatigue, and shortness of breath may decrease

Within years:

  • 1 year
    • Risk of heart disease is cut in half
    • Risk of smoking-related heart attack is cut in half
  • 10 years
    • Risk of dying from lung cancer is cut in half
  • 15 years
    • Risk of dying from a heart attack is the same as someone who never smoked

It is never too early or too late to quit smoking

When you quit

  • Wounds from surgery may heal faster
  • Less chance of infection and bleeding after surgery
  • Radiation and chemotherapy treatments may be more effective

Self-check #3

Is the following statement true or false?

"The benefits of quitting take a long time." 

That statement is false. The benefits of quitting do not take long.

Getting ready to quit

Important things to consider:

  • Quitting is a process, not an event
  • Smoking is an automatic behaviour: you may not always be aware of reaching for a cigarette
  • One pack of cigarettes per day equals 110,000 hand to mouth repetitions per year
  • Smoking is linked with many behaviours: waking up, eating, drinking alcohol/coffee, driving
  • Smoking is linked with social events: breaks at work, parties, friends’ homes

Make a quit plan

Making a plan will increase your success

Consider:

  • What is your goal?
  • What are your reasons for quitting?
  • You likely have had success in being tobacco-free before.What helped you?
  • Who will support you in this process?

Ask yourself:

  • Why do I smoke?
  • What does a cigarette do for me?
  • Do I really enjoy it?
  • Do I really need to smoke?
  • What might be good about not smoking?

Step 1: Set a quit date

  • Start thinking about a quit date that will work for you
  • Consider choosing a Monday or a weekend to begin your quit attempt
  • What is YOUR Quit Date?

Step 2: Consider a quit smoking aid

Examples of smoking aids include:

  • Patch
  • Lozenge
  • Pills
  • Gum

Nicotine replacement therapy (NRT)

What do we know about nicotine replacement therapy?

  • NRT helps to minimize cravings and withdrawal symptoms
  • NRT can double your chance of quitting
  • NRT is a clean method of nicotine delivery without additional toxins
  • No prescription needed
  • NRT is a safe and effective treatment when taken as directed

Patch

  • Delivers a continuous amount of nicotine through the skin

Gum

  • Provides partial substitution for the nicotine in cigarettes
  • Gum is not chewed continuously
  • Multiple pieces of gum per day can be used to manage immediate cravings with quick relief

Lozenge

  • Used for the reduction of nicotine withdrawal symptoms including cravings

Inhaler

  • Releases nicotine in the form of vapor when air is inhaled through the inhaler
  • May provide some degree of comfort by providing a hand-to-mouth ritual similar to smoking

Prescription medications

Zyban (Bupropion)

  • Pill form taken 2x daily for 8-12 weeks
  • Begin taking pill 2 weeks before quitting
  • Helps reduce nicotine cravings by balancing chemicals in your brain
  • Can double quit rates

Champix (Varenicline)

  • Pill form taken 2x daily for 12 weeks
  • Helps reduce nicotine cravings
  • Helps reduce the satisfaction you get from smoking

Speak to your Health Care Provider to see if this treatment is right for you

Pharmacy support

  • Ask your local pharmacy if they provide the QUIT
    • (Quit Using and Inhaling Tobacco) program
  • Sunnybrook M1 Pharmacy offers the QUIT Program — no referral needed
    • Call first to register at (416) 480-4502
  • Provide 9 free counseling sessions over 1 year (in person/email/telephone)

Step 3: Obtain support

  • Who will support your quit attempt? 
  • Who may not want you to quit?
  • What might be their reasons?
  • Connect with Smokers’ Helpline
  • Speak to your health care professionals
  • How to support a friend or family member in a quit attempt:
    • Let your friend/loved one choose their own quit date.
    • Help them make their home and their car tobacco-free.
    • Ask your friend/loved one what would be most helpful.
    • Don't offer them cigarettes or smoke in front of them.
    • Don't make fun of their preparations for quitting and/or how they deal with cravings.

Step 4: Strategize and prepare for your quit date

  • Start to reduce your daily tobacco use prior to your quit date
  • You may want to try a “quit morning
  • Make your home and car tobacco-free prior to your quit date.
  • Avoid spending time with people who smoke
  • Stock up on oral substitutes (gum, carrot sticks, hard candy, water)

What are your "triggers?"

  • Think about times during the day when you normally smoke:
    • When you wake up
    • Driving
    • Breaks at work
    • Socializing
  • What could you do instead?

Quit day - you can do it!

  • Throw out all cigarettes, matches, lighters, ashtrays
  • Keep yourself busy during times you normally would smoke
  • Consider nicotine replacement therapy
  • Connect with Smokers’ Helpline
  • Be aware of withdrawal symptoms

What to expect & withdrawal symptoms

  • You can expect to feel nicotine withdrawal symptoms
  • They are worse for the first 3-4 days
  • Symptoms can last 2-3 weeks
  • Common symptoms can include:
    • Sleep disturbance,
    • Poor concentration,
    • Cravings for nicotine,
    • Increased appetite,
    • Depression.

*Speak to your Health Care Provider if you are having some of these effects

Reduce your caffeine intake

Caffeine concentrations can double after you quit:

If you drink 1 cup of coffee:

  • It will feel like you had 2
  • If you drink 2 cups of coffee
  • It will feel like you had 4

This might explain why you are feeling jittery!

Dealing with cravings

Remember the 5 “D”s:

  1. Delay: The urge will pass!
  2. Deep breathing: Taking time to relax can help you manage your cravings.
  3. Drink water: Drinking 6-8 glasses a day can help you flush out toxins and hydrate your body.
  4. Do something: Go for a walk, chew carrot sticks, brush your teeth. You CAN get through the craving.
  5. Dialogue: Call Smokers’ Helpline or talk to a friend for support.

Step 5: How to stay quit

  • Quitting smoking is the single best thing you can do to improve your health
  • Each day will get easier
  • Cravings and withdrawal symptoms will decrease
  • Begin to enjoy life without smoking
  • Now is the time to consider making other healthy changes in your life

Closing words

  • Quitting is a process that happens over time
  • Good motivation will carry you far
  • Many people have tried to quit several times before they are successful
  • Quitting smoking is difficult but it is possible

* Remember, quitting smoking is the single most important thing you can do for your health!

Thinking about quitting? We can help

  • Speak to a member of your healthcare team
  • Visit the Patient Education and Research Learning Centre (PEARL) – Odette Cancer centre, 1st floor
  • Register for our monthly “Quit Smoking Tips” class by calling 416-480-4534 or at patienteducation@sunybrook.ca

Have a question? Email us at smokingcessation@sunnybrook.ca

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