Quitting Smoking

Why Do You Smoke?

Most people don't think about when or why they smoke. They just do it. But knowing when and why you smoke can help you choose the quitting strategy that is most likely to work. Perhaps you smoke:

• To relieve tension, especially after arguments or during stressful times, or when you feel angry, depressed, or upset.
• To control your weight, either by keeping it down or because you're afraid of weight gain if you quit.
• For stimulation, to focus, improve your concentration, or boost your energy when you have low energy.
• To be part of the group, by joining your friends in having a cigarette.

For parents: Why children and teens smoke

Many children and teens use cigarettes, cigars, and smokeless tobacco because their friends do. Movies and TV shows can make smoking seem attractive. Teens, especially girls, often use smoking to try to control their weight.

Teens may think that smoking is a way to look more mature, independent, and self-confident to their peers. They may smoke to rebel against their parents. But most teens do not know how addictive cigarettes are. If your child smokes, it might help to talk with him or her about some of the reasons to stop smoking. If you smoke or have quit, talk with your teen about how you regret starting and how hard it can be to quit.

You may not think so, but children and teens are influenced by their parents. They are especially likely to smoke if their parents smoke. And they are more likely to quit if their parents quit. And if your child never smokes during the teen years, he or she is less likely to start smoking in the future.

• Substance Use Problems: Dealing With Teen Substance Use

Thinking About Quitting?

When you're craving tobacco, it's hard to focus on quitting. Preparing yourself before you quit can help. Before you quit, get ready for a life without nicotine.

Think about your reasons for quitting

What would motivate you to quit smoking? Think about it. It's important to have your own reasons for quitting .

Staying healthy is a common reason to want to quit smoking. Or maybe you want to feel more in control of your life, instead of feeling controlled by tobacco. Teens may have other reasons to quit smoking.

Talk to your family and friends about quitting. Their support might help you decide to quit.

• Quitting Smoking: Getting Support

Know the risks of smoking

What worries you about smoking? Make a list. Talk about it with your doctor. You may worry about:

• Health problems. Are you out of breath when you walk up the stairs? Are asthma symptoms getting worse? Are you coughing a lot?
• Long-term health risks. Are you afraid of having a heart attack or stroke? How about lung disease or cancer?
• Risks to others. Do you worry about family members getting lung cancer and heart disease? Are you afraid that your children might start smoking because you do? Are you concerned that your baby may die of sudden infant death syndrome (SIDS) if you smoke? Maybe your children have frequent ear infections or asthma.

Did you know that most all of the health risks of smoking go away if you quit?

Look forward to the rewards

What do you gain by quitting? You can:

• Feel better and be able to do more.
• Cough less and have less shortness of breath.
• Have a younger-looking and healthier body.
• Set a good example for others (especially children).
• Save money by getting rid of the cost of smoking. To find out how much you spend on cigarettes, see the Interactive Tool: How Much Is Smoking Costing You?
• Be in control of your habits.
• No longer feel embarrassed about being a smoker.

Prepare for roadblocks

Quitting smoking when you have other health problems

If you have depression or anxiety, talk to your doctor before you quit smoking. He or she may have helpful ideas on which medicines may work best for you to quit smoking.

Smoking can also affect the level of certain medicines in your blood. If you take medicines for a health problem, talk with your doctor before you quit smoking to see whether you should change the dose of any of your medicines.

Planning Your Strategy to Quit

Learn what works for you.

When it comes to quitting smoking, some people find it helpful to plan ahead. Others don't. Do what works for you. If you are ready to quit right now, see the section Ready to Quit Today?

If you prefer to plan ahead, start by asking yourself some questions. Are you a goal-setter? How confident do you feel that you will succeed at giving up smoking? Asking yourself these questions is one way to prepare yourself for quitting.

Know your reasons

Your reason for wanting to quit is important. Maybe you want to protect your heart and your health and live longer. Or maybe you want to spend your money on something besides cigarettes. If your reason comes from you—and not someone else—it will be easier for you to try to quit for good.

After you know your reasons for wanting to quit, use the U.S. Surgeon General's five keys to quitting: get ready, get support, learn new skills and behaviors, get and use medicine, and be prepared for relapse.

