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C le a ring

the A irQuit

SmokingToday

U.S. DEPARTMENT OFHEALTH AND HUM AN SERVICESNational Insti tut es of Health

National Cancer Institute


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Introduct ion 2How to use th is booklet 3

Before You START a Sm oke-Free Life 3W hy is qu itting so hard? 3

Some things to think about before you START 5

Now Lets START 12Set a qu it date 12

Tell your family, friends, and co-workers

that you plan to qu it 13

Anticipate and p lan for th e challenges

youll face while qu itting 14

Remove cigarettes and other tobacco

from your hom e, car, and work 15

Talk to your doctor about get ting help to qu it 16

The week before you quit 22

Todays the Big Day Your Quit Date! 23Keep busy 23

Stay away from what tem pts you 24Plan to reward yourself 25

W hen you really crave a cigarette 25

Rem em ber th e in stant reward s of quittin g 26

Find new th ings to do 27

Quit t ing for Good 28Stick with it 28

If you do slip up 30

A note about gaining weight 31Fin ally th e lon g-term reward s of q uittin g 3 4

For M ore Inform at ion 35

1

Table o f Conten ts


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From those of us at the National Cancer In stitu te1:

Con gratulations! You are taking th e first step to

qu itting cigarette smoking.We wrote this booklet with th e help of ex-smok ers

and experts. It can h elp you get ready to qu it. It can

also help you through the days and weeks after

you q uit. The booklet tells you abo ut tools to help

you b ecome a non -smok er. It also tells you w hat

problems to expect when you quit. Being prepared

can h elp you through the hard times.

There are man y ideas in th is booklet. Use the tips

that w ork best for you . You can q uit for good, even

if youve tried before. In fact, most sm okers try to

qu it man y tim es before they succeed . Stay up beat.

Keep trying. Use what youve learned until you can

quit for good.

2

1 The National Cancer Institute (NCI) is part of the National Institutes of H ealth (NIH), one

of eight agen cies in th e U.S. Departm ent o f Health and H um an Services (DHHS). The NCI

is the Federal Governm ent' s principal agency for cancer research and training.

Introduction


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Why is quitting so hard?

Many ex-sm okers say qu itting was the hardest th ing

they ever d id. Do you feel hook ed? You re probab ly

add icted to n icotine. N icotine is in all tobaccoproducts. It makes you feel calm and satisfied. At

the sam e time, you feel more alert and focused. Th e

more you smoke, the more nicotine you need to feel

good . Soon , you d on t feel norm al with ou t n ico-

tine. It takes time to break free from nicotine addic-

tion. It may take more than one try to quit for good.

So dont give up too soon . You will feel good again .

Q uitting is also hard because sm oking is a big partof your life. You enjoy h oldin g cigarettes and puffing

on them . You m ay smoke wh en you are stressed,

bored, or angry. After months and years of lighting

up, smoking becomes part of your daily routine.

You m ay light u p w ithou t even th inking abou t it.

3

Bef ore You START aSm ok e-Free Life

How to u se this booklet

This booklet has five parts that you can read in order,or you can read just t he inform ation you w ant:

1. Before You START a Smoke-Free Life

2 . START by Preparing

3. Tod ays th e Big Day You r Qu it D ate!

4 . Qui t t ing f or Good

5. For M ore Inf orm ation

Parts 1, 2, 3, and 4 take you step-by-step through the

process of qu itt ing. Part 5 is a list o f g roup s th at o ff er

more information and programs to help you quit.


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Sm oking goes with oth er things, too. You m ay light

up wh en you feel a certain way or do certain th ings.

For example: Drinking coffee, wine, or beer

Talking on th e ph one

Driving

Being with oth er smok ers

You m ay even feel un com fortab le not smok ing at

times or in places where you usually have a cigarette.

These tim es and p laces are called triggers. Thats

because they trigger, or turn on, cigarette cravings.

Breaking th ese habits is the h ardest part o f qu itting

for some smokers.

Q uitting isnt easy. Just read ing th is booklet

wont d o it. It m ay take several tries. Bu t you learn

som ething each time you try. It takes will power

and strength to beat your addiction to nicotine.

Remember that millions of people have quit smoking

for good . You can b e on e of them !Just think ing abou t qu itting m ay make you anxious.

But your chances will be better if you get ready first.

Quitting works best when youre prepared. Before you

quit, START by taking th ese five imp ortant steps:

S = Set a quit date.

T = Tell family, friends, and co-workers thatyou plan to qu it.

A = Ant icipate and plan for the challengesyoull face while quitting.

R = Rem ove cigarettes and oth er tobaccoprod ucts from your h om e, car, and w ork.

T = Talk to your doctor about getting helpto qu it.

4

Keep in M ind

Your bo dy g ets m orethan nicotine w hen

you smo ke.

There are more than

4,000 chemicals in

cigarette smoke. Some

of t hem are also in w ood

varnish, t he in sect p oison

DDT, arsenic, nail polishremover, and rat poison.

The ashes, tar, gases,

and o th er poison s in

cigarettes harm your

bo dy over t im e. They

damage your heart and

lun gs. They also m ake

it harder for you totaste and smell things,

and fight infections.

Source: U.S. Departm ent o f Health and

Human Services. Reducing Tobacco Use:

A Report of the Surgeon General. Centers

for Disease Cont rol and Prevention, 200 0.


