Everything You Need To Know About Smoking Cessation

What is smoking cessation?

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What is smoking cessation? /

Smoking cessation is the process of quitting tobacco smoking. This process is characterized by challenging periods of withdrawal symptoms depending on the intensity of the nicotine addiction. Smoking cessation lowers the risk of cancer and other serious health problems caused by smoking tobacco. Despite the health benefits in the long-term, smoking cessation is a huge challenge for smokers. Even though over two thirds of smokers want to quit¹, the average quit success rate has been hovering around 7.5%². But smokers can and do quit, research suggests that for many smokers, it may take about 30 attempts before being successful at quitting smoking³.

There are many smoking cessation techniques out there and it is up to the smokers to determine which one works best for them.

Gradual reduction

Gradual reduction works by gradually reducing the amount of cigarettes or other tobacco products consumption⁴. Gradual reduction can involve the use of NRT products or other methods such as behavioral changes throughout the day like avoiding triggers, drinking water and seeking distractions. Gradual reduction opens the door to a more psychological perspective. Some people might seek out behavioral counselling while others may try mindfulness-based activities to increase the chances of quit success in the long term.

Quit Aids

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Quit Aids /

NRT (Nicotine Replacement Therapy):

NRT works by providing people with nicotine in order to regulate the withdrawal symptoms and gradually reduce the consumption⁴. The nicotine can be provided in the form of gums, patches, sprays, inhalers, or lozenges. This way, people can consume nicotine without the toxic chemicals resulting from tobacco combustion.

Prescription medications:

These do not contain nicotine. However, they help to regulate cravings and withdrawal symptoms by affecting the interaction of nicotine with your brain.

Cold Turkey:

Some people try quitting smoking ‘cold turkey’, which means to immediately stop all forms of nicotine consumption. This technique requires a lot of willpower and motivation as it can be quite brutal on the smoker. While withdrawal symptoms may be a lot more intense than with gradual cessation, quitting cold turkey gets people over the intense withdrawals faster compared to cutting back on nicotine gradually.

E-cigarettes:

Some people have succeeded in quitting smoking by using e-cigarettes. Although e-cigarettes may help non-pregnant smokers if used as a complete substitute for all other smoked tobacco products including cigarettes, current research is not sufficient to recommend e-cigarettes as a smoking cessation product.

Cytisine:

Some natural health products contain cytisine which is a natural compound that blocks some effects of nicotine including the ‘reward’ system partially responsible for the addiction aspect ⁴ . While this helps in reducing withdrawal symptoms, people won’t feel as satisfied if they start smoking again. As their interaction with nicotine won’t be the same. While cytisine hasn’t been approved as an official smoking cessation treatment, it can improve the chances of quitting.

Alternative therapies:

Mindfulness-based practices like meditation, hypnosis, acupuncture and some relaxation techniques are alternatives to other smoking cessation treatments. From this perspective, each smoking cessation story is unique and personal. It is important that people find what works best for them in order to benefit and drive from their will and confidence about quitting smoking.

There are many challenges that we do not take into consideration when talking about smoking cessation. A lot of people underestimate the power of nicotine addiction and as a consequence, the difficulty of quitting smoking. Due to withdrawal symptoms, smoking cessation can have serious impacts on one’s state of mind. Some research indicates a correlation between smoking in general, smoking cessation and depression ⁵ .

It is important to understand that addiction is multifactorial, the process of dependency follows experimentation before falling for many reasons. While the reward system is the forefront phenomenon to which we associate nicotine addiction, the fact that this addiction is multifactorial confirms that there are many facets of complexity including psychological, physiological, physical and behavioral aspects.

There are many misconceptions about smoking cessation, let’s go through a few of them:

Use of NRT for any duration of time helps smokers quit.

NRT is a considerable smoking cessation treatment that should ideally be used for 8 weeks or longer. Using NRT for more than 4 consecutive weeks can help smokers to quit. However, using NRT for less than 4 weeks may decrease the effectiveness of the treatment and decrease chances of success. NRT should ideally be used for 8 weeks or longer⁶.

Transitioning from daily to occasional smoking is an effective cessation strategy.

The majority of occasional smokers who used to smoke daily transition back to daily smoking⁶.

Smokers who don’t want to quit are the same people as those who cannot quit.

The likelihood of quitting depends a lot on the intensity of nicotine dependence. Moreover, not every smoker wants to quit. According to the CDC, in 2015 in the US, nearly 7 in 10 (68.0%) adult cigarette smokers wanted to stop smoking⁷.

It’s too late to quit, the damage is done.

Even if quitting late, quitting smoking is never a bad choice and will always remain the healthiest decision. In fact, the health effects of quitting smoking are almost immediate. Your heart rate and blood pressure start dropping only after 20 minutes after quitting smoking. A few days after quitting, the carbon monoxide level in your blood drops to normal. After 2 weeks to 3 months, your circulation improves and your lung function increases. After 1 to 12 months, coughing and shortness of breath decreases. Tiny hair-like structures that move mucus out of the lungs start to regain normal function, increasing their ability to handle mucus, clean the lungs, and to reduce the risk of infection.

Cutting down cigarettes or smoking mild cigarettes reduces the harm from smoking.

There is no such thing as a healthy smoker. Even occasionally, smoking is harmful and can cause serious health complications. Additionally, the Ontario Tobacco Research Unit states that despite legislation changes that removed “light and mild” descriptors from cigarette packaging, claiming to smoke “light and mild” brand cigarettes was a continuous phenomenon even after the removal.

Nicotine is one of the most addictive substances. Another current issue is that nicotine consumption occurs through the consumption of other toxic products as a consequence of tobacco combustion or the heating of e-liquids. By consuming nicotine, we are automatically consuming other substances that are harmful to the human metabolism.

It is difficult to quit smoking, but it is possible. A lot of people have done it and you can do it too. Remember, if one approach does not work, you can always try another one. Every quit attempt is valuable.

References:

¹ Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020 [accessed 2020 May 21].

² Creamer, M. R., Wang, T. W., Babb, S., Cullen, K. A., Day, H., Willis, G., Jamal, A., & Neff, L. (2019). Tobacco Product Use and Cessation Indicators Among Adults—United States, 2018. MMWR. Morbidity and Mortality Weekly Report, 68(45), 1013–1019. https://doi.org/10.15585/mmwr.mm6845a2.

³ Chaiton, M., Diemert, L., Cohen, J. E., Bondy, S. J., Selby, P., Philipneri, A., & Schwartz, R. (2016). Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ open, 6(6), e011045. https://doi.org/10.1136/bmjopen-2016-011045.

⁴ Methods: Ways to quit. QuitNow. (2021). https://quitnow.ca/quitting/preparing-quit/methods-ways-quit.

⁵ Glassman AH, Helzer JE, Covey LS, et al. Smoking, Smoking Cessation, and Major Depression. JAMA. 1990;264(12):1546–1549. doi:10.1001/jama.1990.03450120058029

⁶ Chaiton M, Diemert L, Zhang B, Bondy S. Busting Myths About Smoking Cessation: A Synthesis of Population-Level Findings from the Ontario Tobacco Survey. Toronto: Ontario Tobacco Research Unit, April 2016.

⁷ Centers for Disease Control and Prevention. (2021, June 2). Fast facts. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.