Preparing to stop 03. Stopping 13 Contents. Staying stopped 17. Stop-smoking medications 22. For pregnant smokers 27. Secondhand smoke 29

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3 Preparing to stop 03 Stopping 13 Contents Staying stopped 17 Stop-smoking medications 22 For pregnant smokers 27 Secondhand smoke 29 Further help 30

4 Stopping smoking takes willpower, but it is possible millions have succeeded. This booklet will help you by taking you step-by-step through the stages of stopping. It will help you make up your mind if you want to stop, help you prepare and get through the first few days of stopping, and show you how to stay stopped. It answers smokers questions about stopping and gives information about stop-smoking medications, including nicotine replacement therapy (NRT), bupropion (Zyban ), and varenicline (Champix ). If you go through these stages using the ideas and advice in the booklet, you can stop smoking. If at any stage you get stuck don t worry just go back to stage one and start again. Good luck! 2

5 Preparing to stop Preparing to stop smoking can take anything from days to months. It is the most important stage. If you really want to stop, and you are well prepared, you will succeed. Once you are ready to stop you can move on to actually stopping but you should not attempt that until you are ready, until your preparation is complete. Preparing to stop Think of stopping smoking as being a bit like going through a revolving door. If you succeed first time that s great, but most smokers go round several times before eventually leaving it. So if you don t stop the first time you try, don t worry. After a break, try again. Eventually you will succeed. 3

6 Stopping smoking is a choice When you reach page 13 and have completed your preparation you will: Preparing to stop be sure you want to stop know why you want to stop be ready to stop have an action plan Always remember that it can be done. About 10 million people in Britain have stopped smoking and stayed stopped in the last 15 years. That s over 1,000 every day! The first key to success is wanting to stop and stopping for your reasons, not someone else s. So ask yourself do I really want to stop? Use the checklist and add your own reasons. 4

7 I want to stop because... I want to improve my health I don t want my children to become smokers Checklist It s not fair to people I am with I could do with the extra money It smells and clings to clothes It s anti-social I don t like being addicted Preparing to stop 5

8 Key questions Is smoking really so dangerous? Preparing to stop Unfortunately it is. About 5,000 people in Britain die each year in road accidents. Smoking kills about 120,000 a year that s more than 300 every day. On average, smokers die 15 years earlier than non-smokers. This could mean the difference between seeing your grandchildren growing up or not. Children are especially vulnerable to tobacco smoke and protecting them from it will improve their health a lot. When possible ask smokers not to smoke near them. 6

9 Is it worth stopping? Yes. The benefits are immediate. Within weeks you will have better breathing and cleaner clothes. Even better, the risk of serious disease starts going down immediately and continues going down for years as your body recovers. Problems or excuses? As soon as you start thinking about a stop day, is it suddenly easy to think of problems reasons to delay? Are they really problems, or are they excuses? Here are some common examples. This isn t the right time Preparing to stop There are bad times to stop for example when you are under extra stress. But it s easy to use this as an excuse not to stop. If you want to stop, the right time is as soon as possible. 7

10 It s too late to stop, the damage is probably done If you stop smoking before you get seriously ill you are likely to remain healthy. The danger from smoking accumulates. Since the damage done by smoking builds up over years, the sooner you stop the better. Preparing to stop I might put on weight Some people do when they stop, but some don t. In those that do the average weight gain is a few pounds. A few common sense rules will help. Try not to eat more, and try not to eat snacky things you wouldn t normally eat, or drink too much alcohol. The stop-smoking medications help many smokers keep the weight down while they are taking them, so you might try them. It is better to lose weight once you have stopped smoking. Don t try to stop smoking and go on a severe diet at the same time. 8

11 Now see if you are ready to stop Yes No Ready? Preparing Are you certain you want to stop? Do you know why? Are they your own reasons? Are you ready to choose a day? Are you ready to make an action plan? Any NOs? Go back to page 3. All YESs? Turn the page and make your action plan. to stop 9

12 Preparing to stop Action plan Choose a day Will the first few days be easier when you re busy or relaxed? I am stopping on Get support Tell family and friends you have decided to stop. I am going to ask On the day before Review your plan, get rid of remaining cigarettes, plan the day. I am going to On day one The biggest problem will be to help me. The solution is 10

13 A good action plan has a timetable, anticipates problems, includes support, and includes rewards. You should also decide if you need one of the stop-smoking medications. Change your routines Smoking is strongly linked to certain situations like the first cigarette of the day, the cup of tea or coffee, when the phone rings. You need to break the link between the situation and smoking by changing your routines. For example have an orange drink instead of coffee for a while. Coping with stress? Preparing to stop Many smokers feel stressed when they try to stop. Some of this is caused by nicotine withdrawal, and will pass once you have given up. In the meantime anything you can do to reduce stress will help. 11

14 Try not to take on too much; don t put pressure on yourself. Try to leave time each day to relax, with simple exercises like deep breathing and stretching. Even a few minutes can slow you down and release a little tension. Preparing to stop My stress level was through the roof and I was thinking about cigarettes all the time, but in the end I thought it s not going to beat me. It was hard, but I did it. JB, Port Talbot 12

