Microsoft word - quitting_tobacco

Quitting Tobacco

Quit? You will if you want to; you will not if you don’t want to. This is written to give you as much
information as I have about increasing the quit rate in someone who wants to.
Starting with a little motivation, I am skipping over, “did you know those things can kill you?” in favor
of some good news.
About seven years after you quit smoking, the risk of you getting all the dreaded smoking diseases goes
down to around 1.2 times more than someone who never smoked. Compare this to the 4.0 risk you have
while smoking. Pipe and cigar smokers, dippers and chewers may have lower risks to start. This material is
ideally suited for those who are trying to quit non-cigarette tobacco as well.
Studies? I will tell you what the studies show. Studies show you are more likely to quit if it is your own
idea and also if you quit at the same time as a smoking spouse. (Don’t wait for them – lead.)
Studies show you are more likely to quit if your doctor says you should – “Okay, I say you should!”
Studies show if you set a date and get psyched up, you are more likely to quit than if you act on a moment’s
inspiration.
Like most everything, humans quit tobacco cold turkey much better than if they taper. If a thousand
“two-packers” taper from forty to four cigarettes per day, they are more likely to go back to forty than go to
zero.
So make up your mind, line up your spouse the best you can, pick a date, get psyched and quit cold turkey.
Only when you have the above arranged are you ready for the other goodies that will increase the
probability of your success. Please do not waste these good tools on a third-rate effort and later tell me,
“No, those don’t work”. Of course they don’t work, they are inanimate tools – you do the work, they make
it easier and more likely you will meet with success.
Studies show that if you take the pill Zyban, which is also called Wellbutrin, at least two weeks before
your quit date, you are more likely to quit. Those who take it for a year also gain less weight with quitting.
You cannot take Zyban/Wellbutrin if you have ever had seizures or a serious head injury. It is taken twice
per day, at least eight hours apart and not too close to bedtime, or it may bother your sleep.
Studies also show that more people quit with Zyban plus a nicotine patch than using either alone.
If you smoke twenty cigarettes or more a day, I suggest one month of the 21 mg. patch, one month of a
14 mg. patch and one month of a 7 mg. patch. Change it every morning. Take it off at bedtime to avoid
vivid dreams or restless sleep and don’t get overconfident or cheap and quit early – they are cheaper than
the cigarette habit.
Ten to twenty cigarettes per day – I advise the 14 mg. patch one month and 7 mg. patch one month. Less
than ten per day – 7 mg. for two months. You may buy nicotine patches at the drugstore without a
prescription.

So you have decided to quit, enlisted your spouse, set a date, used Zyban two weeks before, quit cold
turkey and are using the patch and you still want to smoke? Wow! Have we got a treat for you. The studies
show that people who use the nicotine patch and a nicotine inhaler quit more than with either alone, so fill
the prescription for Zyban/Wellbutrin and the nicotine inhaler I give you, buy the right size patches
yourself and, when you still want to smoke, puff on your nicotine inhaler. People really do quit all the time.
Do not underestimate the difficulty or assume these steps are needlessly elaborate, but rather take them to
maximize and insure your good effort.
Now it is time for a non-study, unscientific conversation on the problem of restarting after months and even
years of having quit. I have seen no studies about this, but offer you the following observations and advice:
First, the very day most people ruin months or years of good, hard work, they wake up that day and don’t
have a clue they are going to start back smoking. Usually people do it on the spur of the moment – ninety
per cent of the time they are upset, ten per cent of the time they are out having a good time with the guys.
In that potentially fatal moment, “Big Lie One” and “Big Lie Two” get told. Big Lie One is: “I’m really not
starting back, I’m just going to have this one.”
Big Lie Two is: “I’m really not going to keep smoking – I’m just going to finish this pack” – and poof! you
are back to smoking.
I have never seen a study that addresses this too-common problem, but let’s you and I talk. You are full-
grown, this is America and if you really want to restart smoking, that certainly seems your right.
If you do not want to restart, then when you quit this time, make a “contract deal” with yourself that goes
something like this: “I don’t buy a new house in two seconds, or a new car in two seconds; I reserve my
right to buy a house, a car or to start back smoking, but I promise myself I won’t do it without seventy-two
hours of thought.”
I doubt very many people will start back after the seventy-two hours is up. Think about it now, make
yourself this psycho-deal and make a real effort to avoid being one of these disappointed people.
If you want to quit, the best way is to set that date now! This will give you time to start getting psyched up
and line up all the other things in this section.
I know you can do it. When you have quit eight weeks, please contact my office so we can note it in your
chart. Good luck.

Source: http://www.tomsloanmd.com/resources/QuittingTobacco.pdf