Q&A About Qutting Smoking
This information is brought to you by the
National Cancer Institute. We hope that it will help you in your quest
to quit smoking.
- Is it very important to stop smoking?
Tobacco use remains the single most preventable cause of death in the
United States. Cigarette smoking accounts for nearly one-third of all
cancer deaths in this country each year.
Smoking is the most common
risk factor for the development of lung cancer, which is the leading cause
of cancer death. It is also associated with many other types of cancer,
including cancers of the
cervix. Smoking also increases the risk of other health problems, such as
chronic lung disease and heart disease. Smoking during pregnancy can have
adverse effects on the unborn child, such as premature delivery and low
- What are the immediate benefits of stopping smoking?
The health benefits of smoking cessation (quitting) are immediate and
substantial. Almost immediately, a person's circulation begins to improve and
the level of carbon monoxide in the
blood begins to decline. (Carbon monoxide, a colorless, odorless gas found
in cigarette smoke, reduces the blood's ability to carry oxygen.) A person's
pulse rate and blood pressure, which may be abnormally high while smoking,
begin to return to normal. Within a few days of quitting, a person's sense of
taste and smell return, and breathing becomes increasingly easier.
- What are the long-term benefits of stopping smoking?
People who quit smoking live longer than those who continue to smoke. After
10 to 15 years, a previous tobacco user's risk of premature death approaches
that of a person who has never smoked. About 10 years after quitting, an
ex-smoker's risk of dying from lung cancer is 30 percent to 50 percent less
than the risk for those who continue to smoke. Women who stop smoking before
becoming pregnant or who quit in the first 3 months of pregnancy can reverse
the risk of low birth weight for the baby and reduce other
pregnancy-associated risks. Quitting also reduces the risk of other
smoking-related diseases, including heart disease and chronic lung disease.
There are also many benefits to smoking cessation for people who are sick
or who have already developed cancer. Smoking cessation reduces the risk for
infections, such as
pneumonia, which often causes death in patients with other existing
- Does cancer risk change after quitting smoking?
Quitting smoking reduces the risk for developing cancer, and this benefit
increases the longer a person remains "smoke free." People who quit smoking
reduce their risk of developing and dying from lung cancer. They also reduce
their risk of other types of cancer (see question 1). The risk of premature
death and the chance of developing cancer due to cigarettes depends on the
number of years of smoking, the number of cigarettes smoked per day, the age
at which smoking began, and the presence or absence of illness at the time of
quitting. For people who have already developed cancer, quitting smoking
reduces the risk of developing another primary cancer.
- At what age is smoking cessation the most beneficial?
Smoking cessation benefits men and women at any age. Some older adults may
not perceive the benefits of quitting smoking; however, smokers who quit
before age 50 have half the risk of dying in the next 16 years compared with
people who continue to smoke. By age 64, their overall chance of dying is
similar to that of people the same age who have never smoked. Older adults who
quit smoking also have a reduced risk of dying from coronary heart disease and
lung cancer. Additional, immediate benefits (such as improved circulation, and
increased energy and breathing capacity) are other good reasons for older
adults to become smoke free.
- What are some of the difficulties associated with quitting smoking?
Quitting smoking may cause short-term after-effects, especially for those
who have smoked a large number of cigarettes for a long period of time. People
who quit smoking are likely to feel anxious, irritable, hungry, more tired,
and have difficulty sleeping. They may also have difficulty concentrating.
Many tobacco users gain weight when they quit, but usually less than 10
pounds. These changes do subside. People who kick the habit have the
opportunity for a healthier future.
- How can health care providers help their patients to stop smoking?
Doctors and dentists can be good sources of information about the health
risks of smoking and about quitting. They can tell their patients about the
proper use and potential
side effects of nicotine replacement
therapy (see question 8), and help them find local smoking cessation
Doctors and dentists can also play an important role by asking
patients about smoking at every office visit; advising patients to
stop; assisting patients by setting a quit date, providing self-help
materials, and suggesting nicotine replacement therapies (when appropriate);
and arranging for follow up visits.
- What is nicotine replacement therapy?
Nicotine is the drug in cigarettes and other forms of tobacco that causes
addiction. Nicotine replacement products deliver small, steady
doses of nicotine into the body, which helps to relieve the withdrawal
symptoms often felt by people trying to quit smoking. These products,
which are available in four forms (patches, gum,
nasal spray, and inhaler), appear to be equally effective. There is
evidence that combining the nicotine patch with nicotine gum or nicotine nasal
spray increases long-term quit rates compared with using a single type of
nicotine replacement therapy. Nicotine gum, in combination with nicotine patch
therapy, may also reduce withdrawal symptoms better than either medication
alone. Researchers recommend combining nicotine replacement therapy with
advice or counseling from a doctor, dentist, pharmacist, or other health
- The nicotine patch, which is available over the counter (without
prescription), supplies a steady amount of nicotine to the body through
the skin. The nicotine patch is sold in varying strengths as an 8-week
smoking cessation treatment. Nicotine doses are gradually lowered as the
treatment progresses. The nicotine patch may not be a good choice for people
with skin problems or allergies to adhesive tape.