1. Get ready

Contact your doctor or local health department to learn about medicines and to find out what kinds of help are available in your area for people who want to quit smoking. Telephone helplines operated by your state can also help you find information and support for quitting smoking.

Check with your insurance provider to find out if medicines and counseling are covered under your health plan. Your employer may also help pay the cost of a quit-smoking program or provide help to pay for medicines, even over-the-counter ones.

Free smartphone and tablet apps may be another helpful way to plan your quit. Apps such as the National Cancer Institute's QuitPal can help you set goals, track your progress, and share your struggles and successes with family and friends. QuitPal can also support you with text reminders.

Here are some other ways to get ready to quit smoking:

• Set your goals. To achieve a long-term goal like quitting smoking, you may find it helpful to break the task into smaller goals. Every time you reach a goal, you feel a sense of pride along the path to becoming tobacco-free. A personal action plan can help you reach your goals.
  • Set your goals clearly. Write down your goals, or tell someone what you are trying to do. Goals should include "by when" or "how long" as well as "what." For example: "I will track my smoking for 1 week, starting tomorrow." Or "I will cut back from 20 cigarettes a day to 15 by this time next week."
  • Set a quit date, and stick to it. This is an important step. Choosing a good time to quit can greatly improve your chances of success. Avoid setting your quit date on high-stress days, such as holidays.
  • Reward yourself for meeting your goals. Quitting smoking is a difficult process, and each small success deserves credit. If you don't meet a goal, don't punish yourself. Instead, hold back on a reward until you achieve your goal. For example, give yourself something special if you succeed.
  • Pace yourself. You may want or need to quit slowly by reducing the number of cigarettes you smoke each day over the course of several weeks. Set a comfortable pace. Certain activities won't be temptation-free for many months after you quit.
  • Be realistic. You may feel very excited and positive about your plan for change. Be sure to set realistic goals—including a timeline for quitting—that you can meet. For example, your goal could be to cut back from 20 cigarettes a day to 10.
• Make some changes. Get rid of all cigarettes, ashtrays, and lighters after your last cigarette. Throw away pipes or cans of snuff. Also, get rid of the smell of smoke and other reminders of smoking by cleaning your clothes and your house, including curtains, upholstery, and walls. Don't let people smoke in your home. Take the lighter out of your car. Try some methods to reduce smoking, such as gradually increasing the time between cigarettes, before your official quit date. A smoking tracker can help you keep track of what triggers urge you to use tobacco. This gives you important information on when it's toughest for you to resist.
• If you have tried to quit in the past, review those past attempts. Think of the three most important things that helped in those attempts, and plan to use those strategies again this time. Think of things that hindered your success, and plan ways to deal with or avoid them. Write this down as a plan.

2. Get support

You will have a better chance of quitting successfully if you have help and support from your family, friends, and coworkers. Others sources of support include:

• Your doctor. He or she can help you put together a plan of medicines and nicotine replacement therapy (NRT) that works for you. This could be Chantix or the nicotine patch, or maybe the nicotine patch along with gum for those times you need something more.
• Phone support (1-800-QUIT NOW). Telephone counselors can help you with practical ideas. Often they are people who have quit smoking themselves.
• Social networking. Many smartphone or tablet quit-smoking apps allow you to share your progress with your friends and family. This is a way you can get the extra support and encouragement you need when you're having a hard time or when you want to celebrate a new smoke-free milestone.
• Talk to a friend who used to smoke, and ask him or her to be a support person you can call when the going gets rough.
• Try a quit smoking program on the Internet. These often have chat rooms. People who use telephone, group, one-on-one, or Internet counseling are much more likely to stop smoking than people who try to quit on their own.

• Quitting Smoking: Getting Support

If a partner or friend is quitting, you can help.

• Quitting Smoking: Helping Someone Quit

3. Learn new skills and behaviors

Since you won't be smoking, decide what you are going to do instead. Make a plan to:

• Identify and think about ways you can avoid those things that make you reach for a cigarette (smoking triggers), at least at first. Try to change your smoking habits and rituals. Think about situations in which you will be at greatest risk for smoking. Make a plan for how you will deal with each situation.
• Change your daily routine. Take a different route to work, or eat a meal in a different place. Every day, do something that you enjoy.
• Cut down on stress. Calm yourself or release tension by reading a book, taking a hot bath, or digging in your garden. See the topic Stress Management for ways to reduce stress in your life.
• Spend time with nonsmokers and people who have stopped smoking.
• Start seeing yourself as a person who is making healthy choices.

