http://www.fitango.com/categories.php?id=630Fitango EducationHealth TopicsAfter quitting
1Overview**Key Points**-- Quitting is the only way that smokers cansubstantially reduce their risk of disease. Althoughqui...
2Overview**Key Points**-- Common withdrawal symptoms associated withquitting include nicotine cravings, anger,frustration,...
3Overview**Key Points**-- Triggers are the moods, feelings, places, orthings that you do in your daily life that make youw...
4Overview**Key Points**-- Strong and consistent evidence shows thatnicotine replacement products can help relievenicotine ...
5Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**Quitting smoking may caus...
6Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**Common withdrawal symptom...
7Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**-- Depression.-- Weight g...
8Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**The good news is that the...
9Handling Withdrawal**What are some of the triggers for smoking?**In addition to nicotine cravings, reminders in yourdaily...
10Handling Withdrawal**What are some of the triggers for smoking?**-- Being around smokers.-- Starting the day.-- Feeling ...
11Handling Withdrawal**What are some of the triggers for smoking?**-- Enjoying a meal.-- Drinking an alcoholic beverage.--...
12Handling Withdrawal**What can I do about nicotine cravings?**As a smoker, you get used to having a certain levelof nicot...
13Handling Withdrawal**What can I do about nicotine cravings?**The urge to smoke will come and go. Cravingsusually last on...
14Handling Withdrawal**What can I do about nicotine cravings?**-- Remind yourself that they will pass.-- Avoid situations ...
15Handling Withdrawal**What can I do about nicotine cravings?**-- Try this exercise: Take a deep breath throughyour nose a...
16Handling Withdrawal**What can I do about anger, frustration, andirritability?**After you quit smoking, you may feel edgy...
17Handling Withdrawal**What can I do about anger, frustration, andirritability?**Studies have found that the most commonne...
18Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Engage in a physical activity, such as...
19Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Ask your doctor about nicotine replace...
20Handling Withdrawal**What can I do about anger, frustration, andirritability?**Within 24 hours of quitting smoking, you ...
21Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Remind yourself that anxiety will pass...
22Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Reduce caffeine by limiting or avoidin...
23Handling Withdrawal**What can I do about depression?**It is normal to feel sad for a period of time afteryou first quit ...
24Handling Withdrawal**What can I do about depression?**Having a history of depression is associated withmore severe withd...
25Handling Withdrawal**What can I do about depression?**Many people have a strong urge to smoke whenthey feel depressed. H...
26Handling Withdrawal**What can I do about depression?**-- Identify your specific feelings at the time thatyou seem depres...
27Handling Withdrawal**What can I do about depression?**-- Make a list of things that are upsetting to youand write down s...
28Handling Withdrawal**What can I do about weight gain?**Gaining weight is common after quitting. Studieshave shown that, ...
29Handling Withdrawal**What can I do about weight gain?**Although most smokers gain fewer than 10 poundsafter they quit sm...
30Handling Withdrawal**What can I do about weight gain?**-- Ask your doctor about the medicationbupropion. Studies show th...
31Handling Withdrawal**What can I do about weight gain?**-- If weight gain is a problem, you may want toconsult a nutritio...
32Handling Withdrawal**What can I do about weight gain?**You may want to analyze situations in whichwatching others smoke ...
33Handling Withdrawal**What can I do about weight gain?**Here are some tips:-- Limit your contact with smokers, especially...
34Handling Withdrawal**What can I do about weight gain?**-- Do not let people smoke in your home. Post asmall “No Smoking”...
35Handling Withdrawal**What can I do about weight gain?**-- Focus on what you’ve gained by quitting. Forexample, think of ...
36Handling Withdrawal**What can I do about weight gain?**Many smokers light up a cigarette right after theywake up. After ...
37Handling Withdrawal**What can I do about weight gain?**-- The morning can set the tone for the rest of theday. Plan a di...
38Handling Withdrawal**What can I do about weight gain?**-- Begin each day with a planned activity that willkeep you busy ...
39Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**Most smokers report that one reason t...
40Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**Everyday worries, responsibilities, a...
41Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**-- Know the causes of stress in your ...
42Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**-- Try relaxation techniques, such as...
43Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**You may have become used to ...
44Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Tips for short trips:-- Remo...
45Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Take an alternate route t...
46Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**“So, I’m not enjoying this c...
47Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Ask passengers not to smo...
48Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Take a stretch break.-- T...
49Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**You may be used to smoking w...
50Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Here are some tips:-- If you...
51Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Try switching to decaffei...
52Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- When you quit smoking, dr...
53Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Food often tastes better aft...
54Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Here are some tips:-- Know w...
55Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- If you have coffee or a f...
56Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**You may be used to smok...
57Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**Here are some tips for ...
58Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**-- Don’t drink at home ...
59Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**When you quit smoking, ...
60Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**-- Make a list of thing...
61Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**-- Look at and listen t...
62Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**Yes. Nicotine r...
63Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**Five forms of n...
64Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- The nicotine...
65Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Nicotine gum...
66Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- The nicotine...
67Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Nicotine nas...
68Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- A nicotine i...
69Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Experts reco...
70Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**It is far less ...
71Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**Yes, a doctor m...
72Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Bupropion, a...
73Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Varenicline,...
74Handling Withdrawal**Are there alternative methods to help people quitsmoking?**Some people claim that alternative appro...
75Handling Withdrawal**How can I get help quitting tobacco?**NCI and other agencies and organizations can helpsmokers quit...
76Handling Withdrawal**How can I get help quitting tobacco?**Call NCI’s Smoking Quitline at 1–877–44U–QUIT(1–877–448–7848)...
After quitting
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After quitting

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Key Points


-- Quitting is the only way that smokers can substantially reduce their risk of disease. Although quitting is difficult, millions of people have quit smoking for good. Many tips are offered in this fact sheet, but everyone is different so choose the tips that will work best for you. In general, keeping busy and avoiding the things that tempt you to smoke will help you manage withdrawal symptoms and avoid your triggers to smoke.


-- Common withdrawal symptoms associated with quitting include nicotine cravings, anger, frustration, irritability, anxiety, depression, and weight gain. It may help to know that withdrawal symptoms are usually worst during the first week after quitting. From that point, the intensity of the symptoms drops over the first month. In the meantime, there are many steps you can take to make it easier to quit smoking.


-- Triggers are the moods, feelings, places, or things that you do in your daily life that make you want to smoke. Triggers for smoking may include being around other smokers, feeling stressed, drinking coffee or tea, and enjoying a meal. Knowing your triggers helps you stay in control because you can avoid them, or, when you can’t, you can do things to keep your mind off smoking.


-- Strong and consistent evidence shows that nicotine replacement products can help relieve nicotine cravings and withdrawal symptoms. These products are available in five different forms—patch, gum, lozenge, nasal spray, and inhaler. In addition, cravings and withdrawal symptoms can be relieved by the prescription medications bupropion and varenicline.

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After quitting

  1. 1. http://www.fitango.com/categories.php?id=630Fitango EducationHealth TopicsAfter quitting
  2. 2. 1Overview**Key Points**-- Quitting is the only way that smokers cansubstantially reduce their risk of disease. Althoughquitting is difficult, millions of people have quitsmoking for good. Many tips are offered in this factsheet, but everyone is different so choose the tipsthat will work best for you. In general, keepingbusy and avoiding the things that tempt you tosmoke will help you manage withdrawal symptomsand avoid your triggers to smoke.
  3. 3. 2Overview**Key Points**-- Common withdrawal symptoms associated withquitting include nicotine cravings, anger,frustration, irritability, anxiety, depression, andweight gain. It may help to know that withdrawalsymptoms are usually worst during the first weekafter quitting. From that point, the intensity of thesymptoms drops over the first month. In themeantime, there are many steps you can take tomake it easier to quit smoking.