15 Stopping Day one Day1 Make time at the beginning of the day to review your plan. Use the checklist on page 5 to remind yourself why you are doing this. This will help, especially over the first few weeks. The key to the first few days is anticipating problems and changing your routines. If you find it almost impossible to drink without smoking you might have to avoid alcohol for a short while. Don t worry if this doesn t sound much fun. These are temporary changes. They will get you through the first few weeks. Stopping Don t forget to reward yourself for success (choose the reward carefully). My reward for getting through day one will be 13

16 Helpful hints If you need to put something in your mouth try sugar-free chewing gum or something healthy and non-fattening (like a carrot). Stopping If you need to do something with your hands, find something to fiddle with pencil, coin, worry beads, anything. Try drinking orange juice or eating fruit when you feel like a cigarette something that changes the routine. Save the cigarette money for an average smoker in Britain, in a few months you would have saved enough for a holiday. Think of a suitably healthy reward for the end of the first day and first week. 14

17 Week one There will be times when your old smoking self rebels and tempts you Week to smoke. When it does, review your reasons for stopping. 1 Start each day with a fresh commitment to stopping. Make sure you have arranged the support you need. Try and take time out to relax and don t forget to reward yourself for getting through each day. When you get the urge to smoke do something to distract yourself: check the money you are saving, wash the car, walk the dog, ring a friend, do some gardening. Don t allow an argument to start in your head about stopping. You have already made the decision. Stopping My reward for getting through week one will be 15

18 Take one day at a time This is a cliché but it s worth the effort. At the end of each day congratulate yourself on having made it through the day. Stopping At the beginning of each day make it your goal to get through today without smoking. Let tomorrow wait. This should help you not to worry about the rest of your life without smoking. You can also ring Smokers Helpline Wales on Your call will be answered by trained counsellors and will be fully confidential. 16

19 Staying stopped DO think positive There will be times when you feel tired and are tempted to give in. Remember why you stopped are stopping. Be positive. If you remain determined the temptation will pass. DON T play games One favourite is "one cigarette won t hurt", also called "I ll just have one to prove I ve kicked it". Recognise these games for what they are a weakening of your resolve and resist them. You have to understand what s going on inside your head. When I want a cigarette I think but wouldn t it be awful to go through all that again. For one cigarette it s just not worth it. LV, Rhyl Staying stopped 17

20 DO take care After the first few weeks, especially if it was easy, your friends may stop encouraging you, and even forget you are stopping. Don t become complacent and don t get into difficult situations. Staying stopped More problems or more excuses? But I haven t got any willpower Everybody has some willpower. You use your willpower every day to get things done in life. It is not a fixed thing and it can be developed. Boredom If you re afraid of long empty periods to fill, or just think you ll feel bored without cigarettes, keep busy. 18

21 Alcohol Be careful. Consider avoiding it temporarily, or carefully planning times when you will be drinking. Smoking friends People who offer you cigarettes (oh go on, just have one) may be jealous you are stopping. If they persist, accept one and break it up while they watch. Tension Learn to relax. Even short periods of quiet and relaxation can reduce stress. Staying stopped 19

22 How long does it take to get through the worst? For most people the worst of the withdrawal is over in a few weeks, or at worst a few months. What if I smoke? Staying stopped It s not the end of the world. Many smokers are caught in the revolving door before eventually breaking free. If this happens, have a break, don t feel guilty, and when you are ready, try again. A new life When you haven t smoked for a few months and realise you have succeeded, this could be a good time to look at other issues possibly diet and weight. Use your new confidence to make other changes to improve your health. Stopping smoking could be the beginning of a new life. My reward for getting through the first month will be 20

23 Free at last One day you will wake up and realise that you went the whole of the previous day without even thinking about cigarettes. I definitely feel a lot healthier. That s one thing. The freedom is another, not having anything controlling your life. You don t realise how it controls you when you are smoking, not until you stop. You think you ll never get over wanting a cigarette, but you do and your life feels so much better without them. AG, Cardiff. 21 You have made it. You have become a non-smoker! Staying stopped

24 Stop-smoking medications Stop-smoking medications There are currently three types of stop-smoking medication. The nicotine replacement therapies (NRT) have been around longest, the best known being the gum and the patch. You can buy NRT over the counter or it can be prescribed. There are also two prescription only medicines available, buproprion (Zyban ) and varenicline (Champix ), which work in a different way to NRT. Nicotine replacement therapy NRT really does work. Scientific trials show that if you want to stop smoking it doubles your chances of stopping. It can help you stop even if you have tried it before. It is not a magic cure, but it gets nicotine into your system without the dangerous tar, carbon monoxide and other poisonous chemicals in tobacco smoke, which include ammonia, arsenic, DDT, hydrogen cyanide, lead and mercury. So it is much safer than tobacco and much less addictive. NRT deals with the physical aspects of stopping smoking. It works by replacing the nicotine from your cigarettes while you get used to becoming a non-smoker, easing the withdrawal. Once you feel comfortable without cigarettes you phase out the NRT. There are six NRT products: patch, gum, nasal spray, inhalator, tablet and lozenge. Each is as good as the others, so you should choose the one which suits you best. Since they all 22