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Som e things to t hink about befo reyou START

Think about why you want to quitDecide for sure th at you wan t to qu it. Promise your-

self th at you ll do it. Its O K to h ave m ixed feelings.

Don t let that stop you . There will be tim es every day

that you dont feel like qu itting. You will have to stick

with it anyway.

Find reasons to qu it that are im portant to you .

Think of more than just health reasons. For example,

think of:

How much money youll save by not buying

cigarettes

The time youll have for you rself instead of

taking cigarette breaks, rush ing out to bu y a

pack, or searching for a light

Not b eing short of breath or coughing as mu ch

Setting a better example for your childrenWrite down all the reasons why you want to quit.

List ways to fight th e u rge to sm oke, too. (You will

find tips for coping later in this booklet.) Keep your

list where youll see it often. Good places are:

Where you keep your cigarettes

In your wallet or purse

In the kitchen

In your car

5

Keep in M ind...

Even a little

second-hand smoke

is da ng erou s.

Secon d-hand sm oke

can cause cancer in n on -smokers. It can also cause

breath ing prob lems and

heart disease. Peop le

who breathe second-hand

sm oke get colds and f lu

more easily. And they often

die younger than those

w ho don t breathe i t .Pregnant w om en w ho

breathe second-hand

sm ok e have m any risks:

They m ay lose th eir

babies.

Their bab ies m ay be

bo rn sm all.

Their babies are more

likely to die o f SIDS

(Sudden Infant Death

Syndrome).

Their children may be

cranky, restless, and

get sick more often.

Their children are more

likely to have learningproblems.

Children w ho b reathe

secon d-hand sm oke have

troubles too. They are

much more likely to have

breath ing prob lem s such

as asthma. They also get

more ear and lung infec-

tions (like pneumonia).

Source: U.S. Departm ent o f Health and

Human Services. Sm oking and Tobacco

Control M onograph 1 0: Health Effects of

Exposure to Environm ental Tobacco Smo ke.

National Cancer Institute, August 1999.


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6

When you reach for a cigarette youll find your list.

It will remind you wh y you want to stop.

Here are som e exam ples of reason s to qu it:

I will feel health ier right away. I will have m ore

energy and better focus. My senses of sm ell and

taste will be better. I will have whiter teeth and

fresher breath . I will cough less and breathe better.

I will be healthier the rest of my life. I will lower

my risk for cancer, heart attacks, strokes, early

death , cataracts, and skin wrinkling.

I will m ake m y partner, friend s, fam ily, kids,

grand children, and co-workers proud of m e.

I will be proud of myself. I will feel more in

control of my life. I will be a better role model

for others.

I will no longer expose others to m y

second-hand smoke.

I will have a healthier baby. (If youre pregnant)

I will have more money to spend. I won t h ave to wor ry: W hen will I get to

smoke n ext? or W hat do I d o wh en Im in a

smoke-free p lace?

O ther reasons:

___________________________________________

___________________________________________

___________________________________________

___________________________________________


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Nicotine Addiction Test

Find out how m uch you depen d on nicotineKnow ing ho w addicted you are to nicot ine can help you quit . It can help you

decide if you need extra help, such as m edicine or sup po rt f rom a program .

Take this test to f ind out how hooked you are.

Check t he box for every yes answ er:

Do you usually smoke your first cigarette within a half hour after you wake up?

Do you f ind i t hard no t t o sm oke w here sm oking isnt a llow ed?(At the library, movie theater, or doctors office?)

Do you sm oke 1 0 o r m ore cigarettes a day?

Do you sm oke 2 5 o r m ore cigarettes a day?

Do you sm oke m ore dur ing th e mo rning th an dur ing the rest of the day?

Do you sm oke even w hen you re sick?

How m any boxes did you check? ______

The m ore boxes you checked, th e m ore addicted you are.

You ll have to w ork h ard t o q uit, even if you checked o nly one bo x or no b oxes at all.

You m ay be very addicted to nicotine if you checked m ore than th ree boxes.

M edicine can h elp you qu it. Read abo ut th ese m edicines starting on page 17 .

Remem ber, no m atter how hooked you are, you can sto p sm oking!The key is staying strong and sticking w ith it.

M odified f rom Fagerstrom KO, Schneider NG. M easuring n icotine depend ence: A review of t he Fagerstrom Tolerance Questionn aire.

Journ al of Behavioral M edicine 1989; 12 (2): 159-1 82.

7


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Keep track of when and why you smokeThink about when you smoke and why you sm oke.

Do this for the next few weeks. Keep a record ofevery cigarette you smoke. Cop y the C raving Jou rn al

on page 11 . You will probab ly need on e copy for

every day.

You will find that you light u p a lot withou t

thinking about it. And you m ay be temp ted to skip

writing d own som e of the cigarettes you sm oke. Bu t

keeping th is journ al is very helpful if you do it right.

You ll learn about you r sm ok ing tr iggers. And youll

learn wh ich cigarettes are you r favorites. These facts

will help you p repare to figh t your u rge to sm oke.

Know your t riggersCertain th ings trigger, or tur n on , your n eed for a

cigarette. They can be moods, feelings, places, or

things you d o.

Think about what m ight tem pt you to smoke.