4. Get and use medicine

The U.S. Food and Drug Administration (FDA) has approved several medicines to help people quit smoking. You will double your chances of quitting even if medicine is the only treatment you use to quit. Your odds get even better when you combine medicine and other quit strategies, such as counseling. ^{footnote 1}

You won't have to take medicines forever—just for as long as it takes to help you quit. Your employer or health plan may help pay the cost of a quit-smoking program or provide help to pay for medicines. And remember that no matter how much it costs to buy medicines to help you stop smoking, it's still less than the cost of smoking.

The first-choice medicines are: ^{footnote 2}

• Nicotine replacement therapy. This includes nicotine gum, patches, lozenges, and inhalers. You can buy gum, patches, and lozenges without a prescription.
• Bupropion SR (Zyban). This is a non-nicotine prescription medicine that reduces withdrawal symptoms and cravings.
• Varenicline (Chantix). This prescription medicine helps withdrawal symptoms and cravings, and it reduces the pleasure you feel from smoking.

• Quitting Smoking: Should I Use Medicine?

Remember, taking medicines and using telephone or in-person counseling or a quit-smoking program at the same time greatly increases your chances of success.

5. Be prepared for relapse

Most people are not successful the first few times they try to quit smoking. If you start smoking again, don't feel bad about yourself. A slip or relapse is just a sign that you need to change your approach to quitting.

A slip of just one or two cigarettes can lead back to regular smoking, but many smokers can get back to not smoking by changing their plan. For example, they may add counseling or a medicine. Or they may talk to a friend who used to smoke. Make a list of things you learned. And think about when you want to try again, such as next week, next month, or next spring. Or you don't have to wait. If you're still motivated to quit, you can try again as soon as you want.

You might get some ideas for things you can do differently by looking at "Prepare for roadblocks" in the Thinking About Quitting? section. Maybe you can try something new next time, such as a new medicine or type of counseling. You might try combining tools, such as counseling and medicine. Keep trying, and don't be fooled into thinking that smoking "light" cigarettes will help. They do not make smoking safer.

If you slip

If you slip or smoke a little, don't give up. Talk to someone who has quit smoking, or to a counselor, to get ideas of what to do. If you are taking medicine or using nicotine replacement, keep doing so unless you go back to regular smoking.

Quitting smoking is hard, but it can be done. To stay motivated, keep reminding yourself why you want to quit smoking. Make a list of your reasons to quit and the benefits you expect from quitting. Put your list of reasons on your bedroom dresser, in your wallet, or on the refrigerator. Review it whenever you are struggling with the quitting process. Add to your list whenever another reason or benefit occurs to you.

If you have tried to quit smoking before, remember that most people try to quit many times before they are successful. Don't give up.

Ready to Quit Today?

Congratulations! You are taking a big step. You are ready to quit today. It's exciting. But it can also be scary. If you're not quite ready yet, but you think you will be soon, see the section Thinking About Quitting?

If you've been planning to quit, you may already know that when you stop smoking, you may not feel so great at first. Some people feel grouchy and have cravings. The good news is that these things are at their worst in the first 2 to 3 days. They can last 2 to 3 weeks after you quit, or maybe longer. And there are things that can help.

If you decided to quit today but haven't planned ahead, don't worry. Here are some things to consider to help you succeed:

Use medicine

Using nicotine replacement products and/or medicine doubles your chances of quitting. ^{footnote 1} When you quit smoking, your body craves the nicotine that it was used to getting when you smoked. But the nicotine isn't the harmful part of smoking or chewing. It's all the other things in tobacco that are bad for you, such as tar and carbon monoxide. Nicotine from medicine is absorbed so slowly and at such low levels that it is rarely addictive.

• Nicotine replacement products can help with cravings and withdrawal.
• Other medicines that can help are bupropion (Zyban) and varenicline (Chantix).

