Giving up smoking

If you’re a smoker, choosing to stop is a decision that will benefit your health. Giving up smoking may be stressful and difficult to do, but in the long term it will help you feel better and be healthier.

Reasons to quit Back to top

People smoke for a number of reasons. Most smokers do it because they find it relieves stress and helps them relax. Smoking can also be a source of support when things go wrong and can give a feeling of pleasure. These are all reasons why many people continue smoking once they’ve been diagnosed with cancer.  

Living with cancer and its treatment can be very difficult, and you may feel you need all the support you can get, including smoking. Nobody can force you to give up – the best reason to stop smoking is because you want to and because you feel ready to.   

Sometimes your doctor may advise you on the benefits of stopping smoking in your specific situation or for your type of cancer. Having an understanding of how smoking affects your health may also motivate you to stop. Smoking increases the risk of several types of cancer, including cancers of the lung, mouth, gullet, stomach, pancreas, kidney, bladder and cervix, and some types of leukaemia. It also increases your risk of developing many other health problems, including heart and lung diseases, strokes, circulatory problems, dementia, impotence and infertility.

There’s also some research that shows that smoking can make some types of cancer grow more quickly. This may be because smoking weakens the body’s immunity and some of the chemicals in cigarette smoke may help the tumour to grow.

If you’re having treatment for cancer, stopping smoking will help you with this too. It can help the body’s ability to respond to treatment and heal. In general, non-smokers have fewer side effects from cancer treatment, and the side effects they do have tend to be less severe. Stopping smoking may also lower the risk of cancer coming back after treatment.

Smoking is expensive, so quitting will also save you money. If you smoke twenty a day, you spend about £2,000 a year on cigarettes. Stopping means you’ll have more money to spend on other things.

Smoking causes premature skin ageing. Within a few weeks of stopping, your skin
will look clearer and brighter. And straight away, your breath, hair and clothes will
smell better.

Smoking doesn’t only harm your own health. People around you, who are exposed to second-hand smoke (called passive smoking), are also at a higher risk of getting smoking-related diseases.

Children whose parents smoke are more likely to start smoking themselves. If you have children or grandchildren, you can become a good role model for them by quitting. Also, children of parents who smoke often worry about their parents’ health, so by giving up you’ll be putting your children’s minds at rest.

Making changes Back to top

There are three stages to giving up smoking:

1. Preparing to stop
2. Stopping
3. Staying stopped.

Preparing to stop Back to top

Deciding to give up smoking and really wanting to succeed are important steps in becoming a non-smoker. Giving up smoking isn’t easy. But you can increase your chances of success by preparing for possible problems in advance and making sure you have support in place to help you overcome them.

It can help to:

• Make a list of your reasons for stopping. You can use this to motivate yourself at times when you feel tempted to smoke.
• Set a specific date to stop. Smoke as normal and don’t cut down on the number of cigarettes you smoke before that date. Then stop suddenly on your set date. 
• Get support. Talk to people who can give you help and support to quit. This might include your family, friends and colleagues. Tell them you’ve set a date when you’ll stop smoking. Think about whether someone you know wants to give up too – perhaps you could do it together and encourage and support one another. Your doctor or pharmacist is an important person to talk to – they can offer practical help and advice and refer you to a free local stop smoking service. You could also call a stop smoking helpline.
• Use medicines to help reduce any cravings. The first 3–4 days after you’ve stopped, when your body is feeling the effects of nicotine-withdrawal, can be the most difficult. There are medicines that can improve your chances of success in overcoming withdrawal effects. Your GP or NHS Stop Smoking Adviser can talk over the options with you. If you plan to use medicines to help you cope, make sure that you get them well in advance of the date you plan to give up on. It’s best to start taking medicines like bupropion and varenicline 1–2 weeks before you quit.  
• Try to find other ways of dealing with stress. The shock of being diagnosed with cancer or coping with treatment can make it harder to quit, because many smokers use cigarettes to cope with stress. Other ways of coping with stress include exercising, using relaxation or meditation CDs, and talking things over with someone you trust. Some people use hypnotherapy or go to classes to learn relaxation or meditation techniques. If you think stress may be a problem for you, ask your specialist nurse or GP for advice. There's more information on ways of coping with stress in the cancer and complementary therapies section.
• Set yourself goals. These could include getting through the first day, week and month smoke-free. Plan rewards for yourself when you set your goals.
• Put aside the money you’d otherwise have spent on smoking. Use it to treat yourself or your family instead.
• Get rid of cigarettes, ashtrays and lighters. Do this the day before you give up. Also check the house, the car and your clothes for any stray cigarettes. 
• Buy a supply of healthy, non-fattening snacks. These could include fruit and sugar-free chewing gum. 
• Plan your first smoke-free day. Decide what you’re going to do instead of smoking during breaks at work or when you feel stressed.

Stopping Back to top

It may help to change your routine. If possible, stay away from places or situations that you associate with smoking. If you always want to light up when you have a cup of coffee, try drinking tea. Avoiding alcohol to begin with is also a good idea. People often find their willpower is weaker after a drink or two.

You may be tempted to snack more when you stop smoking, so try to eat healthy, non-fattening snacks.

A stress ball may help if you need to do something with your hands. Or, you could take up an activity, like knitting, gardening or playing computer games, to keep your hands occupied and take your mind off cigarettes.

If your doctor has prescribed medicines to help you give up, use these as prescribed. Let your doctor know if you have any problems.