Put a check n ext to things that tem pt you to smok e:

___________________________________________

___________________________________________

8

Feeling stressed

Feeling down

Talking on th e ph one

Drinking liquor, like

wine or beer

Watching TV

Driving your car

Finish ing a meal Playing cards

Taking a work break

Being with other

smokers

Drinking coffee

Seeing someone else

smoke

Cooling off after a

fight

Feeling lon ely After having sex

Other triggers:


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Meet these triggers head-onKnowing your triggers is very important. It can

help you stay away from things that tempt you tosmoke. It can prepare you to fight the urge when

you are temp ted.

Stay away from places where smoking is allowed.

Sit in the n on-smok ing section at restauran ts.

Keep your hands busy. Hold a pencil or paper

clip. Doodle or write a letter. Carry a water bottle.

Stay away from people who smoke. Spend time

with n on-smok ing friend s. Put something else in your m outh . Chew sugar-

free gum. Snack on a carrot or celery stick. Keep

your m outh and h ands busy with a toothpick,

sugarfree lollipop , or straw.

Drink less or stay away from alcohol. Drinking

alcohol often makes people want to smoke. Drink

ju ice, soda, or ice water in stead .

Remember: The urge to smoke will com e and go. Cravingsusually last for a brief period of time. Try to wait it out...

Want som e tips for fighting the u rge to sm oke?

See Tod ays th e Big Day You r Q uit Date! star tin g

on page 23.

9


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Craving Journal

Keep track of each cigarette you smo ke and how

much you wanted it. Every time you light up, write

down:

The tim e

W here you w ere

What you were doing

W ho w as with you

Rate how strongly you wanted to smoke:

1 = just a little

2 = som e

3 = a lot

1 0


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1 1

Craving Journal

Dat e: ______________

Cigaret te Tim e o f Craving W hat I w as W ho I w as How I w as

num ber day level do ing w ith feeling

Exam ple 10 :45 a.m . 3 at w ork alone st ressed out

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

Adapted f rom One Step At A Tim e Program Book 3. Canadian C ancer Society, 199 8.


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1 2

S

M y Quit Date is:

_________________________________

Set a q uit date

Pick a date within the next two weeks to quit.

That gives you enou gh t ime to get ready. But itsnot so long that you will lose you r d rive to qu it.

Think abou t choosing a special day:

You r b irthday or wed d ing ann iversary

New Year s Day

Independence Day (July 4)

World No Tobacco Day (May 31)

The Great American Smokeout(the third Thursday of each November)

If you sm oke at work, qu it on the weekend or

during a d ay off. That way you ll already be

cigarette-free when you return .

Now Let s START


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1 3

TTell you r f am ily, friends, andco-w orkers that you p lan to quit

Quitting smoking is easier with the support ofoth ers. Tell you r fam ily, friend s, and co-workers that

you plan to quit. Tell them how they can help you.

Som e peop le like to h ave friend s ask h ow th ings

are going. O thers find it nosy. Tell the peop le you

care abou t exactly how they can help. Here are

some ideas:

Ask everyone to understand your change in

m ood . Remind them that th is won t last lon g.

(The worst will be over within two weeks.)

Tell them this: The longer I go without cigarettes,

the sooner Ill be my old self.

Does someon e close to you sm oke? Ask th em

to qu it with you, or at least n ot to sm oke

aroun d you.

Do you take any m edicines? Tell your d octor and

pharm acist you are qu itting. Nicotine changeshow some d rugs work. You m ay need to change

your prescription s after you q u it.

Get sup po rt from other peop le. You can try talk-

ing with oth ers one-on-on e or in a grou p . You can

also get sup port on the p ho ne. You can even tr y

an Internet chat room. This kind of supp ort helps

smok ers qu it. The m ore sup port you get, the

better. But even a little can help. See page 21 orthe resource list starting on page 35 to find th is

kind of help.


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1 4

W ithdraw al: How You

M ay Feel W hen You Quit

Common feel ings ofsm oking w i thdraw al

include:

Feeling depressed

Not being able to sleep

Getting cranky,

frustrated, or mad

Feeling anxious,

nervous, or restless Having trouble thinking

clearly

Feeling hungry or

gaining weight

Not everyone has feelings

of w i thdraw al. You m ay

have one or many of these

problem s. And they maylast different amounts

of t ime. The medicines

described on pages 17

th rough 20 can he lp .

Source: Diagnostic and Statistical M anual of

M ental Disorders, Fourt h Ed. (1994). American

Psychiatr ic Association. Washingto n, D.C

AAn ticipate an d p lan for the challengesyoull face w hile q uitt ing

Expecting challenges is an imp ortant part of gettingready to quit.

Most people who go b ack to smok ing d o it within

three m on ths. You r first three mon ths m ay be hard.

You m ay be m ore temp ted wh en you are stressed o r

feeling d own. Its hard to b e ready for th ese times

before they happen. But it helps to know when you

need a cigarette m ost.

Look over your C raving Jou rn al. See when youm ay be temp ted to sm oke. Plan for how to d eal

with the u rge before it hits.

You should also expect feelings of withd rawal.

Withdrawal is the d iscom fort of giving u p nicotine.

It is you r b od ys way of telling you its learn ing to

be sm oke-free. These feelings will go away in time.

Keep reading for tips on han d ling u rges and

withdrawal.