Get support

Support can help you through the stress of losing this part of your life. Your doctor can prescribe medicines that can get you through withdrawal. And he or she can help you plan the best way to use nicotine replacement products and can refer you to counseling programs. Friends and family (especially those who used to smoke) can provide shoulders to lean on, and they can encourage you to stay smoke-free. They can help distract you when you want to smoke, and they can understand when you're a bit grouchy.

People who use telephone, group, one-on-one, or Internet counseling are much more likely to stop smoking. Experienced counselors have practical ideas that can help you succeed. Here are some ways to get support:

• National tobacco quitline: 1-800-QUIT NOW (1-800-784-8669)
• Counseling from a doctor, nurse, or therapist
• Stop-smoking programs, such as the American Lung Association's Freedom from Smoking program (www.lungusa.org). In these programs you can:
  • Get help deciding which medicines may be right for you.
  • Use message boards, live chat, and email to talk with counselors and people who have also quit.
  • Sign up for daily email or text messages.

• Quitting Smoking: Getting Support

Make a plan

If you quit today but haven't planned ahead, now is a good time to plan your quit strategy. Think of problems or barriers you have faced. And think of ways to reward yourself for reaching specific milestones. Write out your personal action plan .

For more information, see the Planning Your Strategy to Quit section of this topic.

Know your reason

You are taking an important step to improve your life. Make sure that you know your reasons for quitting smoking. The most common reason to quit is to live longer. It's a gift you can give yourself and your family.

Dealing With Relapse

If you slip or smoke a little, don't give up. Talk to someone who has quit smoking, or to a counselor, to get ideas of what to do. A slip can quickly turn into regular smoking, so it's important to do something different soon. If you are taking medicine or using nicotine replacement, keep doing so unless you go back to regular smoking. And consider adding a new treatment, like one-on-one counseling.

You're not alone in going back to smoking. Most people who quit try many times before they quit for good.

Don't feel bad about yourself. A relapse is just a sign that you need to try a different approach to quitting smoking. If you tried to quit without medicines or a program, think about trying them next time. Medicines and nicotine replacement (gum, patches, lozenges) can double your chances of success. ^{footnote 1} And using medicines and counseling is even more effective.

Think about what made you start smoking again. Maybe you couldn't handle the cravings. Or maybe you didn't have enough support from family or friends. Maybe something stressful happened that triggered the urge to smoke, and then you couldn't stop.

Whatever it was, remember that help is here when you are ready to try again. You might want to read Thinking About Quitting? or Planning Your Strategy to Quit in this topic.

Staying Smoke-Free

To quit smoking, you have to learn how to deal with your cravings and temptations to smoke. But staying smoke-free involves learning how to think and act like a nonsmoker.

Many people who are able to make it through those first tough weeks without smoking run into trouble about 3 to 4 weeks after they quit. Surprisingly, this is just about the time when physical cravings have stopped. And yet—people often go back to smoking. Why does this happen? Some researchers found that staying smoke-free may depend on how well someone has been able to start seeing himself or herself as a nonsmoker. ^{footnote 3} To help you start seeing yourself as a nonsmoker, think about hanging out with other nonsmokers, starting a healthy behavior such as going to an exercise class or a healthy-cooking class, or trying any other activity that is not compatible with thinking of yourself as a smoker.

Tips to deal with cravings in the first few weeks

Many of the changes you feel when you first quit smoking don't feel good. Nicotine withdrawal can make you feel grouchy, hungry, and nervous. You may have trouble sleeping or concentrating. These symptoms can last for a few days to several weeks. But they do go away, especially if you take medicine. You may struggle with changing your smoking habits and rituals. This is a lot to deal with, but keep at it. You will feel better.

