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Deciding to quit tobacco is a major milestone. But staying quit is the longest and most important part of the process. It’s important to have strategies and support to help you get through it.

Dealing with nicotine withdrawal

Nicotine is the addictive substance in tobacco. When you use tobacco, many parts of your body get used to the nicotine. When you quit tobacco, you also quit nicotine. You will likely have withdrawal symptoms, because now your body has to get used to not having nicotine.

Withdrawal from nicotine can be uncomfortable. It has 2 parts: the physical and the mental.

The physical symptoms are annoying, but not life-threatening. Still, if you’re not ready to resist them, they can tempt you to go back to smoking or chewing. Nicotine replacement and other medicines can help reduce a lot of these symptoms.

Many people who use tobacco find that the mental part of quitting is harder than the physical part. When you use tobacco, it often becomes linked with a lot of the things you do – waking up in the morning, eating, reading, watching TV, drinking coffee. It will take time to “un-link” tobacco from these activities.

This is why, even if you use nicotine replacement therapy, you may still have strong urges to smoke or chew. There are strategies that can help you with this.

Noticing excuses

One way to overcome urges or cravings is to notice excuses for smoking as they come up. An excuse is a false thought that seems to make sense at the time but isn’t true. If you choose to believe in such a thought, even for a short time, it can serve as an excuse to use tobacco.

If you’ve tried to quit before, you might recognize many of these common excuses:

• “I can have just one and it won’t hurt.”
• “I'll just do it once to get through this rough spot.”
• “Today isn’t a good day. I’ll quit tomorrow.”
• “If I don’t have a cigarette, I’m going to go crazy!”
• “How bad is smoking/chewing, really? Uncle Harry smoked/chewed all his life, and he lived to be over 90.”
• “You’ve got to die of something.”
• “Life is no fun without tobacco.”

You can probably add more to the list. As you go through the first few days without tobacco, write down excuses as they come up and see them for what they are – messages that can trick you into going back to smoking/chewing.

Look out for them, because they always show up when you’re trying to quit. After you write down the excuse, let it go and move on. Be ready with a distraction, a plan of action, and other ways to re-direct your thoughts.

Ideas to help you stay committed to quitting

Avoid temptation. Stay away from people and places that tempt you to smoke or chew. Later on, you’ll be able to handle these more easily.

Change your habits. Switch to juice or water instead of alcohol or coffee. Choose foods that don’t make you want to smoke or chew. Take a different route to work. Take a brisk walk instead of a tobacco break.

Choose other things for your mouth. Use substitutes you can put in your mouth like sugarless gum or hard candy, raw vegetables such as carrot sticks, or sunflower seeds. Some people chew on a coffee stirrer or a straw.

Get active. Do something to reduce your stress. Exercise or find an activity that keeps your hands busy, like needlepoint or woodworking, to help distract you from the urge to use tobacco. Clean out a closet, vacuum the floors, go for a walk, or work in the yard.

Breathe deeply. When you smoked, you breathed deeply as you inhaled. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remember your reasons for quitting and the benefits you’ll gain when you do. Deep breathing can also help you remember that you’re cleaning the toxins from tobacco out of your body.

Delay. If you feel that you’re about to light a cigarette, hold off. Tell yourself you must wait at least 10 minutes. Often this simple trick will allow you to move beyond the strong urge to smoke. This works for smokeless tobacco too: wait 10 minutes until the urge lessens.

Reward yourself. What you’re doing isn’t easy, and you deserve a reward. Put the money you would have spent on cigarettes or tobacco in a jar every day and then buy yourself a weekly treat. Buy a book or some new music, go out to eat, start a new hobby, or join a gym. Or save the money for a major purchase.

You can also reward yourself in ways that don’t cost money. Visit a park or go to the library. Check local news listings for museums, community centers, and colleges that have free classes, exhibits, films, and other things to do.

Staying tobacco-free

Staying quit is the final, longest, and most important part of the process. If you’ve quit before, you can use the same methods to help you through withdrawal, or you can try something new. Try to anticipate times when you may be tempted to smoke or chew. Plan on how you’ll use other ways to cope with those situations.

Unexpected strong desires to smoke or chew can sometimes happen months or even years after you’ve quit. Excuses can show up then, too. To get through these without relapse, try to:

• Remember your reasons for quitting. Think of all the benefits to your health, your finances, and your family.
• Ask your tobacco-using friends for support. Tell them to not share their cigarettes or tobacco with you, no matter what!
• Remind yourself that there is no such thing as just one dip or one cigarette, or even just one puff.
• Ride out the desire to smoke or chew. It will go away, but don’t fool yourself into thinking you can have just one.
• Avoid alcohol. Drinking lowers your chance of success.
• If you’re worried about weight gain, put some energy into planning a healthy diet and finding ways to exercise and stay active.
• Keep getting the counseling and support that has helped you so far.

Recovering from slips

What if you do smoke or chew? Here’s the difference between a slip and a relapse: A slip is a one-time mistake that’s quickly corrected. A relapse is going back to using tobacco.

You can use the slip as an excuse to go back to using tobacco, or you can look at what went wrong and renew your commitment to staying away from tobacco for good.