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1 5

RRem ove cigarette s and ot her t ob acco f romyour ho m e, car, and w ork

Getting rid of things that remind you of smokingwill also help you get ready to quit. Try these ideas:

Make things clean an d fresh at work , in your car,

and at hom e. Clean your d rapes and clothes.

Sham poo your car. Buy yourself flowers. You will

enjoy their scent as your sense of smell returns.

Throw away all your cigarettes and m atches.

Give or th row away your lighters and ashtrays.

Remember the ashtray and lighter in your car!

Have your d entist clean you r teeth to get rid of

smoking stains. See how great they look. Try to

keep th em that way.

Some smokers save one pack of cigarettes.

They do it just in case. O r they want to prove

they h ave the w illpower n ot to sm oke. Don t!

Saving one pack just

makes it easier to start smoking again.

Dont use other forms of tobaccoinstead of cigarett esLight or low-tar cigarettes are just as harmful as

regular cigarettes. Sm okeless tobacco, cigars, pipes,

and herb al cigarettes also harm your h ealth . For

example, bidi cigarettes are just as bad as regular

cigarettes. Clove cigarettes are even worse. They

have more tar, nicotine, and deadly gases. All tobac-

co products have harmful chemicals and poisons.


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1 6

Pregnant or Thinking

About Having a Baby?

Theres no bet ter t ime

to quit than now .

W om en w ho sm oke have

a harder t ime gettingpregnant. A nd you face

more dangers if you do

get pregnant:

You may lose the baby

or have a stillborn

(dead) b aby.

You r baby m ay be

bo rn small. You r bab y is m ore likely

to die of Sudden Infant

Death Syndrome (SIDS).

You r baby m ay be

cranky, restless, and

get sick more often.

Your baby is more

likely to have learningproblems.

The go od new s is th at

quitt ing can help you

have a healthy baby. It

helps to qu it at any t ime

while you are pregnant.

Its even better to quit

beforeyou get pregnant.

Adapted f rom W omen and Smoking:

A Report of the Surgeon General 2001 .

U.S. Departm ent of Health and Human

Services, 2001.

TTalk to you r doctor abo ut g etting h elp to qu itQ uitting cold tu rkey isnt you r on ly choice. Talk to

your doctor about other ways to quit. Most doctorscan answer your q uestions and give advice. They can

suggest m edicine to h elp with withd rawal. You can

bu y some of these medicines on your own . For others,

you n eed a p rescription.

Your d octor, den tist, or p harmacist can also p oint

you to p laces to find sup port or toll-free qu it lines.

(The N ational Cancer Institutes Sm ok ing Q u itline can

help, too. It can help you find support in your area.See W here to Find Help on page 21 .)

If you cann ot see you r doctor, you can get some

medicines without a prescription that can help you

quit smoking. Go to your local pharmacy or grocery

store for over the coun ter m edicines like th e nicotine

patch, nicotine gum , or nicotine lozenge. Read th e

instructions to see if the medicine is right for you.

If youre not sure, ask a pharmacist.


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2 These are the names of some of the medications you can use to helpyou qui t. Many large drug stores or pharmacies sell t heir own brands ofnicotine gum and nicotine patch. The follow ing is not intended to be acom plete list of products nor do es it constitute e ndorsement of a nybrand o r product by the N ationa l Cancer Institut e, Nationa l Institut es

of Health, or the Departm ent of Health and H uman Services.

Bupropion SR pills Zyban, Wellbutrin

Nicot ine gum drug store brands, Nicoret te, Nicotrol

Nicot ine inhaler Nicotrol

Nicot ine lozenge Commit

Nicot ine nasal spray Nicotrol

Nicot ine patch drug store brands, Nicoderm

Medicines that help wit h withdrawalWhen you quit smoking, you may feel strange at

first. You m ay feel du ll, tense, and not yourself.These are signs that your body is gettin g used to life

without nicotine. It usually only lasts a few weeks.

Many p eop le just cant hand le how they feel after

they quit. They start smoking again to feel better.

Maybe this has happened to you. Most people slip

up in the first week after quitting. This is when feel-

ings of withdrawal are strongest.

There are medicines2 that can help with feelings of

withdrawal:

Bupropion SR pills

Nicotine gum

Nicotine inhaler

Nicotine lozenge

Nicotine n asal spray

Nicotine patch

1 7


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1 8

Using these medicines can double your chan ces

of quitting for good. Ask your doctor for advice.

But rem em ber: Medicine alon e cant do all thework. It can help with cravings and withdrawal,

bu t quitting will still be h ard at tim es.

Here is m ore info rmat ion about t hedifferen t m edicines.

Nicot ine Gum, Patch, Inhaler, Spray,and Lozenge (NRT)

Nicotine gum , patches, inhalers, sprays, and lozengesare called nicotine replacement therapy (NRT).

Thats becau se they take th e p lace of nicotine from

cigarettes. NRT can help with withdrawal and lessen

your u rge to smoke.

You need a prescription to bu y the inh aler and

nasal spray. Bu t you can b uy n icotine gum , n icotine

patches, and nicotine lozenges on your own.

Oth er M edicinesBup ropion SR is a m edicine th at has no nicotine.

You need a p rescrip tion to get these pills. They

seem to help with withdrawal and lessen the urge

to smoke.

