Taking the challenge of the Great American Smokeout?  A Mass General tobacco research expert offers ways to help you quit smoking.

Tobacco smoking is the leading preventable cause of illness and death. It is responsible for 480,000 deaths per year, and it shortens life expectancy by 10 years.

But the good news is that no matter how long you’ve smoked, no matter how heavily, your health will benefit from quitting. It is never too soon or too late in life to stop smoking.

It is never too soon or too late in life to stop smoking.

Most smokers tell us they want to quit. However, most attempts to quit fail. Nicotine is addictive and about two-thirds of people trying to quit smoking don’t get professional support.

Research and experience have shown us that your best chance of stopping permanently is to get support to learn how to live your life without cigarettes and to use medications that can ease the process of withdrawing from nicotine.

Ease Off Nicotine

When people try to quit smoking, they may feel depressed, anxious or irritable, and crave a cigarette. That happens because nicotine is a highly addictive drug and their bodies have to adjust to living without it. However, drugs and devices are readily available that ease the physical discomfort of nicotine withdrawal and the urge to smoke. Smokers who use them when they quit double their chance of success.

One approach is to use a product that supplies nicotine in a different form than cigarettes.  Examples are skin patches, gum and lozenges, which are available without a prescription, as well as an inhaler and nasal spray, which require a prescription. These products deliver small amounts of nicotine to help the smoker wean off nicotine slowly. They don’t contain the other products in tobacco smoke that cause most of the harms from smoking.

Smokers who use the available drugs and devices when they quit can double their chance of success.

At the Mass General Tobacco Research and Treatment Center, we have found that a combination approach is safe and more effective than any one of these products alone. My advice is to use the patch continually and when you have an urge to smoke, add another product that is absorbed quickly—gum, lozenges or an inhaler.

Another strategy is to use one of the two pills that the Food and Drug Administration has also approved to treat smoking: bupropion (Zyban) and varenicline (Chantix). Bupropion, a drug also used to treat depression, increases the odds of quitting, separate from its antidepressive effect.

Varenicline seems to be more effective than bupropion. There are some concerns that in some people it may cause changes in behavior or mood. You and your doctor should discuss which of the prescription medications might be best for you..

Support is Key

Many programs are available that can help motivate you to quit and provide support as you deal with withdrawal symptoms, cravings and tempting situations.

Don’t be discouraged if you haven’t been able to quit smoking in the past.

The most widely used alternative is counseling by telephone. There is a free national network of telephone quit lines at 1-800-QUIT-NOW.  If you call, you can set up free telephone appointments with a tobacco coach who can guide you as you wean off cigarettes.

Another option is to meet in person with a tobacco coach. MGH Community Health Associates offers free one-on-one quit-smoking coaching to patients and community members at MGH health centers in Revere, Chelsea, Charlestown and Everett. Contact Living TOBACCO-FREE at 781-485-6210.

Keep Trying

Don’t be discouraged if you haven’t been able to quit smoking in the past. Get help and keep trying. You will eventually succeed with the right combination of supports.

For more information about Mass General’s Tobacco Research and Treatment Center's efforts, please contact us.

See also: Can E-Cigarettes Help You Quit Tobacco?

Nancy Rigotti
Nancy A. Rigotti, MD, is associate chief of the Division of General Internal Medicine at Massachusetts General Hospital and founder and director of the hospital’s Tobacco Research and Treatment Center. She is past president of the Society for Research in Nicotine and Tobacco and has contributed to the U.S. Surgeon General’s reports on tobacco.