Even if you do relapse, try not to get too discouraged. Very few people are able to quit for good on the first try. In fact, it takes most people several tries. The important thing is to figure out what helped you when you tried to quit and what worked against you. Use this information to make a stronger attempt at quitting the next time.

Weight gain after quitting smoking

Some people who quit tobacco gain weight, but the weight gain that follows quitting is usually small. The average gain is less than 10 pounds in most studies. Remember that it’s much worse for your health to keep smoking than it is to gain a small amount of weight.

You’re more likely to quit tobacco for good if you deal with quitting first, and then take steps to lose weight. While you’re quitting, try to focus on ways to stay healthy, rather than on your weight.

Stressing about your weight could make it harder to quit. Healthy living through a healthy diet and exercise can limit your weight gain and help you lose any weight you do put on.

Follow a healthy eating pattern. Try to eat a variety of colorful fruits and vegetables, whole grains, lean meats, and low-fat dairy products. Also try to avoid or limit red and processed meats, sugar-sweetened beverages, and highly processed foods. Be sure to drink plenty of water.

Get regular physical activity. Walking is a great way to be physically active and increase your chances of not smoking. Walking can help you by: reducing stress, burning calories and toning muscles, and giving you something to do instead of thinking about smoking.

All most people need for walking is a pair of comfortable shoes, and most people can walk pretty much anytime. You can use these ideas as starting points and come up with more of your own:

• Walk around a shopping mall
• Get off the bus one stop before you usually do
• Find a buddy to walk with during lunch time at work
• Take the stairs instead of the elevator
• Walk with a friend, family member, or neighbor after dinner
• Push your baby in a stroller
• Take your dog (or maybe a neighbor’s) out for a walk

The American Cancer Society recommends getting 150-300 minutes of moderate intensity or 75-150 minutes of vigorous physical activity each week. Getting more is even better. But if you don’t already exercise regularly, check with your health care provider before you start.

Also try to get enough sleep. This can help reduce your stress, which can support your quit and healthy living efforts.

Managing stress after quitting tobacco

People who use tobacco often mention stress as one of the reasons for going back to using.

Stress is part of life for everyone. The difference is that people use nicotine (the addictive substance in tobacco) to help cope with stress and unpleasant emotions. When you quit, you have to learn new ways of handling stress that don’t involve nicotine.

Nicotine replacement can help for a while, but over the long term you’ll need other methods.

Physical activity and other stress-management techniques

Physical activity is a good stress-reducer. It can also help with the feelings of depression or loss that some people have for a while after they quit. There are also stress-management classes and self-help books. Check your community newspaper, library, or bookstore.

Spirituality

Spirituality can give you a sense of purpose and help you remember why you want to stay tobacco-free. Spiritual practices involve being part of something greater than yourself. These types of practices might include:

• Prayer
• Meditation
• Religious practices or church work
• Music
• Being outside in nature
• Creative or artistic activities
• Volunteering to help others

Think about how you can deal with stress and not use tobacco. Look at the resources around you and plan on how you’ll handle the stressors that come your way.

Taking care of yourself

Tell your health care team if you currently use any type of tobacco, or if you’ve used in the past. This will help you get the preventive health care you need. Using tobacco puts you at risk for many health issues. Part of your health care should focus on screening for these issues and taking steps to stay as healthy as possible.

Check the inside of your mouth

Regularly check the inside of your mouth for any changes.

If you notice any changes or problems, have your doctor or dentist look at your mouth, tongue, gums, and throat. You might be able to find some changes early (such as leukoplakia, white patches on the mouth tissues). Early detection might prevent oral cancer or help your health care team find it at a stage that’s easier to treat.

Watch for other symptoms

Smokers should also be aware of any of these changes:

• Change in cough
• A new cough
• Coughing up blood
• Hoarseness
• Trouble breathing
• Wheezing
• Headaches
• Chest pain
• Loss of appetite
• Weight loss
• General tiredness
• Frequent lung infections

Any of these could be signs of lung cancer or other lung problems. Tell your health care team right away if you notice any of these changes.

Stay up to date on cancer screenings

Lung cancer screening is recommended for people at high risk due to smoking history. American Cancer Society recommends annual screening with a low dose computed tomography (LDCT) scan for people who:

• Are 50-80 years of age
• Currently smoke or smoked in the past AND
• Have a smoking history of 20 or more pack years*

*A pack-year is equal to smoking 1 pack (or about 20 cigarettes) per day for a year. For example, a person could have a 20 pack-year history by smoking 1 pack a day for 20 years, or by smoking 2 packs a day for 10 years.

If this describes you, talk with your health care team about your lung cancer risk and the potential benefits and risks of lung cancer screening. To prepare you for a discussion with your health care provider, you can read more about the current screening guidelines.

Learn more: American Cancer Society guidelines for early detection of lung cancer

Remember that tobacco users have a higher risk for many cancers, not only lung cancer. If you have any health concerns that may be related to your tobacco use, see a health care provider as soon as possible.

Taking care of yourself and getting treatment for problems early on will give you the best chance for successful treatment. But the best way to take care of yourself and decrease your risk for life-threatening health problems is to quit using tobacco.

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