Staying stopped Back to top

It can take up to three months to become a non-smoker, but it usually takes less time. The physical and psychological withdrawal symptoms in the first few days can be very hard to cope with, but they’ll improve every day that you don’t smoke. Take things one day at a time. The following things can help:

• Choose to spend time with non-smokers and ex-smokers who will support your efforts to quit.
• Replace smoking with other activities that you enjoy.
• Remind yourself of your reasons for giving up. Carry the checklist of your reasons for stopping smoking with you, so you can refer to it if you need to. Quitting is a commitment that you have made to yourself and, while it requires strong willpower, it also has huge benefits. 
• Mark off the days since you first stopped on your calendar, so you can see how well you’re doing.
• Reward yourself. Use the money you would have spent on smoking to buy yourself something you’ll enjoy. You might want to use some of the money to buy little treats each week, like CDs, going for a nice meal or having a massage. You might also want to save towards a bigger reward, like a special night out or a holiday.
• Be aware of temptations to smoke.
• Have nicotine gum or tablets available for social situations that might tempt you to smoke. Make a deliberate effort to avoid the shops where you used to buy your cigarettes. 
• Don’t give up trying to stop smoking, even if you don’t succeed the first time. Most people need several attempts before they stop completely. Remember that giving up smoking is hard enough for most people. But when you’re giving up after a cancer experience it can seem even tougher. You may have side effects to cope with, or other worries caused by the cancer or its treatment – for example problems with work, money or relationships. So don’t be too hard on yourself if things don’t go smoothly at first. Try to make sure you get as much support as possible.

Using medicines to help reduce cravings Back to top

It’s often the physical craving for a cigarette that causes people to start smoking again. There’s a range of different treatments available to help you cope with the symptoms of physical withdrawal. Using medicines to help reduce cravings can double your chances of success. And if you combine a stop smoking medicine with an NHS support service, you’re up to four times more likely to become a non-smoker.

Nicotine replacement therapy (NRT)

NRT works by giving your body enough nicotine to ease withdrawal symptoms and cravings when you stop smoking. It comes as skin patches, chewing gum, tablets, lozenges, inhalers, mouth (oro-mucosal) sprays and nasal sprays. You can buy these products over the counter or you can get them on prescription from your GP or NHS Stop Smoking Service|. Using NRT doubles your chances of stopping smoking.

Bupropion (Zyban®)

Zyban is a non-nicotine tablet that works by reducing the urge to smoke and other withdrawal symptoms. It’s not suitable for everyone and is not recommended for people who have had brain or spinal cord tumours or a history of seizures (fits).

You start taking the tablets 1–2 weeks before you stop smoking, and a course usually lasts for 7–9 weeks. The tablets are only available on prescription. Certain medicines should not be taken with Zyban, so it’s important that it’s prescribed by a doctor who knows your full medical history and which other medicines you’re taking. Some people have reported feeling depressed whilst taking Zyban, but this could also be due to the symptoms of withdrawal from smoking.

Varenicline (Champix®)

This is another non-nicotine tablet that can help relieve craving and withdrawal symptoms when giving up smoking. Champix is only available on prescription. You start taking the tablets 1–2 weeks before you stop smoking. A course of treatment usually lasts for 12 weeks. As with Zyban, some people have reported feeling depressed while taking Champix. 

Like all medicines, NRT, Zyban and Champix have potential side effects.

Read the information leaflet that comes with the drugs. Your doctor or pharmacist
can give you more information about these treatments.

NHS Stop Smoking Services Back to top

NHS Stop Smoking Services| can really make a difference to your chances of success. Research shows that people who use them are twice as likely to succeed as people who try to give up on their own. Speak to your doctor or call a stop smoking helpline for further advice and to find out where your local Stop Smoking Service is.

NHS Stop Smoking Services provide specialist treatment for those wanting to quit.
The staff who deliver these services:

• provide information about smoking and giving up
• help you prepare a plan for quitting
• give ongoing support
• prescribe medicines to help improve withdrawal symptoms
• arrange weekly meetings where you can meet other people who are trying
  to give up.

Other useful organisations Back to top

NHS Smokefree

NHS Smokefree| provide free support, expert advice and tools including the Quit Kit to help you stop smoking. Watch videos from real quitters on what helped them stop.

QUIT

Quit| provides support and practical guidance to people who want to give up smoking.

References Back to top

This section has been compiled using information from a number of reliable sources, including:

• electronic Medicines Compendium. (accessed December 2011).
• Guide to quitting smoking. American Cancer Society. (accessed December 2011).
• National Comprehensive Cancer Network. (accessed December 2011).
• Ostroff J, Dhingra L. Smoking cessation and cancer survivors. Handbook of cancer survivorship. 2007. Springer. New York.
• Public health guidance 10, smoking cessation services in primary care, pharmacies, local authorities and workplaces, particularly for manual working groups, pregnant women and hard-to-reach communities. February 2008. National Institute for Health and Clinical Excellence (NICE). Schottenfield D.
• Cancer epidemiology and prevention. 3^rd edition. 2006. USA. Oxford University Press.
• Smokefree. (accessed December 2011).
• Smokers have slimmer odds of surviving colon cancer. National Comprehensive Cancer Network. (accessed December 2011).
• Smoking cessation advice for adults over 18.
• Smoking cessation can reduce late side effects of radiotherapy. OncologySTAT.  (accessed December 2011).
• Varenicline for smoking cessation. July 2007. National Institute for Health and Clinical Excellence (NICE).

Quotes are sourced from Healthtalkonline|.