The following tips may help you in the first few weeks:

• Deal with temptations and cravings when you quit smoking.
• After you quit, don't smoke at all—not even one puff. Prevent a slip (smoking one or two cigarettes) or relapse (returning to regular smoking) by avoiding smoking triggers, such as alcohol and stress. Don't keep cigarettes in your house or car. If you do slip or relapse, stay calm. Remind yourself that you have a plan, and think about how hard you've worked to quit for good.
  • Quick Tips: What to Do When You Crave Nicotine
  • Quitting Smoking: Preventing Slips or Relapses
• Ask friends and family members for help.
  • Quitting Smoking: Getting Support
  • Deal with weight gain.
    • Quitting Smoking: Dealing With Weight Gain

Tips to stay smoke-free over time

To stay smoke-free, you will have to make it past a second big challenge. This will come about 3 to 4 weeks after you quit, when you notice that your physical cravings are almost gone. Making it past this second big challenge will depend on how well you have been able to start thinking and acting like a nonsmoker. You will be able to enjoy and value a smoke-free lifestyle when you: ^{footnote 3}

• Realize from your experiences that you are able to cope with stresses without smoking.
• Face situations where you used to smoke and no longer feel like you need to smoke.
• Find other ways to do things that you used smoking to help you do in the past.
• Reject or move past your image of yourself as a smoker.

There are many ways you can make positive changes in your life, such as starting an exercise program or learning how to manage stress.

• Stop Negative Thoughts: Choosing a Healthier Way of Thinking

Why Quit?

If you're reading this, you may be thinking about quitting smoking or making a plan to quit. Or maybe you have already tried to quit a few times. You probably already know that smoking is bad for your health and that quitting will reduce your risk of getting a disease related to smoking, such as heart or lung disease.

If you continue to smoke, there is a 1 out of 2 chance that you will die earlier because of smoking. Smokers, on average, die 13 to 14 years sooner than people like them who are not smokers. ^{footnote 4} If you quit, most of your risk for having a heart attack or getting cancer goes away. The sooner you quit, the more you reduce your risks.

Everyone who uses tobacco would benefit from quitting. When you quit smoking—no matter how old you are—you will decrease your risk of:

• Early death. Use this Interactive Tool: How Does Smoking Affect Your Lifespan?
• Heart attack and stroke. Quitting can cut your risk of heart attack in half within 2 years.
• Lung cancer and other lung diseases.
• Other cancers. After you quit, your risk for developing cancers of the voice box (larynx), mouth, throat, esophagus, intestines, bladder, kidney, and pancreas gradually declines.
• Sexual and reproductive problems.
• Pregnancy problems. Women who smoke during pregnancy have a higher risk of having their babies early and having babies that have a low birth weight.

In addition to reducing your risk of diseases in the future, you will notice some benefits right away after you stop smoking. Your shortness of breath, energy, and asthma symptoms will likely get better within the first 2 to 4 weeks after you quit. (But don't be surprised if you cough more in the first week after you quit, as your lungs try to clear themselves.)

There are other benefits to quitting:

• You will reduce the health risks for your family members caused by secondhand smoke when you quit smoking.
• Your kids will be less likely to start smoking. If your teen already smokes, he or she is more likely to quit smoking if you quit. ^{footnote 5}
• Underweight babies, stillbirths, and problem pregnancies are less likely in women who quit smoking.

Natural, low-tar, and low-nicotine "light" cigarettes are not any safer to smoke than regular cigarettes. Do not be misled into thinking that these products are any better for you. They are not.

There are risks to smokeless tobacco and e-cigarettes too.

Why quit using cigars, pipes, or chewing tobacco?

You can get cancers of the throat and mouth from using cigars, pipes, or chewing tobacco.

• Even if you think that you don't inhale the smoke from a pipe or cigar, you are at greater risk for disease. Quitting reduces these risks in much the same way as in quitting cigarettes.
• Using smokeless tobacco ("chew") or snuff ("dip" or "rub") gives you a higher risk of mouth cancer, gum disease, and tooth loss.
• Pipes and cigars increase the risk of cancers of the mouth and throat.

For teens: Why quit now?

Avoiding diseases caused by smoking and being in control of your life are good reasons for teens to quit.

If you are a teen and you smoke, chew tobacco, or use snuff, you probably already know that tobacco is bad for you. If you are like most teens, you intend to quit at some point, but you may not feel it's very important to quit now. But the longer you use tobacco, the greater your risk for becoming dependent on it. After you're hooked, it's even harder to quit.

• Substance Use Problems: Dealing With Teen Substance Use