By Linda M. Guhe, MSW, LCSW
It is never too late to stop using tobacco. Quitting tobacco has several benefits, including psychological, health, and financial benefits.
For example, psychologically, quitting tobacco can boost a person’s sense of self-esteem, self-confidence, and self-control. This can result from learning more effective ways of coping with stress and negative moods, and from knowing that you are able to live without tobacco. In addition, quitting tobacco also provides immediate and long-term improvements in health. The following is a timeline list of some benefits to look forward to when quitting tobacco.
Health Benefits of Quitting
- 20 minutes: Blood pressure and heart rate drop
- 8 hours: Carbon monoxide levels drop to normal
- 24 hours: Decreased risk of heart attack
- 48 hours: Improved ability to smell and taste
- 72 hours: Lung capacity improves
- 3 weeks to 3 months: Circulation and lung function improves
- 1 year: Risk for sudden heart attack cut in half
- 5 years: Risk of stroke begins to reduce to level of non-smoker
- 10 years: Decreased risk of cancers including lung, mouth, throat, esophagus, bladder, kidney and pancreas
Financial Benefits of Quitting
Smoking is expensive. Quitting saves money also by avoiding the financial burden not only from buying cigarettes, but also from treating tobacco-related illnesses. Insurance rates for coverage are often lower for former and non-smokers.
The Difficulty of Quitting
Most tobacco users make multiple attempts to quit. Many are surprised at just how difficult it is to stop using tobacco. In fact, for most people, quitting will involve a strong level of commitment and determination. Even with smoking cessation medications and counseling, quitting is hard work. The good news, however, is that today there are resources that provide a picture of the road ahead, help in identifying possible obstacles, and suggestions on coping with setbacks
To begin, it may help to understand that there are two important sides to quitting tobacco: 1) the physiological addiction to nicotine and 2) the behaviors associated with tobacco use. Tobacco users can prepare for and increase their success in quitting by learning more specifically what to expect and how to cope with withdrawal from nicotine and how to identify and change the behaviors associated with tobacco use.
The use of smoking cessation medications (described below) in combination with tobacco cessation counseling can be helpful in the first months to reduce withdrawal symptoms and the chances of relapse. In fact, the combination of pharmacotherapy (using medications) and counseling is considered the most effective approach for tobacco cessation.
Withdrawal
Initially, the most difficult aspect of quitting is coping with the immediate withdrawal symptoms of negative moods, urges to smoke or use, and difficulty concentrating. After a few weeks, the immediate symptoms associated with the depletion of nicotine in the blood decrease. After a longer period of abstinence, withdrawal symptoms can be triggered by the behaviors associated with tobacco use. The potential symptoms of withdrawal can be described as falling into physical, psychological/emotional, behavioral, and social categories.
- Physical withdrawal from nicotine typically peaks 1-3 weeks after quitting and symptoms include sleep disturbance, cravings, increased appetite, fatigue, tenseness, decreased heart rate, coughing (clearing lungs), stomach disturbance, throat irritations, dizziness, light-headedness.
- Psychological and emotional symptoms include poor concentration, drowsiness, mental confusion, depression, irritability, aggression, restlessness, distraction, anxiety/fear, pining, longing, lower stress tolerance, pain of separation, negative mood, anger, anxiety, and depression.
- Social symptoms include possible loss of confidence, loss of self-esteem, sense of vulnerability, and loss of control over discomfort in social situations.
- Behavioral symptoms include disorganization, preoccupation with thoughts of tobacco, tobacco, a compulsion to talk about tobacco, unconsciously reaching for tobacco when it isn’t there, and a feeling of restlessness.
Recognizing, understanding, and learning to cope with withdrawal symptoms are all important strategies for maintaining long-term abstinence and avoiding relapse.
Tobacco Addiction
The majority of tobacco users who have already quit, have quit without seeking outside or professional help. This fact often leads to the false notion that quitting is only a matter of will power. There are important factors that can determine the success rate of quitting tobacco and a person’s chance of relapse without professional or outside help.
A history of psychiatric disorders, history of chemical dependency, and limited access to resources in the community can affect the strength of tobacco addiction. The more tobacco plays a vital role in coping with mood and daily functioning, the more difficult it will be to learn to live without it.
Because nicotine increases positive mood and decreases negative affect like anger, tobacco is often a form of self-medication for individuals suffering from depression. And it is not uncommon for tobacco users to recover from alcohol dependence, only to suffer from poor and deteriorating health from smoking.
By finding the right combination of support, an addiction to tobacco can also, if needed, be effectively treated simultaneously with psychiatric and other chemical dependency disorders. The use of smoking cessation medications, counseling to identify and change behaviors, and social support are all important components in the treatment of tobacco addiction for individuals with a history of mental disorders and substance use problems.
Pharmacotherapy for Tobacco Cessation
Consider taking medications as an aid to quitting tobacco. Nicotine Replacement Therapy is not safe for everyone, so it is important to see your physician for evaluation for prescription drugs and to discuss the safety of available over-the-counter medications.
With those cautions in mind, for most people treating tobacco addiction with medication is safe and effective, and increases the chances for long-term abstinence. The following is a list of “first-line” medications approved by the U.S. Food and Drug Administration (FDA) for use in smoking cessation.
Non-nicotine Medications: These medications help reduce the urge to smoke.
Bupropion SR (also known as Wellbutrin) is a non-nicotine drug that has been approved since 1997 as an aid to smoking cessation. Bupropion SR is also used as an anti-depressant and is available by prescription only.
Nicotine Replacement Therapy: These medications help relieve withdrawal symptoms.
- Nicotine gum is available over-the-counter. The gum is chewed and then “parked” in the side of the mouth between the cheek and gum. Nicotine passes through gum tissue into blood vessels.
- Nicotine inhaler is available by prescription. The nicotine is inhaled into the mouth, not the lungs.
- Nicotine nasal spray is available only by prescription. Nicotine is delivered by pumping the spray into the nostrils where it is absorbed through the nasal membranes.
- Nicotine Patches are available over-the-counter and by prescription. Patches are worn and replaced daily or are removed at night.
- Lozenges are available over-the-counter and are the most recent NRT product to be approved by the FDA. Nicotine is absorbed through the mouth.
Keep in mind that the effectiveness of smoking cessation medications increases when used in combination with a tobacco cessation program that addresses changes in behavior.
