I would like to stop smoking, but I am overwhelmed by the variety of methods to help that are available. I want a safe and effective alternative.

©2008 Robert A. Weissberg, MD

Smoking is truly an addiction for many people. In this context, I will not go into all of the negative effects of smoking, as that is not the emphasis of the question. The addictive drug in tobacco is nicotine, which smokers know well to have a combined relaxing and alerting effect. Interestingly enough, research done on monkeys and chimps in laboratory settings shows that they will work as hard or harder for nicotine/tobacco than they will for heroin or cocaine. Many smoking cessation programs have good short-term effectiveness, but 10-15 % success rates are typical of most programs after one year. A method or program is considered highly effective if >25% of the people using it are still non-smokers at one year. For these reasons, smokers should not be hard on themselves if they do not succeed at first, whatever the method used. But, for further encouragement, research indicates that the more times a smoker has quit and gone back to smoking, the more likely they are to succeed long term the next time they try.

When one is overwhelmed by something, the best thing to do is to cut it up into parts, and tackle one at a time. With all of the pressures on smokers these days to quit, or not smoke in public places, many are on the defensive. I often ask smokers to first make a list of all of the good things about smoking, and then compliment them on wishing to help themselves in these ways. Of course, a major means of self-help would also be to stop smoking. But, it is important that the smoker have a plan for how many other ways they will accomplish the good things, once they are non-smokers. Other behavioral means can be used. One method involves keeping a cigarette diary for a few days, listing each cigarette smoked with the setting, and rating the importance of each. Then, they can work on eliminating the least important cigarettes first. Most people will be able to cut their intake by 1/2 to 2/3 in this way. Going the rest of the way then becomes easier.

Lifestyle changes are very important for the person seeking to become a non-smoker. Substituting a brief walk outside, an interval of deep breathing and meditation, having a cup of relaxing herbal tea, instituting an aerobic exercise program, staying away from situations where smoking is most likely and habitual are all possibly aids to smoking cessation. In addition to regular meditation, hypnosis and auto-hypnosis, which can be easily learned, can be powerful adjuncts to smoking cessation, as well as having many other benefits.

Nicotine itself is not what causes most of the problems of smoking, for most people. Nicotine is most addictive, as is cocaine, when it is smoked, as it gets right to the brain rapidly, and thus leaves the brain rapidly. Nicotine replacement, using nicotine patches, can be very helpful in two ways: they give a sustained level of nicotine, which is less addictive, making it easier to taper off; they immediately eliminate the tobacco, which is what causes cancer and lung disease, and much of the heart disease. Use of nicotine patches, now available OTC, can be very helpful. There are also some prescription drugs that can reduce craving for nicotine; these should be discussed with your physician.

There is no magic bullet to stop smoking. Some key points: give yourself credit for every change you make in the right direction; focus on the positives; fit the method and plan to your specific situation; early in your efforts, expand your repertoire of behaviors for relaxing and focusing, using means that produce benefits to your health and well-being; if you "fail" this time, consider it practice for the next time, when you are more likely to succeed.