  4. 4. 3Overview**Key Points**-- Triggers are the moods, feelings, places, orthings that you do in your daily life that make youwant to smoke. Triggers for smoking may includebeing around other smokers, feeling stressed,drinking coffee or tea, and enjoying a meal.Knowing your triggers helps you stay in controlbecause you can avoid them, or, when you can’t,you can do things to keep your mind off smoking.
  5. 5. 4Overview**Key Points**-- Strong and consistent evidence shows thatnicotine replacement products can help relievenicotine cravings and withdrawal symptoms. Theseproducts are available in five different forms—patch, gum, lozenge, nasal spray, and inhaler. Inaddition, cravings and withdrawal symptoms canbe relieved by the prescription medicationsbupropion and varenicline.
  6. 6. 5Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**Quitting smoking may cause short-term problems,especially for those who have smoked heavily formany years. These temporary changes can result inwithdrawal symptoms.
  7. 7. 6Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**Common withdrawal symptoms associated withquitting include the following:-- Nicotine cravings (nicotine is the substance intobacco that causes addiction).-- Anger, frustration, and irritability.-- Anxiety.
  8. 8. 7Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**-- Depression.-- Weight gain.-- Studies have shown that about half of smokersreport experiencing at least four withdrawalsymptoms (such as anger, anxiety, or depression)when they quit. People have reported othersymptoms, including dizziness, increaseddreaming, and headaches.
  9. 9. 8Handling Withdrawal**What are some of the withdrawal symptomsassociated with quitting smoking?**The good news is that there is much you can do toreduce cravings and manage common withdrawalsymptoms (see Questions 3–7, 16, and 18). Evenwithout medication, withdrawal symptoms andother problems subside over time. It may also helpto know that withdrawal symptoms are usuallyworst during the first week after quitting. Fromthat point on, the intensity usually drops over thefirst month. However, everyone is different, andsome people have withdrawal symptoms forseveral months after quit
  10. 10. 9Handling Withdrawal**What are some of the triggers for smoking?**In addition to nicotine cravings, reminders in yourdaily life of times when you used to smoke maytrigger you to smoke. Triggers are the moods,feelings, places, or things you do in your daily lifethat turn on your desire to smoke.Triggers may include any of the following:
  11. 11. 10Handling Withdrawal**What are some of the triggers for smoking?**-- Being around smokers.-- Starting the day.-- Feeling stressed.-- Being in a car.-- Drinking coffee or tea.
  12. 12. 11Handling Withdrawal**What are some of the triggers for smoking?**-- Enjoying a meal.-- Drinking an alcoholic beverage.-- Feeling bored.
  13. 13. 12Handling Withdrawal**What can I do about nicotine cravings?**As a smoker, you get used to having a certain levelof nicotine in your body. You control that level byhow much you smoke, how deeply you inhale thesmoke, and the kind of tobacco you use. When youquit, cravings develop when your body wantsnicotine. It takes time to break free from nicotineaddiction. Also, when you see people smoking orare around other triggers, you may get nicotinecravings. Cravings are real. They are not just inyour imagination. At the same time, your moodmay change, a
  14. 14. 13Handling Withdrawal**What can I do about nicotine cravings?**The urge to smoke will come and go. Cravingsusually last only a very brief period of time.Cravings usually begin within an hour or two afteryou have your last cigarette, peak for several days,and may last several weeks. As the days pass, thecravings will get farther apart. Occasional mildcravings may last for 6 months.Here are some tips for managing cravings:
  15. 15. 14Handling Withdrawal**What can I do about nicotine cravings?**-- Remind yourself that they will pass.-- Avoid situations and activities that you used toassociate with smoking.-- As a substitute for smoking, try chewing oncarrots, pickles, apples, celery, sugarless gum, orhard candy. Keeping your mouth busy may stop thepsychological need to smoke.