Som e people h ave side effects when using

bupropion SR pills. The side effects include dry

m outh and not b eing able to sleep.


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Thinking About Using NRT?

Bot to m line: Read t he instructions th at com e w ith th e m edicine.Talk to you r doctor or p harm acist if you have any que stion s.

Ask yo ur d octo r, den tist, o r ph arm acist if nicot ine g um , th e p atch, or som e

other kind of NRT is right for you. These medicines can cause side effects in

som e people. Som e people sho uld no t use NRT w ith ou t a d octo rs help. Pregnant

w om en are a goo d examp le.

Be patient. Using NRT correctly can t ake som e gett ing u sed t o. Follow th e

instruction s and g ive it som e tim e.

Do nt m ix to bacco and NRT. Having one or two cigarettes while you use the

gum, patch, nasal spray, inhaler, or lozenge is not dangerous, but your goal is

to quit smoking for good. Use NRT only when you are ready to stop smoking.

If you do slip u p and sm oke a cigarett e or tw o, do nt give up on NRT. Keep t rying .

Start out using enough medicine. Use the f ull amo un t o f N RT in th e instruction s.

Don t skip or fo rget t o u se you r NRT after you f irst stop smo king.

Slow ly use less an d less m ed icine . But do nt sto p com pletely un til youre ready.

You can set u p a schedule w ith your do ctor o r ph armacist.

Keep som e of t he m edicine w ith you af ter you stop using it. This w ay you ll

be ready for an emergency.

W ait a half hour af ter using the g um , lozenge, or inhaler before you eat

or drink anything acidic. Acidic foo ds and drinks can keep nicotine g um s and

inhalers from working. Acidic foods and drinks include tomato sauce, tomatoes,

oranges, lemons, grapefruit, coffee, soda, orange juice, and grapefruit juice.

Source: NRT Product User's Guides. GlaxoSmit hKline Co nsumer Healthcare, Pittsburgh , PA, 200 2.

1 9


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This medicine isnt right for:

Pregnan t wom en

People who have seizures People with eating d isorders

Heavy drinkers

Ask you r d octor, dentist, or ph armacist if th is

m edicine is right for you . Make sure to u se it th e

right way if your doctor prescribes it.

Join a quit -smoking programYou m ay wan t to try a quit-sm oking program or

supp ort group to help you qu it. These programs

can work great if youre willing to com m it to them.

How do quit-smoking program s and supp ort

group s work? They help smok ers spot and cope

with p roblems th ey have when trying to q uit. The

programs teach problem-solving and other coping

skills. A quit-smoking program can help you quit

for good by:

Helping you better un derstand wh y you sm oke

Teaching you how to handle withdrawal

and stress

Teach ing you tips to help resist th e urge to smoke

2 0


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Where to Find Help1. Your state m ay have a toll-free telephone qu itline.

Call the q uitline to get on e-on-on e help.2. Call the N ational Cancer Institutes Sm oking

Q uitline at 1-877-44 U-QUIT (1-877-448 -7848 ).

This nu m ber works anywhere in th e U.S. You

can get one-on-one help quitting. Or you can ask

wh ere to get help in you r state.

3. Visit the Nation al Cancer Institu tes smokefree.gov

Web site at h ttp ://www.smokefree.gov. Th is Web

site offers science-d riven tools, inform ation, an d

sup port that has helped sm okers qu it. You will

find state and national resources, free materials,

and qu itting advice from the N ation al Cancer

Institute and its partners.

4. More and m ore workp laces have help for workers

wh o wan t to qu it. Som e offer qu it-smoking clinics

and sup port on the job. Oth ers will pay for

ou tside p rogram s for th eir wor kers. Ask at wor k

about th e choices open to you.5. Your d octor may know about a quit-sm oking

program or support group near you.

6. See For More Inform ation beginn ing on page 35

in this booklet. It lists groups that offer:

On e-on-one sup port

Group support

Sup port from a form er smoker

Write down your plan for quitting in the space

below. Write wh at you w ill do w hen you are

triggered to smoke. Writing the steps youll take

before you quit will help you stop smoking for good.

2 1


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Steps Ill take before quitting:

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

How Ill handle triggers:

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

The w eek before you quit

Dat e: _______________ to _______________

2 2


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Keep in M ind

If you decided to use asupport program , use it

fully. Go to the sessions.

Call your telephone quit-

line. Visit you r Int ernet site.

The m ore supp ort you get,

the more likely you will

qu i t fo r good.

Are you using medicine t ohelp you q uit? If so, follow

th e direction s. If you do nt ,

youre m ore likely to g o

back to smoking. Also,

dont rush to stop using

th e m edicine. Stick w ith it

fo r at least 1 2 w eeks. Or

fo llow your d octors advice.

Tod ays the day you start you r sm ok e-free life!

Remind your fam ily and friends th at today is your

qu it d ate. Ask them to sup port you du ring th e firstfew days and weeks. They can help you through

the rough spo ts.

Here are more tips to help you get through this

very important day.

Keep bu sy

Keep very bu sy today. Go to a m ovie. Exercise.

Take long walks. Go bike riding. Spend as much free time as you can where

sm oking isnt allowed. Som e good p laces are

m alls, libraries, m useum s, theaters, departm ent

stores, and places of worship.

