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National Cancer InstituteQUIT SMOKINGT O D AYU.S. DEPARTMENTOF HEALTH ANDHUMAN SERVICESNational Institutesof Health

Table of ContentsIntroduction. 1Before you START a Smoke-Free Life . 2Quitting.is.Hard. 2Preparing.to.Quit. 3Now Let’s START. d.Coworkers.You.Plan.to.Quit. . 17My.Quitting.Worksheet. 19Today’s the Big Day – Your Quit Date. . 21Keep.Busy.and.Find.New.Things.to.Do. 21Stay.Away.From.What.Tempts.You. 23Plan.to.Reward.Yourself. 25Quitting for Good – You Can Do It!. 27Keep.Your.Guard.Up. 27Don’t.Get.Discouraged.if.You.Slip. . 28Stay.Upbeat. . 29Focus.on.a.New,.Healthier.Lifestyle. 30Remember the Long-Term Rewards. . 32For More Information. 34National.Cancer.Institute. 34American.Cancer.Society. 35American.Heart.Association. 35American.Legacy.Foundation. 35American.Lung.Association. 36Centers.for.Disease.Control.and.Prevention. 36

IntroductionFrom those of us at the National Cancer Institute:Congratulations! You are taking the first step toquitting cigarette smoking.We wrote this booklet with the help of ex-smokersand experts. It can help you prepare to quit andsupport you in the days and weeks after you quit.It also describes problems to expect when youquit. Being prepared can help you through thehard times.Many tips are offered in this booklet—choosewhat works best for you. You can quit for good,even if you’ve tried before. In fact, most smokerstry to quit many times before they succeed.Stay upbeat. Keep trying. Use what you learn eachstep of the way until you quit for good. Soon, youtoo will be an ex-smoker.The National Cancer Institute (NCI) is part of the National Institutes ofHealth, one of agencies in the U.S. Department of Health and HumanServices. NCI is the U.S. Government’s principal agency for cancer researchand training.

Before youSTART a Smoke-Free LifeQuitting is d.

KEEP IN MINDPreparing to quitThink about why you want to lth.reasons,.such.as: My.body.will.start.healing.right.away. I.will.have.more.energy.and.focus. I.will.feel.more.physically.fit. I.will.have.whiter.teeth.and.healthier.gums. I.will.cough.less.and.breathe.easier. d.smoke.Your body gets morethan nicotine whenyou smoke.Cigarette smokecontains more than4,000 chemicals. Someof these chemicals arealso found in woodvarnish, theinsecticide DDT,rat poison, and nailpolish remover.The ashes, tar, gases,and other poisons—such as arsenic—incigarettes harm yourbody over time. Theydamage your heartand lungs. They alsomake it harder foryou to taste and smellthings and to fightinfection.Source: U.S. Department ofHealth and Human Services.Reducing Tobacco Use:A Report of the SurgeonGeneral. Atlanta, GA: U.S.Department of Health andHuman Services, Centersfor Disease Control andPrevention, NationalCenter for Chronic DiseasePrevention and HealthPromotion, Office onSmoking and Health, 000.

KEEP IN MINDEven a little secondhand smoke is dangerous.Secondhand smoke—also called environmental tobaccosmoke—comes from a burning tobacco product and from thesmoke exhaled by smokers. Inhaling secondhand smoke iscalled involuntary or passive smoking.Nonsmokers who breathe secondhand smoke may: develop cancer or heart disease have breathing problems get colds and the flu more easily die younger than people who don’t breathesecondhand smokePregnant women who breathe secondhand smoke may: give birth to low-weight babieshave babies who are more likely to die of sudden infantdeath syndrome (SIDS)Children who breathe secondhand smoke may: have breathing problems, such as asthma get more ear infections develop more lung infections, such as pneumoniaSource: U.S. Department of Health and Human Services. The HealthConsequences of Involuntary Exposure to Tobacco Smoke: A Report ofthe Surgeon General. Atlanta, GA: U.S. Department of Health and HumanServices, Centers for Disease Control and Prevention, Coordinating Centerfor Health Promotion, National Center for Chronic Disease Prevention andHealth Promotion, Office on Smoking and Health, 006.4