  16. 16. 15Handling Withdrawal**What can I do about nicotine cravings?**-- Try this exercise: Take a deep breath throughyour nose and blow out slowly through yourmouth. Repeat 10 times.Go online to Smokefree.gov(http://www.smokefree.gov), a Web site createdby the National Cancer Institute’s (NCI) TobaccoControl Research Branch, and use the Step-by-StepQuit Guide to learn about other tips for managingcravings.
  17. 17. 16Handling Withdrawal**What can I do about anger, frustration, andirritability?**After you quit smoking, you may feel edgy andshort-tempered, and you may want to give up ontasks more quickly than usual. You may be lesstolerant of others and get into more arguments.
  18. 18. 17Handling Withdrawal**What can I do about anger, frustration, andirritability?**Studies have found that the most commonnegative feelings associated with quitting arefeelings of anger, frustration, and irritability. Thesenegative feelings peak within 1 week of quittingand may last 2 to 4 weeks.Here are some tips for managing these negativefeelings:-- Remind yourself that these feelings aretemporary.
  19. 19. 18Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Engage in a physical activity, such as taking awalk.-- Reduce caffeine by limiting or avoiding coffee,soda, and tea.-- Try meditation or other relaxation techniques,such as getting a massage, soaking in a hot bath, orbreathing deeply through your nose and outthrough your mouth for 10 breaths.
  20. 20. 19Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Ask your doctor about nicotine replacementproducts or other medications.**What can I do about anxiety?**
  21. 21. 20Handling Withdrawal**What can I do about anger, frustration, andirritability?**Within 24 hours of quitting smoking, you may feeltense and agitated. You may feel a tightness inyour muscles—especially around the neck andshoulders. Studies have found that anxiety is oneof the most common negative feelings associatedwith quitting. If anxiety occurs, it builds over thefirst 3 days after quitting and may last 2 weeks.Here are some tips for managing anxiety:
  22. 22. 21Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Remind yourself that anxiety will pass with time.-- Set aside some quiet time every morning andevening—a time when you can be alone in a quietenvironment.-- Engage in physical activity, such as taking a walk.
  23. 23. 22Handling Withdrawal**What can I do about anger, frustration, andirritability?**-- Reduce caffeine by limiting or avoiding coffee,soda, and tea.-- Try meditation or other relaxation techniques,such as getting a massage, soaking in a hot bath, orbreathing deeply through your nose and outthrough your mouth for 10 breaths.-- Ask your doctor about nicotine replacementproducts or other medications.
  24. 24. 23Handling Withdrawal**What can I do about depression?**It is normal to feel sad for a period of time afteryou first quit smoking. If mild depression occurs, itwill usually begin within the first day, continue forthe first couple of weeks, and go away within amonth.
  25. 25. 24Handling Withdrawal**What can I do about depression?**Having a history of depression is associated withmore severe withdrawal symptoms—includingmore severe depression. Some studies have foundthat many people with a history of majordepression will have a new major depressiveepisode after quitting. However, in those with nohistory of depression, major depression afterquitting is rare.
  26. 26. 25Handling Withdrawal**What can I do about depression?**Many people have a strong urge to smoke whenthey feel depressed. Here are some tips formanaging depression:-- Call a friend and plan to have lunch or go to amovie, concert, or other pleasurable event.
  27. 27. 26Handling Withdrawal**What can I do about depression?**-- Identify your specific feelings at the time thatyou seem depressed. Are you actually feeling tired,lonely, bored, or hungry? Focus on and addressthese specific needs.-- Increase physical activity. This will help toimprove your mood and lift your depression.-- Breathe deeply.
  28. 28. 27Handling Withdrawal**What can I do about depression?**-- Make a list of things that are upsetting to youand write down solutions for them.-- If depression continues for more than 1 month,see your doctor. Ask your doctor aboutprescription medications that may help you withdepression. Studies show that bupropion andnortriptyline can help people with a past history ofdepression who try to quit smoking. Nicotinereplacement products also help.