Do you m iss having a cigarette in your han d?

Hold something else. Try a pencil, a paper clip,

a m arble, or a water bo ttle.

Do you m iss having something in your m outh ?Try tooth picks, cinnam on sticks, lollipop s, hard

candy, sugarfree gum, or carrot sticks.

Drink a lot of water and fru it juice. Avoid

d rinks like wine and beer. They can trigger you

to smoke.

2 3

Tod ay s the Big D ayYour Quit Dat e!


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Stay aw ay f rom w hat tempts you

Instead of smoking after m eals, get up from the

table. Brush your teeth or go for a walk. If you always smok e wh ile d riving, try something

new: Listen to a new radio station or your favorite

music. Take a different route. Or take the train or

bus for a while, if you can.

Stay away from things that you con nect with

smoking. Do it today and for th e next few weeks.

These may include:

Watching your favorite TV show

Sitting in your favorite chair

Having a drink before dinner

Do things and go places where smoking is not

allowed. Keep this up until youre sure th at you

can stay smoke-free.

Remember, m ost peop le don t sm oke. Try to be

near non -sm okers if you m ust be som ewhereyoull be tem pted to smoke, for example at a

party or in a bar.

2 4


26/39

Plan to rew ard you rself

You will save m on ey by becom ing sm oke-free.

Is there someth ing youd like to bu y foryourself or som eone else? Make a list. Figure

out what these things cost. Then start putting

aside cigarette money to buy some of them.

Buy yourself something special today to celebrate.

See a m ovie. Buy a CD you ve been wan ting.

O r buy some oth er treat. Be careful w ith food

treats. You need less food wh en you don t smok e.

This is true no m atter how m uch you w ant topu t something in your m outh.

W hen you really crave a cigarette

Remember: The urge to smoke usually lasts only

three to five minutes. Try to wait it out. Or look

at the p lan you m ade last week. (See page 22 .)

You wrote d own steps to take at a tim e like th is.

Try th em ! You can also tr y these tips:

Keep oth er th ings arou nd instead of cigarettes.

Try carrots, p ickles, sun flower seeds, app les,

celery, raisins, or sugarfree gum.

Wash your h and s or the d ishes wh en you want

a cigarette very badly. O r take a shower.

2 5


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Learn to relax qu ickly by taking d eep b reaths.

Take 10 slow, deep b reaths and ho ld th e last one.

Then breathe out slowly. Relax all of your mus-cles. Picture a soothing, pleasant scene. Just get

away from it all for a m om ent. Th ink only abou t

that p eaceful image and noth ing else.

Light incense or a candle instead of a cigarette.

W here you are and wh at is going on can m ake

you crave a cigarette. A change of scene can

really help. Go outside, or go to a different room.

You can also try changing what you are doing.

No matter what, dont th ink , Just on e wont

hurt. It will hurt. It will undo your work so far.

Remember: Trying something to beat th e urge is

always better than trying noth ing.

Rem em ber the instant rew ards of q uitt ing

Your bo dy b egins to heal within 20 m inu tes after

your last cigarette. The p oison gas and n icotinestart to leave your body. You r p u lse rate goes back

to normal. The oxygen in your blood rises to a

normal level.

With in a few d ays you m ay notice oth er things:

You r senses of taste and sm ell are better.

You can breath e easier.

You r smok ers hack star ts to go aw ay.

(You m ay keep coughing for a wh ile, thou gh.)

2 6


28/39

The n icotine leaves your b od y within th ree days.

You r bod y starts to repair itself. At first, you m ay feel

worse instead of better. Withdrawal feelings can behard . But they are a sign that you r body is healing.

(See Withd rawal: How You May Feel Wh en You

Quit on page 14.)

Find n ew things to d o

Starting tod ay you m ay want to create some

new habits.

Here are some things you might try:

Swim m ing, jogging, playing tennis, bike rid ing,

or shooting baskets. Its hard to sm oke an d do

these things at the same time. How about walking

your dog?

Keep your h and s bu sy. Do crossword pu zzles or

needlework. Paint. Do woodworking, gardening,

or h ou sehold ch ores. You can also write a letteror paint your nails.

Enjoy having a clean tasting mo uth . Brush your

teeth often and u se m outh wash.

Take a stretch wh en you re temp ted to reach for

a cigarette.

Set aside tim e for th e activities that satisfy you and

mean the most to you. There are natural breaks

even during a busy day. After dinner, first thing inthe morning, or just before bed are good examples.

You ll also need p lenty of rest wh ile you get used

to your sm oke-free lifestyle.

2 7


29/39

Stick w ith it

Look at page 3 again. Beating an addiction to nico-

tine takes a lot of will power an d determ ination .You should feel great abou t yourself for m aking it

so far. Nows the time to focus on sticking with it.

Keep your guard upYour bod y has changed since you began to sm oke.

You r brain h as learned to crave nicotine. So certain

places, people, or events can trigger a strong urge to

sm oke, even years after qu itting. Thats wh y you

should never take a puff again, no matter how long

it has been since you qu it.

At first, you m ay not be able to d o th ings as well

as wh en you were sm oking. Don t worry. This wont

last long. Your m ind and bod y ju st need to get u sed

to being without nicotine.