Think.of.some.other.reasons.to.quit,.such.as: er.role.model.for.others,.especially.my.kids. I.will.feel.more.in.control.of.my.life. I.will.have.more.money.to.spend. uying.cigarettes,.or.searching.for.a.light.Write down why you want to es.for.your.list.are: where.you.keep.your.cigarettes in.your.wallet.or.purse. in.your.kitchen. .why.you.want.to.stop.My reasons to quit are

KEEP IN MINDPregnancy and smoking are not a good mix.If you are pregnant or thinking about having a baby, there’sno better time to quit smoking than now. Women who smokehave a harder time getting pregnant. If they do get pregnant,they risk losing the baby or having a stillborn baby. Andbabies born to mothers who smoke: may be smaller than normal at birthare more likely to die of sudden infant deathsyndrome (SIDS) may be cranky, restless, and get sick more often are more likely to have learning problems as they developThe good news is that quitting can help you have a healthybaby. It helps to quit any time during your pregnancy,but it’s even better to quit before you become pregnant.Information to help you stop smoking is available in Englishand Spanish at www.smokefree.gov/resources.html.Source: U.S. Department of Health and Human Services. Women andSmoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department ofHealth and Human Services, Centers for Disease Control and Prevention,National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health, 00 .6

Learn how much you depend on ch.you.depend.on.nicotine. . . How soon after you wake up do yousmoke your first cigarette? . Do you smoke more frequently in thehours after waking than during therest of the day? . Do you find it difficult not to smoke?4. Which cigarettes would you mosthate to give up? . How many cigarettes do yousmoke a day?6. Do you smoke when you’re so sickthat you’re home in bed?.Less than minutes6– 0 minutes –60 minutesAfter hourYesNoYesNoThe first one inthe morningAny other 0 or less – 0 – 0 or moreYesNoUnderstand what your score ce: Heatherton, TF, Kozlowski LT, Frecker RC, Fagerstrom KO. TheFagerstrom Test for Nicotine Dependence: a revision of the FagerstromTolerance Questionnaire. British Journal of Addictions. 99 ; 86: 9– 7.

Understand what makes you want to garette.Know your igger.your.craving.for.a.cigarette.8

Waking.in.the.morning Driving.my.car Drinking.coffee,.tea,.or.alcohol Being.a.passenger Smelling.a.cigarette After.having.sex Being.with.other.smokers Seeing.someone.smoke Taking.a.break Talking.on.the.phone Checking.email Surfing.the.Internet Watching.TV After.eating After.completing.a.task Feeling.stressed Feeling.lonely.or.depressed Being.or.feeling.less.tolerant Feeling.bored Feeling.angry,.irritable,.or.impatientMeet your triggers head ghting.the.urge.to.smoke.is.easier.if.you: take.a.deep.breath in.or.pencil or.nonsmoking.restaurant. hang.out.with.people.who.don’t.smoke er.or.juice.insteadI will deal with my triggers by

Know your options for quitting ut.with.your.doctor. Cold ependence. Over-the-counter age.18. 0

KEEP IN MIND Prescription on.medications,.see.page.18. Counseling and group eetings,.or.quitlines. t.can.help.you.anywhere.in.the.United.States.Not everyone hasfeelings of withdrawal,but many smokers do.You may experienceone or manysymptoms ofwithdrawal and theymay last for differentperiods of time.Common feelings ofsmoking withdrawalinclude: feeling down, blue,or depressedfeeling anxious,nervous, orrestlesshaving troublethinking clearlybeing unableto sleepfeeling tired orrun downfeeling hungry orgaining weight