  29. 29. 28Handling Withdrawal**What can I do about weight gain?**Gaining weight is common after quitting. Studieshave shown that, on average, people who havenever smoked weigh a few pounds more thansmokers, and, when smokers quit, they attain theweight they would have had if they had neversmoked.
  30. 30. 29Handling Withdrawal**What can I do about weight gain?**Although most smokers gain fewer than 10 poundsafter they quit smoking, the weight gain can betroublesome for some people. However, the healthbenefits of quitting far outweigh the health risks ofa small amount of extra weight.Here are some tips for managing weight gain:
  31. 31. 30Handling Withdrawal**What can I do about weight gain?**-- Ask your doctor about the medicationbupropion. Studies show that it helps counterweight gain.-- Studies also show that nicotine replacementproducts, especially nicotine gum and lozenges,can help counter weight gain. Because somepeople who quit smoking increase their foodintake, regular physical activity and healthy foodchoices can help you maintain a healthy weight.
  32. 32. 31Handling Withdrawal**What can I do about weight gain?**-- If weight gain is a problem, you may want toconsult a nutritionist or diet counselor.**How can I resist the urge to smoke when I’maround smokers?**
  33. 33. 32Handling Withdrawal**What can I do about weight gain?**You may want to analyze situations in whichwatching others smoke triggers an urge in you tosmoke. Figure out what it is about those situationsthat makes you want to smoke. Is it because youassociate feeling happy with being around othersmokers? Or, is there something special about thesituations, such as being around the people youusually smoked with? Is it tempting to join othersfor routine smoke breaks?
  34. 34. 33Handling Withdrawal**What can I do about weight gain?**Here are some tips:-- Limit your contact with smokers, especially in theearly weeks of quitting.-- Do not buy, carry, light, or hold cigarettes forothers.-- If you are in a group and others light up, excuseyourself, and don’t return until they have finished.
  35. 35. 34Handling Withdrawal**What can I do about weight gain?**-- Do not let people smoke in your home. Post asmall “No Smoking” sign by your front door.-- Ask others to help you stay quit. Give themspecific examples of things that are helpful (suchas not smoking around you) and things that are nothelpful (like asking you to buy cigarettes for them).
  36. 36. 35Handling Withdrawal**What can I do about weight gain?**-- Focus on what you’ve gained by quitting. Forexample, think of how healthy you will be when allsmoking effects are gone from your body and youcan call yourself smoke-free. Also, add up howmuch money you have saved already by notpurchasing cigarettes and imagine (in detail) howyou will spend your savings in 6 months.**How can I start the day without smoking?**
  37. 37. 36Handling Withdrawal**What can I do about weight gain?**Many smokers light up a cigarette right after theywake up. After 6 to 8 hours of sleep, a smoker’snicotine level drops and the smoker needs a boostof nicotine to start the day. After you quit, youmust be ready to overcome the physical need androutine of waking up and smoking a cigarette.Instead of reaching for your cigarettes in themorning, here are some tips:
  38. 38. 37Handling Withdrawal**What can I do about weight gain?**-- The morning can set the tone for the rest of theday. Plan a different wake-up routine, and divertyour attention from smoking.-- Be sure no cigarettes are available.-- Before you go to sleep, make a list of things youneed to avoid in the morning that will make youwant to smoke. Place this list where you used toplace your cigarettes.
  39. 39. 38Handling Withdrawal**What can I do about weight gain?**-- Begin each day with a planned activity that willkeep you busy for an hour or more. It will keepyour mind and body busy so you don’t think aboutsmoking.-- Begin each day with deep breathing and bydrinking one or more glasses of water.
  40. 40. 39Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**Most smokers report that one reason they smokeis to handle stress. This happens because smokingcigarettes actually relieves some of your stress byreleasing powerful chemicals in your brain.Temporary changes in brain chemistry cause you toexperience decreased anxiety, enhanced pleasure,and alert relaxation. Once you stop smoking, youmay become more aware of stress.
