Ways to stop smoking

Published by Bupa’s Health Information Team, December 2010.

According to the guidelines in the UK, the best way to stop smoking is through a combination of nicotine replacement therapy (NRT) and varenicline or bupropion hydrochloride, combined with support from your local stop smoking service. However, it’s important for you to find the method that suits you best. This article will look at varenicline and bupropion, and alternative ways to stop smoking. NRT will be covered in more detail in another article.

Medicines to help you stop smoking

Your doctor may be able to prescribe you a medicine to help you stop smoking. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Varenicline

Varenicline helps to reduce your withdrawal symptoms and interrupts the way nicotine affects your body. This means that if you do succumb to temptation and have a cigarette, the nicotine won’t affect you as much as it used to.

You will need to take varenicline for seven to 14 days before stopping smoking and usually for 12 weeks after that. Varenicline can have some side-effects, in particular feeling sick or vomiting. In addition, you may get headaches, insomnia, vivid dreams, increased appetite, diarrhoea and dizziness. It can also make you feel drowsy or depressed. However, although these may be unpleasant, it’s worth trying to remember that the possible long-term health risks of smoking are likely to be far worse.

Bupropion hydrochloride

Bupropion hydrochloride is sometimes prescribed to help reduce cigarette cravings. The way it works isn’t fully understood at the moment, but it’s thought to affect the parts of your brain connected to addiction and withdrawal.

You will need to take bupropion hydrochloride for seven to 14 days before you stop smoking and you can carry on taking it for up to seven weeks. Bupropian hydrochloride can have side-effects including insomnia, headaches, dizziness, a dry mouth and feeling or being sick. You may also notice that you find it harder to concentrate and that it makes you feel drowsy. However, although these may be unpleasant, it’s worth trying to remember that the possible long-term health risks of smoking are likely to be far worse.

Going 'cold turkey'

Giving up smoking by going ‘cold turkey’ simply means that you stop smoking using your willpower alone and without using any medicines or other aids to help you. To do this, you will need to be able to ignore any withdrawal symptoms and refuse to give into temptation. It’s the least complicated way to stop smoking, yet can often be the hardest.

Whether you can give up smoking for good through willpower alone will depend on how motivated you are to stop.

One of the main benefits of going cold turkey to stop smoking is that it costs virtually nothing. And another plus point is that you don’t have to take any nicotine substitutes or drugs.

There are plenty of things you can try to help make going cold turkey easier.

• Find a temporary substitute for smoking, such as chewing gum or drinking a glass of water each time you want a cigarette.
  
• Change your routine to stay away from situations where you would usually have a cigarette. You might find it easier to stop if you don’t go to the pub for the first couple of weeks. Or you might want to tell your work colleagues that you’re stopping so they don’t invite you out for cigarette breaks during the day.
  
• Know your triggers and stay away from them if possible. So if you usually have a cigarette with a glass of red wine in the evening, try having a different drink or going out for a short walk instead.
  
• Make a list of why you want to stop and carry it with you. Read through it when you have a craving and remind yourself why you’re stopping.
  
• Set targets and reward yourself when you get to them. But remember, stopping smoking is for the rest of your life, so you might not find time-based targets very helpful. Why not sign up for a charity run or save all the money you would have spent on cigarettes to pay for a holiday.
  
• Remember that the only reason you feel better when you have a cigarette is because you're feeding your withdrawal symptoms.

Your body gets rid of nicotine as quickly as 48 hours after your last cigarette. This means that your withdrawal symptoms can be intense for the first two or three days, but you will feel better after the third or fourth day. Trying to cut down gradually just prolongs the withdrawal process.

Stopping smoking using willpower alone can be difficult but it’s not impossible – it all depends on how motivated you are.

Alternative therapies

Google ‘quitting smoking’ and you will find numerous sites offering any number of different therapies that promise to help you stop smoking for good. These range from acupuncture and hypnotherapy to books and relaxation techniques. Although some people may find these techniques work for them, there isn’t enough evidence to say for sure how effective they are.

Helplines, counselling and other support

Your GP or practice nurse can refer you to a stop smoking service, or you can refer yourself. This provides counselling and support for smokers who want to stop. You may even find that your GP surgery or local community centre has a support group for people who want to stop smoking.

Quit, the UK charity for stopping smoking, also offers advice and support via freephone helplines, booklets and leaflets, email support and online top tips. Helplines are also available in other languages (eg Urdu and Turkish).

Coping with difficult situations

Because smoking may have been part of your usual routine for a long time, there will be occasions when you find it really difficult to resist cigarettes. Reminding yourself why you’ve quit and how well you’ve done will help you to stay positive. Ask your friends not to offer you a cigarette and if someone does, say “No thanks, I don’t smoke” rather than “I’ve quit”.

If at first you don't succeed…

Don’t worry if you have a lapse – you won’t be the first. But make sure you don’t use it as an excuse to start smoking regularly again. Many ex-smokers admit to the odd mistake, but have moved on and stayed smoke-free. One cigarette doesn’t make you a smoker again. Stopping smoking involves changing your lifestyle, habits and getting rid of an addiction you may have had for years. It’s a challenge, but it’s worth it.

Action points

• Make a plan of action for stopping smoking – and stick to it.
  
• Tell your friends and family that you’re trying to stop smoking, and get their help and support.
  
• Stay positive and remind yourself of what you’ve achieved when the going gets tough.
  
• Get support and treatment from your NHS stop smoking service.
  
• Don't give up on giving up!

For sources and links to further information, see Resources.