SNow Let’sTARTSTARTet a quit ul.to.them,.such.as:KEEP IN MINDSome smokers findit difficult to quit atcertain times—after a bad day orpersonal loss,during a crisis, orat a stressful time,such as a divorce.Examine how youview such times inyour life. Can youafford to wait beforesetting your quitdate? a.birthday.or.wedding.anniversary the.first.day.of.vacation New.Year’s.Day.(January.1) Independence.Day.(July.4) World.No.Tobacco.Day.(May.31) e.it.START: Five important steps toward quitting for goodS Set a quit dateT Tell family, friends, and coworkers you plan to quitA Anticipate and plan for the challenges you willface while quittingMy quit date is. RRemove cigarettes and other tobacco productsfrom your home, car, and workplaceTTalk to your doctor about getting help to quit

STARTell your family, friends, and coworkers you plan to re.some.ideas: t.not.smoke.around.you. you.can.get.support.if.you: The family, friends,and coworkersI want to tell UITNOW.(1–800–784–8669)

ARTSTnticipate and plan for the challengesyou will face while nt.strategies.for.handling.each.Short-term time.Long-term .you.handle.the.tough.times.Smoking .hits. 4

nal.helps.you.smoke.less.0None Just a little Some A lotMy Smoking JournalCigarette Time CravingNumber of Day LevelActivityWho I WasWithMoodExampleAt workAloneStressed 0:4 4 6789 0 4 6 7 8 9. 0

STARTemove cigarettes and other tobacco productsfrom your home, car, and hould: KEEP IN MINDAll forms of tobaccoare harmful.Tobacco productsand delivery methodscome in many forms.However tobaccois packaged ordelivered, it causesdisease andaddiction. Light orlow-tar cigarettesare just as harmful asregular cigarettes.Clear your home, car,and workplace of allforms of tobacco. er.to.start.smoking.again.I can remove reminders of smoking by 6

TSTARalk to your doctor about gettinghelp to ow.and.the.up-to-date.medication.guide.at ications to help you ved.by.the.FDA. 7

Nicotine cessation productsKEEP IN MINDMedications alonecan’t do all the work.They can help withcravings andwithdrawal, but theywon’t completelyprevent withdrawalsymptoms. Even ifyou use medicationto help you stopsmoking, quitting maystill be hard at times.Many people findit helps to combinemedication withbehavior strategies.For example, youcan keep healthysnacks handy to beatcravings, limit timewith smokers, andenroll in a smokingcessation program. ilable.only.by.prescription.Non-nicotine cessation ation.plan.and.to.get.a.prescription.My next doctor’s appointment isDate Time

My Quitting WorksheetReview what you have done so far to prepare yourself to quit smokingsuccessfully.My reasons to quit areMy nicotine addiction test score isMy triggers Waking in the morning Driving my car Drinking coffee, tea, oralcohol Being a passenger Smelling a cigarette After having sex Being with other smokers After completing a task Seeing someone smoke Feeling stressed Taking a break Feeling lonely or depressed Talking on the phone Being or feeling less tolerant Checking email Feeling bored Surfing the Internet Feeling angry, irritable,or impatient. Watching TV After eatingI will deal with my triggers by 9

My Quitting WorksheetThe quit method I’m interested in Cold turkey Over-the-counter medication (gum, patch, lozenges) Prescription medication (inhaler, nasal spray) Counseling and group support Quitlines.My quit date is.The family, friends, and coworkers I want to tell areI can remove reminders of smoking byMy next doctor’s appointment isDate Time

BToday’s theig Day–Your Quit irst.smoke-free.days,.we.suggest.that.you:. keep.busy.and.find.new.things.to.do stay.away.from.what.tempts.you plan.to.reward.yourself.Keep busy and find new things to .Go to nonsmoking placesBe active gyms walk.or.run. libraries take.a.bike.ride malls go.for.a.swim museums shoot.hoops places.of.worship try.a.yoga.class smoke-free.restaurants.

Distract your handsDistract your mind tennis.ball,.pen,.or.coindo.a.crossword.puzzle squeeze.Silly.Putty read.a.book knit.or.crochetplay.cards write.a.letter hold.something—a.Drink the right stuff w.healthy.beverageFool your mouth try.a.toothpick.or.straw eat.a.lollipop. chew.sugar-free.gum eat.carrot.or.celery.sticks tivities.will.return.