  41. 41. 40Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**Everyday worries, responsibilities, and hassles canall contribute to stress. As you go longer withoutsmoking, you will get better at handling stress,especially if you learn stress reduction andrelaxation techniques.Here are some tips:
  42. 42. 41Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**-- Know the causes of stress in your life (your job,traffic, your children, money) and identify thestress signals (headaches, nervousness, or troublesleeping). Once you pinpoint high-risk triggersituations, you can start to develop new ways tohandle them.-- Create peaceful times in your everyday schedule.For example, set aside an hour where you can getaway from other people and your usualenvironment.
  43. 43. 42Handling Withdrawal**How can I resist the urge to smoke when I’m feelingstressed?**-- Try relaxation techniques, such as progressiverelaxation or yoga, and stick with the one thatworks best for you.-- Rehearse and visualize your relaxation plan. Putyour plan into action. Change your plan as needed.-- You may find it helpful to read a book about howto handle stress.
  44. 44. 43Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**You may have become used to smoking whiledriving—to relax in a traffic jam or to stay alert ona long drive. Like many smokers, you may like tolight up when driving to and from work to relievestress, stay alert, relax, or just pass the time. Thereis some evidence that smoking actually does makeyou feel more awake and alert.
  45. 45. 44Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Tips for short trips:-- Remove the ashtray, lighter, and cigarettes fromyour car.-- Keep nonfattening snacks in your car (such aslicorice, sugarless gum, and hard candy).-- Turn on your favorite music and sing along.
  46. 46. 45Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Take an alternate route to work or trycarpooling.-- Clean your car and make sure to use deodorizersto reduce the tobacco smell.Tell yourself:“This urge will go away in a few minutes.”
  47. 47. 46Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**“So, I’m not enjoying this car ride. Big deal! Itwon’t last forever!”“My car smells clean and fresh!”“I’m a better driver now that I’m not smokingwhile driving.”When you are driving or riding with other people:
  48. 48. 47Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Ask passengers not to smoke in your car.-- If you’re not driving, find something to do withyour hands.-- Your desire to smoke may be stronger and morefrequent on longer trips.Tips for long trips:
  49. 49. 48Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Take a stretch break.-- Take fresh fruit along.-- Plan rest stops.-- Plan stops for water or fruit juice.-- How can I resist the urge to smoke when I’mhaving coffee or tea?
  50. 50. 49Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**You may be used to smoking when drinking coffeeor tea (for example, during or after meals or duringwork breaks), and you may associate good feelingswith drinking a hot beverage. When you give upsmoking, expect to feel a strong urge to reach for acigarette while drinking coffee or tea. Althoughyou do not have to give up coffee or tea to quitsmoking, you should expect that coffee or tea willnot taste the same without a cigarette.
  51. 51. 50Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Here are some tips:-- If you used to smoke while drinking coffee ortea, tell people you have quit, so they won’t offeryou a cigarette.-- Between sips of coffee or tea, take deep breathsto inhale the aroma. Breathe in deeply and slowlywhile you count to five, and then breathe outslowly, counting to five again.
  52. 52. 51Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- Try switching to decaffeinated coffee or tea for awhile, particularly if quitting has made you irritableor nervous.-- Keep your hands busy by nibbling on healthyfoods, doodling, or making a list of tasks for theday.-- If the urge to smoke is very strong, drink yourcoffee or tea more quickly than usual and thenchange activities or rooms.
  53. 53. 52Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- When you quit smoking, drinking coffee or teawithout smoking may make you feel sad. Focus onwhat you’ve gained by quitting.-- How can I enjoy a meal without smoking?
  54. 54. 53Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Food often tastes better after you quit smoking,and you may have a bigger appetite. Expect towant to smoke after meals. Your desire to smokeafter meals may depend on whether you are alone,with other smokers, or with nonsmokers.Your urge to smoke may be stronger with certainfoods, such as spicy or sweet foods. Also, the urgeto smoke may be stronger at different meal times.
