Over six million people die every year as a result of smoking.
Almost half of smokers will die from an illness related to smoking.
The three major causes of death related to smoking are lung cancer, chronic obstructive pulmonary disease, and atherosclerotic cardiovascular disease (CAD), which plays a role in most cases of heart attack and heart disease.
About five million Canadians, or 17 per cent of the adult population, smoke.
The habit is on the decline as more people take an active role in their own health.

By stopping smoking, you greatly reduce your chance of disease and death. The sooner you stop, the greater the rewards. You will lower your risk of heart disease, lung disease, cancer, diabetes, osteoporosis and infections. You will also feel healthier; have more energy and less trouble breathing. Whether you enjoy going for a walk or playing with your children or grandchildren, it will be easier to do the physical activities you enjoy. If you already have some trouble breathing, the day you quit you prevent further damage to your body. If you do not have any issues yet, you reduce your chances of having to experience these symptoms. The best choice you can make for your health is to stop smoking immediately.

The barriers

Going through different stages is a necessary part of overcoming any addicting habit. The first and most important step is committing to quit smoking. Some people just do not want to quit yet, others think about quitting, and some really do want to quit. Everyone goes through these stages, and it takes a different length of time for each person. Once you are truly ready to quit, you will encounter some barriers that you must overcome. Quitting is not easy.

Smokers often smoke with other people, and this reinforces the habit. It is a part of social interaction, and change will take effort. Some people find it helps to tell friends, family and smoking buddies that they are attempting to quit. Most people will be very supportive and try to reduce temptation. Still, you must take responsibility and try to put yourself in situations where you can succeed.

Some people do not want to stop smoking because they find it reduces stress. Lighting up helps them to cope. If you use smoking to deal with stress, it is important to recognize that. There is no easy solution, but you can look for other coping strategies. Exercise has been found to help reduce stress and the urge to smoke. Other options include deep breathing techniques or taking a break. Find a way that works best for you.

Strategies for quitting

Cold turkey and willpower

Some people choose to stop smoking ‘cold turkey’ or using willpower. This involves gradually cutting down or stopping all at once. The cold turkey method is challenging for most people. Many benefit from either nicotine replacement therapy or medication.

Nicotine replacement therapy (NRT)

NRT is designed to help supplement your body with nicotine in small amounts. This helps reduce your physical dependency on nicotine, helping to prevent withdrawal symptoms and reduce cravings. Common forms of nicotine replacement therapy include:

Nicotine gum: This chewing gum contains a small amount of nicotine, which is absorbed through the lining of your mouth. When you need help reducing cravings, chew one or two pieces. It is best to chew the piece of gum until you taste nicotine, then leave it parked in your cheek to give it time to absorb.
Nicotine patch: This thin patch is applied to your skin and changed daily. Nicotine is slowly absorbed through the skin to help reduce cravings. A high dose patch is used initially to help with the transition from smoking. The dose is gradually reduced over weeks until you no longer need the patch.
Lozenge: A lozenge works in a similar way to the gum. A lozenge is placed in the mouth and the nicotine given time to absorb. One advantage is that it does not need to be chewed. If you have difficulty chewing or problems with your teeth, the lozenge may be better for you than gum.
Inhaler: This method delivers nicotine to the back of the mouth through an inhaler that is shaped similarly to a cigarette. One advantage is that an inhaler helps to deal with the physical habit of smoking, namely the desire to have something in the mouth.
Nasal spray: With this form of NRT, a solution containing nicotine is sprayed into each nostril every hour to help reduce cravings. At first, more sprays are used each hour until the desired effect is achieved. Over time, the number of sprays is reduced.
Oral spray: This newest form of NRT involves spraying a nicotine solution into the mouth where it can be absorbed. Some find this method appealing because it is easy to use.

Like all medications, NRT carries a risk of side effects. The most common one is irritation of the surface involved for absorption, whether the skin or the lining of the nose or mouth. Over time, irritation tends to diminish.

No matter which nicotine replacement method is chosen, it substantially improves the chances of quitting. NRT has been found to increase the success rate by 50 to 70 per cent.

Medication

For some people, nicotine replacement is not enough. Medication can double or triple your chance of success. Several options are available, but the most effective and popular choices are varenicline (Champix®) and bupropion (Zyban®, Wellbutrin®).

Varenicline has been proven the most successful. This medication blocks nicotine receptors in the brain in small amounts. It is thought to work by reducing the symptoms of withdrawal and blocking the rewarding effects of smoking. The dose of medication slowly increases until an effective (therapeutic) dose is reached. Ideally you should start the medication one week before stopping smoking, allowing time for your body to reach the proper level of medication. The most common side effect of varenicline is nausea. Occasionally, vivid dreams can be an issue. Those who have known coronary artery disease should use this medication with caution.

Bupropion is thought to work by increasing the release of chemicals by different receptors in the brain. This reduces the severity of nicotine cravings and withdrawal symptoms. Ideally, bupropion is started a week before quitting and is usually continued for 12 weeks for best success. People who have seizure disorders are not able to use bupropion. However, those with coronary artery disease can safely use this medication.

Both medications can significantly improve your chances of quitting. Speak to your family doctor if you would like more details.

Behaviour therapy

This helpful strategy is often overlooked. It includes support groups or one-on-one support, especially with your family doctor. Working with others allows you to get proper information on smoking and strategies to quit, helping you work through any barriers. Do not overlook the value of support – it can help increase your chances of quitting by 25 per cent!

Quitting smoking is not easy. It can be a frightening and challenging obstacle to overcome. In Canada, the average number of quit attempts before success is six. Do not be discouraged if you have difficulty - you are not the only one. Whether you chose to quit on your own or with a friend, remember what motivated you to quit smoking and use that to your advantage. Many options are available to help you quit, so do not be afraid to ask for help. When you decide you want to quit, speak to your family doctor or a pharmacist. They will be only too glad to help you along the way. Good luck.

Quit Smoking 101 Keys to success

The benefits