Chronic obstructive pulmonary disease (COPD) is a term used to describe a group of conditions that…
Why quit smoking?
Smoking cessation, or quitting smoking, is the often difficult process of giving up the habit of smoking tobacco. Tobacco contains addictive compounds including nicotine, which makes it difficult for many people to quit. However, if you can beat this habit, it can be rewarding to your health and wellbeing.
Tobacco smoking is a worldwide threat to human life. In 2008, an estimated 5.4 million people died prematurely from tobacco-related diseases and, on current trends, this number will increase to 8 million deaths each year before 2030. 
Most smokers say they would like to quit, and may have tried at least once. Some are successful the first time, but many others try a number of times before they finally give up for good. There are various techniques and supports to help quit smoking.
Health risks of smoking
Tobacco smoking is the single largest preventable cause of death in Australia.  It reduces your life expectancy and also decreases your quality of life. Inhaling the toxins contained in tobacco allows them to reach all areas of your body from the lungs.
Scientific studies confirm that if you smoke, you face increased risks of illness and/or death from conditions including:
- Coronary artery disease, which involves the narrowing and hardening of the arteries that supply oxygen-rich blood to the heart;
- Vascular disease, which involves the reduced circulation of blood around your body, caused by narrowed or blocked blood vessels;
- Chronic obstructive pulmonary disease (COPD);
- Pregnancy complications including premature birth, low birth weight, stillbirth and miscarriage;
- Reduced fertility in both men and women, and erectile dysfunction in men;
- Poor wound healing and increased risk of surgical wound complications, and;
- Dental problems.
Smoking and toxic chemicals
Tobacco smoke contains thousands of chemical compounds, many of which are harmful to the body. In particular, there are certain poisons including carbon monoxide and tar in tobacco smoke.
Carbon monoxide, which is also present in car exhaust fumes, is a poisonous gas that can be fatal in large doses. It harms your body by taking the place of oxygen in your blood. This causes your lungs, heart and other organs to be starved of the oxygen they need to function properly.
Tar is a sticky brown material that coats your lungs. Tar can irritate your lungs and increase the formation of mucus, making it difficult to breathe.
Other dangerous chemicals in tobacco smoke include hydrogen cyanide, ammonia, arsenic, cadmium and lead.
Benefits of smoking cessation
As soon as you quit smoking, your body begins to repair itself. Your health will improve, you will live longer and you can save money. More specific advantages that may be realised after quitting smoking include:
- Sense of smell and taste improve;
- Exercising becomes easier as coughing and wheezing reduce;
- Bad breath improves;
- Risk of lung cancer reduces - after 10 years it is less than half that of a continuing smoker  ;
- Early effects of COPD can be reversed;
- Effects of passive smoking on your family and friends are eliminated, and;
- Risks and adverse effects during pregnancy are removed.
Preparing to quit
Smoking is addictive, so it can take people many attempts before successfully quitting. It is important to find a strategy for quitting that is right for you and suits your lifestyle.
Some people prefer to cut down slowly and eventually quit, while others prefer to quit immediately (referred to as 'cold turkey'). Regardless of the chosen method, a suggested initial step is to follow a three-step plan in preparing to quit.
Decide on your reasons to quit
Reasons for quitting smoking are different for everybody. Some examples that may help you include: getting healthy, avoiding health risks, breathing easier and getting fit, being a role model to your children, saving money, or because you are planning to become pregnant.
Create a quitting plan
Once you have decided on the reasons why it is important to quit, it is time to create a quit plan. This involves picking a date when you will quit smoking. It is best to choose a day within two weeks, to ensure you do not lose your motivation to quit. It can help to choose an easy day to quit smoking, one when you will not be around other smokers. Plan your quit day to involve some healthy activities, such as eating healthy foods, or going for a walk or bike ride.
You may also benefit from setting and achieving some small goals before the quitting day. This could involve avoiding smoking at times that you normally would, for example, with your morning coffee, in a work break, or at the pub. You can also prepare by making your house and car smoke-free, telling friends of your plans to quit and asking them for their encouragement.
Put the quitting plan into action
Now that you have a quit plan, it is time to put it into action. Most importantly, stick to your quit plan.
After quitting, some things that may help you to stay on plan include:
- Replacing a cigarette with a healthy snack, such as a carrot or celery stick, rather than unhealthy foods;
- Increasing your activity level - go for a walk instead of watching television;
- Avoiding smoking situations and being in the company of smokers where possible;
- Taking up a hobby or sport that distracts you from smoking, and;
- Putting aside the money that you would have spent on smoking to reward yourself.