  55. 55. 54Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**Here are some tips:-- Know what kinds of foods increase your urge tosmoke and stay away from them.-- If you are alone, call a friend or take a walk assoon as you’ve finished eating.-- Brush your teeth or use mouthwash right aftermeals.
  56. 56. 55Handling Withdrawal**How can I resist the urge to smoke when Im drivingor riding in a car?**-- If you have coffee or a fruit drink, concentrate onthe taste.-- Wash the dishes by hand after eating—you can’tsmoke with wet hands!-- Eat at smoke-free restaurants.
  57. 57. 56Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**You may be used to smoking when drinking beer,wine, liquor, or mixed drinks, and you mayassociate good feelings with drinking alcoholicbeverages. When you quit smoking, you may feel astrong urge to smoke when you drink alcohol.Know this up front if you are going to drink. If youdo drink, keep in mind that your control over yourbehavior may be impaired under the influence ofalcohol. When you try to quit smoking, drinkingalcohol may make it even tougher to cope.
  58. 58. 57Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**Here are some tips for the first few weeks afterquitting:-- Many people find it helpful to reduce or avoiddrinking alcohol.-- Switch to nonalcoholic drinks.-- If you do drink, don’t choose the alcoholicbeverages you usually have when smoking.
  59. 59. 58Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**-- Don’t drink at home or by yourself.-- Stay away from the places you usually drinkalcohol, or drink only with nonsmoking friends.-- How can I resist the urge to smoke when I’mfeeling bored?
  60. 60. 59Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**When you quit smoking, you may miss theincreased excitement and good feeling thatnicotine gave you. This may be particularly truewhen you are feeling bored.Here are some tips:-- Plan more activities than you have time for.
  61. 61. 60Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**-- Make a list of things to do when confronted withfree time.-- Move! Do not stay in the same place too long.-- If you feel very bored when waiting forsomething or someone (a bus, your friend, yourkids), distract yourself with a book, magazine, orcrossword puzzle.
  62. 62. 61Handling Withdrawal**How can I resist the urge to smoke when I’mdrinking an alcoholic beverage?**-- Look at and listen to what is going on aroundyou.-- Carry something to keep your hands busy.-- Listen to a favorite song.-- Go outdoors, if you can, but not to places youassociate with smoking.
  63. 63. 62Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**Yes. Nicotine replacement products delivermeasured doses of nicotine into the body, whichhelps to relieve the cravings and withdrawalsymptoms often felt by people trying to quitsmoking. Nicotine replacement products areeffective treatments that can increase thelikelihood that someone will quit successfully (5,9).
  64. 64. 63Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**Five forms of nicotine replacement products havebeen approved by the U.S. Food and DrugAdministration (FDA):
  65. 65. 64Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- The nicotine patch is available over the counter(without a prescription). A new patch is worn onthe skin each day, supplying a small but steadyamount of nicotine to the body. The nicotine patchis sold in varying strengths, usually as an 8- to 10-week quit-smoking treatment. Typically, thenicotine doses are gradually lowered as treatmentprogresses. The nicotine patch may not be a goodchoice for people with skin problems or allergies toadhesive tape. Also, some people experience thesid
  66. 66. 65Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Nicotine gum is available over the counter in twostrengths (2 and 4 milligrams). When a personchews nicotine gum and then places the chewedproduct between the cheek and gum tissue,nicotine is released into the bloodstream throughthe lining of the mouth. To keep a steady amountof nicotine in the body, a new piece of gum can bechewed every 1 or 2 hours. The 4-milligram doseappears to be more effective among highlydependent smokers (those who smoked 20 ormore cigarettes per day) (10, 1
  67. 67. 66Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- The nicotine lozenge is also available over thecounter in 2 and 4 milligram strengths. The lozengeis used similarly to nicotine gum; it is placedbetween the cheek and the gums and allowed todissolve. Nicotine is released into the bloodstreamthrough the lining of the mouth. The lozengeworks best when used every 1 or 2 hours andwhen coffee, juice, or other acidic beverages arenot consumed at the same time.