25 differ slightly, you may find advice from a pharmacist helpful. They are available over the counter from pharmacists, and all of them can be obtained on prescription from your doctor. Some NRT products can also be bought in shops that aren t pharmacies e.g. supermarkets or newsagents and garages. Which product? Patch discreet and easiest to use It is put on each morning, is designed to be worn for 16 or 24 hours, and comes in different doses. Heavier smokers should normally start with the highest dose patch. Stop-smoking medications Gum allows good control of nicotine dose The gum comes in 2mg or 4mg doses and various flavours. The taste can be unpleasant at first but most people get used to it in a week or so. It is important to chew slowly because any nicotine that is swallowed is wasted. Read the instructions carefully. The nicotine is absorbed through the lining of the mouth. Heavier smokers should normally start with the stronger gum. 23

26 Stop-smoking medications Spray fast acting, good for heavy smokers It consists of a small bottle of nicotine solution. When the top is pressed down it delivers a dose of nicotine in a spray. Nicotine is absorbed faster than from other forms of NRT and this can be better for heavier smokers. However it can be difficult to get used to because the spray can irritate the nose. Smokers who still experience severe craving and withdrawal with the other NRT products should try the nasal spray. Inhalator good if you miss the ritual of smoking The inhalator consists of a plastic mouthpiece and a supply of replaceable nicotine cartridges. You draw on it like a cigarette. Despite its name the nicotine does not reach the lungs but stops in the mouth and throat. The inhalator delivers nicotine through the lining of the mouth. 24

27 Tablet discreet and flexible, good control This tiny tablet is placed under the tongue (sublingual), where it slowly dissolves. You do not chew or swallow it. It works like the gum and lozenge by allowing nicotine to be absorbed through the lining of the mouth. Lozenge discreet and flexible, good control You suck slowly on the lozenge, occasionally resting between gum and cheek. Works like the gum and sublingual tablet. Stop-smoking medications 25

28 Zyban and Champix Stop-smoking medications As well as NRT, there are other products that do not contain nicotine that can help you go smoke-free. Zyban (bupropion hydrochloride) is a treatment which changes the way your body responds to nicotine. It comes as a tablet. You start taking Zyban a couple of weeks before you quit and then continue the treatment for a few weeks to help you through the withdrawal cravings. 26

29 For pregnant smokers Stopping smoking can be really hard during pregnancy, but it is really worth the effort if you can manage it. Ask your midwife, nurse or GP for information about the effects of smoking, and ask them for help in stopping. They will be able to refer you to specialist help, or you could contact Stop Smoking Wales direct You could also ring the Smokers Helpline Wales on For pregnant smokers Stopping smoking is one of the most important things that will improve the health of your baby. 27

30 It will For pregnant smokers cut the risk of premature birth by half cut the risk of miscarrying increase the chance of a healthy birthweight improve the baby s growth and development halve the baby s risk of chest infection halve the risk of asthma attacks And if you stay stopped your child will be less likely to take up smoking. Partners and others If your partner is pregnant and is trying to stop smoking ask her what you can do to help help her make her action plan if you smoke, consider stopping with her or at least stop smoking near her Your support could make all the difference. 28

31 Secondhand smoke Even non-smokers suffer from secondhand smoke meaning they breathe in tobacco smoke from smokers near them. You can help your friends by not smoking near them. Secondhand smoke can affect people in many ways. Here are some examples of what breathing other people s smoke can cause. Adults Aggravates asthma and allergies. Increases the risk of lung cancer. Increases the risk of coronary heart disease. Irritates the eyes, nose and throat. Causes headaches and dizziness. Babies and children Causes breathing problems babies lungs are very delicate. Increases the risk of glue ear this is a common cause of deafness. Increases the risk and severity of asthma attacks. Increases the risk of chest infections, cot death and meningitis. Secondhand smoke About 40 per cent of children in Wales live in households with an adult who smokes. They don t have a choice about inhaling secondhand smoke. 29

32 Further help 0800 Further help Smokers Helpline Wales You will be offered free, confidential advice and information on giving up smoking. Stop Smoking Wales Stop Smoking Wales is a national service for smokers who would like extra support and encouragement in giving up. Trained staff can offer advice on how to quit and provide access to one-to-one counselling and group support. 30

33 Support from Stop Smoking Wales can be really helpful: I decided to try again when I saw an advert for a support group. I went to that and it really helped. Being with other people who are in the same boat got me through the hard times. AS, Swansea. Further help 31

34 You don t realise how it controls you when you are smoking, not until you stop. You think you ll never get over wanting a cigarette, but you do and your life feels so much better without them. This edition first published by, Welsh Assembly Government, Cathays Park, Cardiff CF10 3NQ ISBN Crown Copyright 2008 Based on text written by Martin Raw G/602/07-08 CMK