Methods to quit smoking
There are numerous techniques and supports to help quit smoking. These include:
'Cold turkey' involves immediately stopping smoking, without using medications. This can be difficult, but there is no harm in trying to quit cold turkey. However, you are likely to be successful with this method if you are a light smoker, smoke less than 10 cigarettes a day, and only experience mild cravings or withdrawal symptoms (see "Withdrawal symptoms of quitting").
While many people claim to quit smoking cold turkey, they often have needed advice or support to help them. Quitting smoking can be more than having to deal with cravings and withdrawal symptoms; often there are social triggers for smoking, such as friends who smoke, stressful situations or when drinking alcohol. These social triggers can often be challenging, which is where getting advice and support can help you quit successfully.
Professional guidance coach
A professional guidance coach can help to provide you with structure, motivation and support. They can help you decide on reasons to quit, encourage you and help you manage your cravings and withdrawal symptoms. This can be in the form of counselling by a trained health professional or general practitioner. You may also benefit from self-help books or websites to help you quit, such as www.quit.org.au.
Nicotine replacement therapy
Nicotine replacement therapy may be beneficial if you experience strong cravings or withdrawal symptoms. Nicotine is the main chemical released from tobacco smoking that causes an addiction to the habit. It stimulates the release of many chemical messengers in the brain, which help enhance attention, memory and feelings of pleasure. However, its effects are short-lived, as within 30 minutes of ceasing tobacco smoking, symptoms of cravings and withdrawals can set in. [3 ]
Nicotine replacement therapy replaces the body's craving for nicotine without exposing it to the harmful effects of other chemicals in tobacco smoke. Using nicotine replacement products to quit is always safer than continuing to smoke. Nicotine by itself has not been found to cause cancer or smoking-related illnesses.
Nicotine replacement therapy is available as chewing gums, inhalers, skin patches, lozenges and tablets. These products are available from pharmacies and some supermarkets.
There are other medications that can be used to assist quitting that include bupropion (commonly known as Zyban® or Clorpax®) and varenicline (commonly known as Champix®). Bupropion was initially developed as an antidepressant, but its mechanism to help quit smoking is unknown. Varenicline works by blocking nicotine in the brain, thereby making smoking less satisfying. These medications may not completely stop cravings, but they can significantly improve (almost double) the chances of quitting.
However, these medications can trigger strong side effects in some people, which include trouble sleeping and vivid dreams. Your doctor can advise if these medications are suitable for you.
There are several other methods to help quit smoking, including hypnotherapy and acupuncture. However, they are less well researched. If you are considering using these methods, please discuss it first with your doctor. It may be worthwhile combining these methods with other proven techniques to help increase your likelihood of quitting.
Methods not recommended
It is a common misconception that weaker tobacco cigarettes, also known as 'lights', 'milds' or 'low-tar', are less dangerous. However, there is no evidence to support that these cigarettes have less risk of causing disease or cancers, than regular-strength cigarettes.
Filters on cigarettes have long been marketed as safer alternatives to non-filtered cigarettes. However, the opposite is likely true. Filters do not work, because:
- Not all the toxic chemicals in smoke are blocked;
- Filtered smoke feels milder on the throat, making it easier to take bigger and deeper puffs, and;
- Only the biggest tar particles are filtered, allowing the smaller particles to travel deeper into the lungs.
There is not enough evidence to recommend the use of filters as a quitting method.
Electronic (E-cigarettes) cigarettes
Electronic cigarettes deliver nicotine and other chemicals as an aerosol vapour into the lungs, without the burning of tobacco. There is insufficient evidence to suggest electronic cigarettes are an effective method to quit smoking. While people may claim electronic cigarettes have helped them to quit smoking, there are also reports of others increasing their nicotine addiction, with some also using both electronic and tobacco cigarettes.
Withdrawal symptoms of quitting
Quitting smoking is not easy and you will probably experience withdrawal symptoms that involve changes in your mood, behaviour and body. Initial symptoms can vary, but may include restlessness and irritability, cravings, hunger, headaches, tiredness, poor concentration, depression, insomnia, sweating and an increased cough. These symptoms will usually only last for about 10 days, but can also take up to about three months to pass.
Quitting smoking can be a difficult thing to do. The good news is, it is never too late to quit and when you do, you will feel much healthier in the long term. It is best to quit as soon as possible, as the sooner you do, the greater the reduction in health risks.
If you have tried to quit smoking in the past, but found it too hard, try again when you feel ready. It can commonly take several attempts to successfully quit. Perhaps you could try an alternative method, or a combination of techniques, which may often be needed for the best chance of quitting. You do not need to quit on your own; your doctor can provide advice and help support you in this process.
For further assistance, please contact Quitline on 13 78 48 or visit www.quit.org.au.