After youve quit, the urge to smoke often hits at

the same times. For many people, the hardest place

to resist the u rge is at hom e. And m any u rges hitwh en som eone else is smoking n earby. Look at your

Craving Journ al to see wh en you m ight b e tem pted.

Then use the skills youve learned to get through

your u rges withou t smok ing.

2 8

Qu itt ing for Good


30/39

af ter youve saved1 da y . . . . . . . . . . . . . . . . . . . . . . . . .$5

1 w eek . . . . . . . . . . . . . . . . . . . . . . . .$35

1 m ont h . . . . . . . . . . . . . . . . . . . . . . .$150

1 ye ar . . . . . . . . . . . . . . . . . . . . . . . . .$1,820

10 y ears . . . . . . . . . . . . . . . . . . . . . . .$18,200

20 y ears . . . . . . . . . . . . . . . . . . . . . . .$36,400

Prices are based on a 2001 average of $5.00 per pack. The cost of a packof cigarettes may differ, depending on w here you b uy them .

Fight the urgesReview th e tips in th is booklet to h elp you fight

the urge to smoke. These tips are meant to helpyou stay a non-smoker.

Stay upbeatAs you go through the first days and weeks without

smoking, keep a positive outlook. Dont blam e or

punish you rself if you do h ave a cigarette. Dont

think of smoking as all or none. Instead, take it

one day at a tim e. Remember th at qu itting is a

learning process.

Keep rewarding yourself f or not smokingNow that you arent buying cigarettes, you prob ably

have m ore spending m on ey. For examp le, if you

used to smok e one pack per day:

2 9

Think abou t starting a m on ey jar if you havent

already. Put your cigarette money aside for each day

you d on t sm oke. Soon youll have enou gh m oney to

buy a reward for yourself.


31/39

If you do slip u p

Don t be discouraged if you slip u p an d sm oke on e

or two cigarettes. Its not a lost cau se. One cigaretteis better th an an en tire pack. But that d oesnt m ean

you can safely smoke every now and then

no m atter how long ago you qu it. On e cigarette may

seem harmless, but it can quickly lead back to one

or two packs a day.

Many ex-sm okers had to try stopp ing man y tim es

before they finally succeeded . W hen p eople slip u p ,

its u sually within the first three m on th s afterqu itting. H eres wh at you can d o if this happ ens:

Un derstand that you ve had a slip . You ve

had a small setback. Th is doesnt m ake you a

smoker again.

Don t be too h ard on yourself. O ne slip u p doesnt

m ake you a failu re. It doesnt m ean you cant

quit for good.

Don t be too easy on you rself either. If you slipup , don t say, Well, Ive blown it. I m ight as well

smoke the rest of th is pack. Its imp ortan t to

get back on the no n-smok ing track right aw ay .

Remember, your goal is no cigarettes not even

one puff.

Feel good about all the time you went without

smoking. Try to learn how to make your coping

skills better. Find the trigger. Exactly wh at was it that m ade

you smoke? Be aware of that trigger. Decide

now how you will cope with it wh en it comes

up again.

3 0


32/39

Learn from your experience. What has helped

you the most to keep from smoking? Make sure

to do that on your next try. Are you using a m edicine to h elp you qu it? Don t

stop using your medicine after only one or two

cigarettes. Stay with it. It will help you get back

on track.

Know and use the tips in this booklet. People

with even one coping skill are more likely to stay

non -sm okers than th ose who d ont kn ow any.

START to stop again!

See you r d octor or an other health p rofessional.

He or sh e can help m otivate you to qu it sm oking.

A note about gaining w eight

You r body uses food m ore slowly wh en you first stop

smoking. You m ay eat m ore when you quit too.

There is a good chance you w ill gain weight. But no t

everyone does.Are you worried abou t gaining weight? Think

about this: What you get from quitting far outweighs

the d rawbacks of add ing a few p ou nd s. You d have

to gain a lot of weight to offset the health rewards

of qu itting.

Here are som e tips to keep from gain ing too

m uch weight.

3 1


33/39

Get in shape Make tim e to exercise every day. O r join a fitness

group . Even w alking will imp rove you r h ealth.And all exercise burns calories, which helps you

gain less weight.

Exercising can distract you from smoking. It low-

ers the stress that makes you crave a cigarette.

Are you starting a n ew exercise program ? Begin

with as little as 10 m inu tes. Slowly bu ild up to

longer period s of tim e. In fact, its a good idea

to talk to you r doctor b efore you start. You r

doctor can suggest what w ill keep you safe and

get you healthy.

Get plenty of rest.

As you get in shap e, you will build m uscle.

Muscle weighs m ore than fat. So you m ay

find that clothes become looser even if you

weigh more.

3 2


34/39

3 3

3The Food G uide Pyramid w as created by the U.S. Department o f A griculture to h elp you

choose what foods to eat and how much to eat to stay healthy.

Fats, Oils, & SweetsUse Sparingly

Milk , Yogurt &

Cheese Group

2-3 Servings

Vegetable Group

3-5 Servings

Meat, Poultry, Fish, Dry

Beans, Eggs, & Nuts Group

2-3 Servings

Fruit Group

2-4 Servings

Bread, Cereal, Rice, &

Pasta Group

6-11 Servings

Key

Fat (natu rally occurring and added)

Sugars (added)

These symbols show fat and

added sugars in foods.

