Smoking is on the decline. But if you are one of the 38 million Americans still smoking daily, you probably know how hard it is to quit.
The majority of smokers – 70% -- report that they want to stop smoking. Of those, 50% say they tried to quit in the previous year. Only 7% succeed.
There is plenty of reason to seek relief from nicotine addiction: Tobacco use accounts for about one-third of all cancers, and 90% of lung cancer cases. It also contributes to heart disease, stroke and lung disease.
So what's the best way to quit smoking?
"The best way to quit smoking is with a combination of medication and counseling," says Maher Karam-Hage, M.D., medical director of the Tobacco Treatment Program at MD Anderson. "They both help. But you double your chances by using both compared with one of them."
Medications to help you quit smoking
There are several medications on the market that can help you reduce your nicotine cravings.
- Chantix (Varenicline) works in two ways. First, it provides a mild version of the nicotine effect. This helps reduce withdrawal symptoms and cravings. At the same time, it stops your brain from feeling the pleasurable effects of nicotine, so smoking doesn't have the same pleasurable effect. This makes smoking less appealing. Chantix is the most effective, says Karam-Hage. But it's also the most expensive.
- Medications like Zyban (Bupropion or Wellbutrin), only block the effects of nicotine in your brain, so smoking is less pleasurable. They don't replace the effect of nicotine.
- Nicotine replacement therapies, like gum and patches, partially satisfy nicotine cravings by giving the body small amounts of nicotine. This can help with cravings and make it easier to stop smoking. The most effective way to use nicotine replacement medications is in combinations of two. That usually means the patch plus one other prescription or over-the-counter medication like lozenges, gum, nasal spray or a puffer.
All these medicines work differently for different people. A professional counselor can help you monitor what's working and what isn't, and adjust what medications you take and how much for the best success.
Why is counseling important?
In addition to helping you manage your medications, a counselor can give you the tools to cope with setbacks, stress and cravings by building skills in several areas:
Problem solving: We all run into problems in life, like personal conflicts, that could can make us feel helpless. Working with a counselor to tackle them one at a time usually translates into knowledge and skills that can be used in other areas.
Coping strategies: Anything from a traffic jam to a death in the family can set off a strong urge to smoke. Learning strategies like deep breathing exercises, meditation and mindfulness can help a smoker get to the other side of a crisis without smoking.
Behavior change: Many smokers may miss the "hand-to-mouth" act of smoking. Counseling can help them find substitutions like using a straw, cinnamon stick or gum.
Identifying triggers: Counseling can help you identify what triggers you to smoke, like that morning cup of coffee or social pressure from friends. Once you identify your triggers, you can learn to deal with them or avoid them.
Once patients start counseling, they appreciate the tools and support it provides in their effort to quit smoking, says Karam-Hage.
"Finally, somebody understands the struggle they're going through," he says. "Someone is acknowledging that it's not a simple thing to quit. That is very helpful."
You can do it
If you are committed to quitting but don't have access to a comprehensive program that includes both counseling and medication, you have options.
Your doctor can prescribe medications to help you quit, and advise you on over-the-counter options like patches, gum and lozenges.
You can get phone and text support through the Centers for Disease Control and Prevention's Quitline. Call 1-800-784-8669 or text QUIT to 47848.
If you are considering using e-cigarettes to help you quit cigarettes, Karam-Hage says not so fast.
"E-cigarettes have not been studied or approved to be used as smoking cessation tools," he says. And since most e-cigarettes contain nicotine, they won't help you eliminate your nicotine addiction.
Using both cigarettes and e-cigarettes together also poses more health risks. Studies show that adding e-cigarettes to your smoking routine worsens respiratory symptoms and other dangers of smoking.