Kicking the smoking habit is such hard work that experts advise tackling it from several angles at once. Rather than relying solely on medical therapies or a nicotine patch or inhaler, the latest thinking is that your behavior may need to change as well. “This is a new finding,” says Michael Fiore, MD, MPH, founder and director of the University of Wisconsin Center for Tobacco Research and Intervention. “Counseling is very effective by itself and medication is very effective by itself—but combining the two gives added benefits.”
Here are some of the most effective nonmedical interventions to consider for your arsenal, whether you try them alone or in addition to other treatments.
Talk to someone
Counseling—whether its with an individual, a group, or by telephone—offers extra motivation to quit, guidance from experts, and emotional support for dealing with cravings and withdrawal symptoms. Its among the most powerful and proven techniques for kicking the habit. The U.S. Public Health Services 2008 guidelines for treating tobacco dependence, which analyzed more than 8,700 smoking-cessation studies, put counseling at the top of the heap among nonmedical interventions and found that the greater the intensity, the better the results. “Every way the panel looked at the research, they found that more is better,” says Dr. Fiore, who also chaired the guideline panel. The following support techniques have the best track records:
1. Quit lines
These are phone lines staffed with trained smoking-cessation counselors who chat you through quitting. In 2004, the National Cancer Institute worked with state and federal agencies to establish a national hotline, 1-800-QUIT-NOW, which has been shown to increase abstinence rates. Adding quit-line counseling to medication has also been shown to boost the effectiveness of the medication.
The service is completely free and, since it's on the phone, remarkably accessible for those who cant get in-person counseling (such as those caring for small children or with health problems). “The good news for any smoker in America who wants to quit is that we now have a universal access number to help anyone, anywhere quit, ” says Dr. Fiore. “And that is an enormous advance.”
The quit-line approach varies from state-to-state; in California, for instance, quit-line counselors offer a 30- to 40-minute counseling session that covers health issues, strategies to deal with withdrawal, and help setting a quit date. The counselor will call back on your quit date and several times again after that. You can find details on the quit line in your state on the Web site of the North American Quitline Consortium. The National Cancer Institute also offers a confidential online text chat called LiveHelp.
2. Individual counseling
One-on-one sessions have also been shown to be effective in helping people quit. You sit down with a psychotherapist, social worker, or counselor trained in smoking cessation or addiction. The idea is to help you identify what exactly in your life triggers you to smoke, as well as to flag high-risk situations, learn how to get through cravings and withdrawal, and develop a plan of action. (1-800-QUIT-NOW can advise callers about how to find a therapist in your area.)
3. Support groups
Groups offer some of the same sort of guidance as individual counseling. The plus is that you meet others trying to quit. You may even get a “quit buddy.” Just as a walking buddy makes it more likely youll exercise, quit buddies help keep you from lighting up. “People are making a commitment to another person that they are ready to quit,” says Jodi Prochaska, PhD, MPH, a clinical psychologist and assistant professor at the University of California, San Francisco, who is affiliated with the universitys Center for Tobacco Control Research and Education. Among the most popular groups are those run by Nicotine Anonymous, a 12-step program (877-TRY-NICA; www.nicotine-anonymous.org); the American Cancer Society can guide you to a class in your area (800-ACS-2345).
Make a plan
Many smokers say that tobacco use is so ingrained into every aspect of their lives—getting up in the morning, finishing a cup of coffee, taking a break from work—that it feels impossible to break free. Thats why experts like Dr. Fiore say making a specific plan to quit in a certain way on a certain date is so important—it provides a framework that can help you withstand even the wiliest of your temptations. These are some of the strategies doctors and counselors recommend:
1. Set a quit date.
Ideally, this should be within two weeks of when you decide to quit.
2. Review past quitting experiences.
Figure out what helped you initially break the habit last time, and try to replicate that behavior. In the same vein, learn from the actions that led to relapseand try to avoid them.
3. Anticipate challenges.
Minimize your chance of relapse by planning ahead. If you usually take a smoke break with your coworkers, figure out something else pleasurable to do during that time, such as go for a coffee, do some stretching, or call a friend.
4. Limit alcohol.
“We know that half the people who try to quit and relapse were drinking,” says Dr. Fiore. “For a smoker that link is so common.” Because of this connection, experts recommend that people trying to quit smoking cut down on or abstain from alcohol, especially in the first few weeks after their quit date.
5. Ask your household for help.
Quitting is harder with smokers around. Make quitting a family affairor at least ask others not to smoke around you.
Maybe you dont care that smoking is bad for you. The key for anyone whos ambivalent about quitting is often choosing a convincing reason beyond the usual warnings. Ask yourself: Does your child have asthma? Do you want younger-looking skin? Do you have cancer in your family? Money is also a big motivator. Calculating how much you spend on cigarettes or promising yourself a big present with the money you save can work. And research shows that financial incentives increase enrollment in smoking-cessation programs as well as short-term quit rates. Other motivational techniques include using a monitor to show the amount of carbon monoxide in your blood or keeping a detailed record of your smoking habits.
If youre one of the many people who smoke to deal with anxiety, youll need to find new ways to cope.
1. Breathe deep.
The American Cancer Society recommends deep breathing as a way to curb the urge to smoke.
Although exercise has not been shown to increase abstinence rates, there is some evidence that it can help control the weight gain associated with quitting. Exercise is also a great way to ease stress.
The National Cancer Institute recommends creating peaceful times in your everyday schedule and learning techniques such as progressive relaxation, where you tense each muscle and release it to rid the body of tension.