Eating t ips for the new non-smoker Follow the Food Guide Pyramid 3. Stay away from

sweets and h igh -calorie food s. Bu t don t cut b ackon eating to lose weight. Craving b oth food and

cigarettes is tough to hand le.

Have healthy, low-calorie foods on hand if you

like to sn ack. Try fresh fru its and vegetables,

ju ices, yogu rt, or air-p opped popcorn withou t

butter.

Drink water before your m eals and between

meals. Drinking plenty of water is healthy for

everyone. It can also give you something to do

instead of smoking a cigarette.

Chew sugarfree gum or suck on sugarfree candy

if you crave sweets.

Food Guide Pyramid: A Gu ide t o D aily Food Choices


35/39

Finallyt he long-term rew ards of quitt ing

Tobacco u se in the Un ited States causes more than

450,000 deaths each year. Of those deaths, 170,000are from cancer.

After youve quit, youve added healthy, full days

to each year of your life. You ve greatly lowered you r

risk of death from lung cancer and other diseases

including:

Heart disease

Stroke

Chronic bronchitis

Emphysema

At least 13 other kinds of cancer

You ve also cu t back on dangerou s second-han d

smoke for your loved ones. Finally, by quitting

sm oking, you re setting a good example. You re

show ing youn g peop le that a life withou t cigarettes

is a longer, h ealth ier, h app ier life.

3 4

Keep in M ind

Almost f our out ofevery five smokers

w ould like to quit .

And almost half of all

adu lt sm okers have

already quit.

It d oesnt m atter how

old you are or how long

youve smoked. Youbecom e health ier and

stronger each day you

are tobacco-free.

Source: Cigarette Smoking Among Adults

United States, 1993. 43(43):785, November

4 , 1994 .


36/39

National Cancer Inst it ute (NCI)Cancer Informat ion Service

Suite 3036A6116 Executive Bou levard, MSC 8 322

Bethesda, MD 2 089 2-832 2

You m ay wan t more inform ation for you rself, you r

fam ily, and your d octor. The N CIs Sm ok ing Q uitline

is staffed by specialists who can h elp you qu it smok -

ing. Toll-free: 1-877-448-7848 (1-877-44U-QUIT)

The smokefree.gov Web site is another source

of inform ation abou t qu itting. You can get

live help and link s to sources of help in your area.

http://www.smokefree.gov

In addition to help qu itting sm oking, the NC Is

Cancer Information Service (CIS) provides accurate,

up-to-date information on cancer. Information spe-

cialists can assist you with quitting and also explainthe latest cancer information in understandable

langu age in English, Spanish, or on TTY equ ipm ent.

Toll-free: 1-800-422-6237 (1-800-4-CANCER)

TTY: 1-800-332-8615

The NCI's Cancer.gov Web site provides inform a-

tion from nu m erous N CI sources, includ ing LiveH elp ,

an instant messaging service. Information specialistsprovide live, on line assistance to u sers of Cancer.gov,

th e NCIs Web site. Th e staff can assist smo kers, in

addition to providing cancer information and helping

users to navigate the Web site. Click on the LiveH elp

link , Mond ay through Friday. http://cancer.gov

3 5

For M ore Inform ation


37/39

American Cancer Society (ACS)1599 Clifton Road, NE

Atlan ta, GA 303291-800-227-2345 (1-800-ACS-2345)

Ch eck your p ho ne b ook to find your local office.

www.cancer.org

The American Cancer Society (ACS) has volunteers

and offices all over th e coun try. ACS helps peop le

learn abou t the h ealth hazards of sm oking and how

to becom e ex-smo kers. Its programs includ e The

Great Am erican Smok eout in November of each

year and the Cancer Cru sade every April. It also h as

m any booklets and other inform ation that can help.

American Heart Association (AHA)7272 Greenville Avenue

Dallas, TX 75231

1-800-242-8721 (1-800-AHA-USA1)

Ch eck your p ho ne b ook to find your local office.www.americanheart.org

The American Heart Association (AHA) has thou-

sand s of volun teers. It h as 130,000 m emb ers

(doctors, scientists, and oth ers) in 55 state and

regional groups. AHA m akes book s, tapes, and

videos abou t the effects of sm oking on the heart.

AHA has also written a guidebook on weigh t-controlin qu it-sm oking p rograms.

3 6


38/39

American Lung Associat ion (ALA)61 Broadway, 6th Floor

New York , NY 10 00 61-800 -586-48 72 (1-800-LUNG-USA)

Check your p hone book to find your local office.

www.lungusa.org

The Am erican Lung Association (ALA) h elps

smok ers wh o want to q uit through its Freedom

From Smoking self-help quit-smoking program.

ALA actively supports laws and information

campaigns for non-smokers rights. It also gives

public information programs about the health

effects of smoking.

Centers for Disease Control and Prevent ion(CDC)O ffice on Sm oking an d Health

Mail Stop K-50

4770 Buford Highway, NEAtlanta, GA 30341-3724

1-800-311-3435 or (770) 488-5705

www.cdc.gov

The CDCs Office on Smoking and Health (OSH) is

the govern m ents lead agency on smoking control.

O SH fun ds b ooklets on sm oking topics, such as

relapse, helping a friend or fam ily m ember quitsmok ing, the h ealth hazards of sm oking, and the

effects of parental smoking on teenagers.


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