  68. 68. 67Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Nicotine nasal spray is available by prescriptiononly. The spray comes in a pump bottle containingnicotine that tobacco users can inhale when theyhave an urge to smoke. Nicotine is absorbed morequickly via the spray than with other nicotinereplacement products. Nicotine nasal spray is notrecommended for people with nasal or sinusconditions, allergies, or asthma or for youngtobacco users. Side effects from the spray includesneezing, coughing, and watering eyes, but theseproblems usua
  69. 69. 68Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- A nicotine inhaler, also available by prescriptiononly, delivers a vaporized form of nicotine to themouth through a mouthpiece attached to a plasticcartridge. Even though it is called an inhaler, thedevice does not deliver nicotine to the lungs theway a cigarette does. Most of the nicotine travelsonly to the mouth and throat, where it is absorbedthrough the mucous membranes. Common sideeffects include throat and mouth irritation andcoughing. Anyone with a breathing problem suchas as
  70. 70. 69Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Experts recommend combining nicotinereplacement therapy with advice or counselingfrom a doctor, dentist, pharmacist, or other healthcare provider. Also, experts suggest that smokersquit using tobacco products before they start usingnicotine replacement products. Too much nicotinecan cause nausea, vomiting, dizziness, diarrhea,weakness, or rapid heartbeat.**Are nicotine replacement products safe?**
  71. 71. 70Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**It is far less harmful for a person to get nicotinefrom a nicotine replacement product than fromcigarettes because tobacco smoke contains manytoxic and cancer-causing substances. Long-termuse of nicotine replacement products has not beenassociated with any serious harmful effects (11).**Are there products to help people quit smokingthat do not contain nicotine?**
  72. 72. 71Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**Yes, a doctor may prescribe one of severalmedicines that do not contain nicotine:
  73. 73. 72Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Bupropion, a prescription antidepressant, wasapproved by the FDA in 1997 to treat nicotineaddiction (under the trade name Zyban®). Thisdrug can help to reduce nicotine withdrawalsymptoms and the urge to smoke and can be usedsafely with nicotine replacement products (9, 12).Several side effects are associated with thisproduct. Discuss with your doctor if this medicineis right for you.
  74. 74. 73Handling Withdrawal**Do nicotine replacement products relieve nicotinecravings and withdrawal symptoms?**-- Varenicline, a prescription medicine marketed asChantix®, was approved by the FDA in 2006 to helpcigarette smokers stop smoking. This drug mayhelp those who wish to quit by easing theirnicotine cravings and by blocking the pleasurableeffects of nicotine if they do resume smoking.Several side effects are associated with thisproduct. Discuss with your doctor if this medicineis right for you.
  75. 75. 74Handling Withdrawal**Are there alternative methods to help people quitsmoking?**Some people claim that alternative approachessuch as hypnosis, acupuncture, acupressure, lasertherapy (laser stimulation of acupuncture pointson the body), or electrostimulation may helpreduce the symptoms associated with nicotinewithdrawal. However, in clinical studies thesealternative therapies have not been found to helppeople quit smoking. There is no evidence thatalternative approaches help smokers who aretrying to quit.
  76. 76. 75Handling Withdrawal**How can I get help quitting tobacco?**NCI and other agencies and organizations can helpsmokers quit:Go online to Smokefree.gov(http://www.smokefree.gov), a Web site createdby NCI’s Tobacco Control Research Branch, and usethe Step-by-Step Quit Guide.
  77. 77. 76Handling Withdrawal**How can I get help quitting tobacco?**Call NCI’s Smoking Quitline at 1–877–44U–QUIT(1–877–448–7848) for individualized counseling,printed information, and referrals to other sources.Refer to the NCI fact sheet Where To Get HelpWhen You Decide To Quit Smoking, which isavailable at on the Internet.

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