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Smoking Cessation: If It Were Easy, Everyone Would Be Doing It

Mark Twain once said, “Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.”

If you’re a smoker, you probably can relate. The Centers for Disease Control and Prevention (CDC) reports that nicotine is so addictive that most people will try to quit two or three times – or even more often – before they’re able to successfully kick the habit.1

You’ve probably also heard the laundry list of reasons to quit. According to the 2004 Surgeon General’s report, cigarette smoking:

  • Causes lung cancer.
  • Contributes to cardiovascular disease (coronary heart disease).
  • Causes a variety of diseases and conditions including: cancers of the bladder, esophagus, mouth, throat, stomach, pancreas, cervix, and kidneys; leukemia; pneumonia; cataracts; and periodontitis.
  • Damages women’s reproductive health by reducing fertility and increasing the risk of miscarriage, prematurity, low birth weight, stillbirth, and infant death. Parental smoking also has been identified as a risk factor for sudden infant death syndrome (SIDS).
  • Can cause lung cancer in those around you. Every year, about 3,000 nonsmokers die from lung cancer due to secondhand smoke.
  • Kills an estimated 440,000 Americans every year.2

Even if you’re aware of what smoking is doing to your health – and possibly the health of those around you – you may feel powerless to quit. Or maybe you think, “I’ve smoked for so long, what’s the point in quitting now?”

Join the club

If you’re like many smokers, you probably do want to quit – and you may have already tried, successfully or otherwise. According to the 2004 Surgeon General’s Report:

  • In 2004, 44.5 million adults – or 20.9 percent of adults in the United States – were smokers. Men accounted for 23.4 percent, and women for 18.5 percent. An estimated 70 percent of these smokers indicated a desire to quit.
  • An estimated 14.6 million – or 40.5 percent – adult, everyday daily smokers in 2004 had stopped smoking for at least one day during the preceding 12 months due to a desire to quit.
  • An estimated 45.6 million adults were former smokers in 2004, representing 50.6 percent of those who had ever smoked.
How to quit

According to the CDC, the following five steps can help you quit … for good:

  1. Get ready.
    • Choose a date.
    • Change your environment. Remove all cigarettes and ashtrays from your home, car, and office. Ask others not to smoke around you.
    • Review past attempts to quit. Think about what worked and what did not.
    • Once you quit, don’t smoke – not even a puff!
  2. Get support and encouragement.
    • You have a better chance of being successful if you have help.
    • Tell family, friends and coworkers, etc. that you are quitting and would like their support. Talk to your health care provider and arrange for individual, group, or telephone counseling. (Telephone counseling is available at 1-800-QUIT-NOW.)
  3. Learn new skills and behaviors.
    • Try to distract yourself from urges to smoke. Talk to someone, go for a walk, or get busy with a task.
    • Change your routine. Take a different route to work. Drink tea instead of coffee. Eat breakfast in a different place.
    • Reduce stress by exercising or participating in a hobby or pastime you enjoy.
    • Plan something enjoyable to do every day.
    • Drink plenty of water and other fluids.
  4. Ask your health care provider for medication, and use it correctly.
    • Medications can help you stop smoking; in fact, they can double your chances for success. The U.S. Food and Drug Administration (FDA) has approved the following medications:
      • Prescription: Bupropion SR; nicotine inhaler; nicotine nasal spray; nicotine patch
      • Over-the-counter: Nicotine gum; nicotine patch; nicotine lozengeSpeak with your health care provider about which option may be right for you.
  5. Be prepared for relapse or difficult situations.
    • Most relapses occur within the first three months of quitting. Don’t be discouraged if you “fall off the wagon” and smoke. Remember: most people try several times before they finally quit.
    • Steer clear of alcohol and situations with other smokers as much as possible. If you gain weight or start to feel depressed after quitting, be sure to talk to your health care provider.
Sticking with it

If you’ve been a smoker for any length of time, smoking has become linked with nearly everything you do – waking up in the morning, eating, reading, watching TV, drinking coffee, and any number of other activities. It will take time to “un-link” smoking from these activities. That’s why, even if you’re using a nicotine replacement, you may still have strong urges to smoke.

One way to overcome these urges or cravings is to recognize rationalizations as they come up. If you’ve tried to quit before, you’ll probably recognize many of these common ways to rationalize having a smoke:

  • I’ll just use it to get through this rough spot.
  • Today is not a good day; I’ll quit tomorrow.
  • It’s my only vice.
  • How bad is tobacco, really? Uncle Harry chewed all his life and he lived to be over 90.
  • You’ve got to die of something.
  • Life is no fun without smoking.
Use the ideas below to help keep your commitment to quitting:
  • Avoid people and places where you are tempted to smoke. Later on, you will be able to handle these situations with more confidence.
  • Alter your habits. Switch to water, unsweetened tea and skim or 1 percent milk instead of alcohol or coffee. Take a different route to work. Take a brisk walk instead of a coffee break.
  • Alternatives. Use oral substitutes such as sugarless gum or hard candy, raw vegetables such as carrot sticks, or sunflower seeds.
  • Activities. Exercise or participate in hobbies that keep your hands (and your mind) occupied – such as needlework or woodworking – and can help distract you from the urge to smoke.
  • Deep breathing. When you were smoking, you breathed deeply as you inhaled the smoke. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remind yourself of your reasons for quitting and the benefits you’ll gain as an ex-smoker.
  • Delay. If you feel that you are about to light up, delay. Tell yourself you must wait at least 10 minutes. Often this simple trick will allow you to move beyond the strong urge to smoke.3


American Cancer Society
American Lung Association
National Cancer Institute
Nicotine Anonymous
  1. “You Can Quit Smoking.”Centers for Disease Control and Prevention (CDC). U.S. Department of Health and Human Services. February 2007. Viewed online 4/5/2007.
  2. “The Health Consequences of Smoking: A Report of the Surgeon General.” Centers for Disease Control and Prevention (CDC). U.S. Department of Health and Human Services. May 27, 2004. Viewed online 03/12/2007.
  3. “Guide to Quitting Smoking.” American Cancer Society. February 2006. Viewed online 03/12/2007.