- Nicotine gum is available over the counter in 2- and 4-mg
strengths. Chewing nicotine gum releases nicotine into the bloodstream
through the lining of the mouth. Nicotine gum might not be appropriate for
people with temporomandibular joint disease (TMJ) or for those with dentures
or other dental work such as bridges.
- Nicotine nasal spray was approved by the U.S. Food and Drug
Administration (FDA) in 1996 for use by prescription only. The spray comes
pump bottle containing nicotine that tobacco users can inhale when they
have an urge to smoke. This product is not recommended for people with nasal
or sinus conditions, allergies, or asthma, nor is it recommended for young
- A nicotine inhaler, also available only by prescription, was
approved by the FDA in 1997. This device delivers a vaporized form of
nicotine to the mouth through a mouthpiece attached to a plastic cartridge.
Even though it is called an inhaler, the device does not deliver nicotine to
lungs the way a cigarette does. Most of the nicotine only travels to the
mouth and throat, where it is absorbed through the mucous
membranes. Common side effects include throat and mouth irritation and
coughing. Anyone with a
bronchial problem such as asthma should use it with caution.
- Are there smoking cessation aids that do not contain nicotine?
Bupropion, a prescription
antidepressant marketed as Zybanฎ, was approved by the FDA in 1997 to
treat nicotine addiction. This drug can help to reduce nicotine withdrawal
symptoms and the urge to smoke. Some common side effects of bupropion are dry
mouth, difficulty sleeping, dizziness, and skin rash. People should not use
this drug if they have a seizure condition such as
epilepsy or an eating disorder such as
anorexia nervosa or bulimia, or if they are taking other medicines that
contain bupropion hydrochloride.
- What if efforts to quit result in relapse?
Many smokers find it difficult to quit smoking, and it may take two or
three attempts before they are finally able to quit. Although
relapse rates are most common in the first few weeks or months after
quitting, people who stop smoking for 3 months are often able to remain
cigarette-free for the rest of their lives.
- What agencies and organizations are available to help people stop smoking?
A number of organizations provide information and materials about where to
find help to stop smoking. State and local health agencies often have
information about community smoking cessation programs. The local or county
government section in the phone book (blue pages) has current phone numbers
for health agencies. Information to help people quit smoking is also available
through community hospitals, the yellow pages (under "drug abuse and
addiction"), public libraries, health maintenance organizations, health fairs,
bookstores, and community helplines.
Several national organizations provide information about how to quit
The Agency for Healthcare Research and Quality (AHRQ) issues smoking
cessation guidelines and other materials for physicians, health care
professionals, and the general public. Printed copies are available by
||AHRQ Publications Clearinghouse
Post Office Box 8547
Silver Spring, MD 209078547
||18885866340 (for deaf and hard of hearing callers)
|Internet Web site:
The National Institutes of Health (NIH) supports research to help
prevent, detect, diagnose, and treat diseases and disabilities. Several of
NIH's Institutes provide information on the harmful effects of smoking.
The Office on Smoking and Health of the Centers for Disease
Control and Prevention distributes pamphlets, posters, scientific reports,
and public service announcements about smoking, and maintains a bibliographic
database of smoking and health-related materials. For more information,
||Office on Smoking and Health
National Center for Chronic Disease Prevention and
Centers for Disease Control and Prevention
Mail Stop K50
4770 Buford Highway, NE.
Atlanta, GA 303413724
|FAX Information Service:
|Internet Web site:
The Office of the
Surgeon General has information about techniques being used to treat
tobacco use and dependence. The Office of the Surgeon General's Web site has
press releases, documents, and other information on tobacco use and cessation.
The American Cancer Society (ACS) offers materials on smoking
cessation and other smoking and tobacco-related topics. The ACS also sponsors
a smoking cessation clinic called FreshStart, which is available in most of
the United States.
For more information or the phone number for a local ACS office, contact
ACS's National Home Office at:
||1599 Clifton Road, NE.
Atlanta, GA 303294251
|Internet Web site:
The American Heart Association (AHA) has information on local and
community-related intervention programs in schools, workplaces, and health
care sites. It also offers brochures on smoking cessation and the relationship
between smoking and heart disease. For more information or the phone number
for a local AHA chapter, contact AHA's national office at:
7272 Greenville Avenue
Dallas, TX 75231
|Internet Web site:
The American Lung Association (ALA), an organization dedicated to
fighting smoking-related diseases, provides information about local smoking
cessation programs as well as its Freedom From Smoking clinics for individuals
and organizations. For more information or the phone number for a local ALA
chapter, contact ALA's national headquarters at: