Cessation : Bureau of Tobacco Control : NYC DOHMH

The New York City Department of Health and Mental Hygiene

Bureau of Tobacco Control

How to Quit Smoking

Quitting smoking is the single most important thing you can do for your health.
Remember, it is never too late to stop smoking. If you need help or want to find a local quit smoking program, call 311.

What is nicotine?
- History
How addicted are you to nicotine? (PDF)
Why should I quit?
- 10 reasons to quit
- Health benefits of quitting smoking
How can I quit smoking?
- 10 Ways To Make Quitting Easier
- Quit smoking medications
Quit Smoking Programs in NYC
- Nicotine Replacement Therapy Giveaway Program
- Quit Smoking Programs by Borough
Additional Resources To Help You Quit Smoking

What is Nicotine

Nicotine is the drug in tobacco that affects the brain and produces a “feel good” effect – but it is also highly addictive. Research suggests that nicotine is as addictive as heroin, cocaine, or alcohol.

After nicotine enters the body through cigarette smoke, it travels through the bloodstream to the brain in approximately 7 seconds. Its effects last between 5 minutes and 2 hours. Nicotine increases dopamine levels in the brain, creating feelings of pleasure. It also increases the flow of adrenaline, which increases heart rate, blood pressure, respiration, and glucose levels in the blood.

Though nicotine acts as a stimulant, it also creates feelings of relaxation and calmness. It decreases appetite and raises metabolism, which cause some smokers to lose weight. As nicotine levels drop in the body, many smokers feel anxious, stressed, or depressed and will use tobacco to relieve these withdrawal symptoms.

History

First isolated as a chemical compound in 1828, nicotine occurs naturally as an oily liquid that burns and smells like tobacco when exposed to air. Tobacco is the main source of nicotine, though it is also found in much smaller amounts in tomatoes, green peppers, potatoes, and eggplants. In high concentrations, nicotine has been used in insecticides and in darts used to bring down elephants.

Why should I quit?

10 reasons to quit

Live a healthier life.
Smoking causes heart disease, stroke, lung and other cancers, and many other diseases. Your health starts getting better the minute you quit.
Live a longer life.
Cigarettes really are “eating you alive.” Smokers killed by tobacco die about 14 years sooner than non-smokers.
Be free of addiction.
Nicotine is one of the most addictive drugs known.
Improve the health of people around you.
Second-hand smoke kills. It causes cancer, heart disease, and other illnesses. Children whose parents smoke are more likely to have bronchitis, asthma, ear infections, and pneumonia.
Save money.
Smoking a pack a day costs more than $2,500 a year. You could do a lot with that cash.
Feel better.
Get rid of your cough, breathe easier, and stop feeling sick all the time. Look better, too: quitters have younger skin, whiter teeth, and more energy.
Quality of life.
Your clothes, car, and home won’t stink. Food will taste better.
Have a healthy baby.
Babies of women who smoke are more likely to be sick or die, and to be born too small or too soon.
Better sexual and reproductive health.
Men who smoke can have trouble getting and keeping an erection. Women who smoke have more difficulty getting and staying pregnant.
Stop feeling like an outcast.
There are fewer and fewer places where smoking is allowed. Most smokers have already quit. You can, too.

Health benefits of quitting smoking

In 24 hours	• Your chance of heart attack drops.
In 2 days	• Your ability to smell and taste improve.
In 2 to 3 weeks	• Your circulation gets better. • You can walk more easily. • Your lung function improves.
In 1 month	• Your cough, sinus congestion, fatigue, and shortness of breath decrease. • Your lungs start to repair themselves, reducing the chance of infection.
In 1 year	• Your risk of heart disease is cut in half.
In 5 years	• Your risk of cancer of mouth, throat, and esophagus drops by about half. • Your risk of stroke and heart disease begins to decrease to that of non-smokers
In 10 years	• Your risk of lung cancer is about half that of continuing smokers.
In 15 years	• Your risk of death returns to the level of people who have never smoked..

How can I quit smoking?

10 ways to make quitting easier

Prepare yourself.
Make a list of your reasons for quitting and read it often.
Pick a quit date.
Get rid of ashtrays and lighters, and throw out all cigarettes.
Have a smoke-free car and home.
It is healthier for others and will help you not smoke.
Get support and encouragement.
Tell you family, friends, and coworkers that you are quitting and ask for their support.
Get a quit buddy.
Ask a smoker to quit with you, or find someone who has already quit who you can talk to for support.
Notice what makes you want to smoke.
Alcohol, coffee, and stress can make you feel like smoking. So can seeing others smoke; ask smokers you know not to light up in front of you.
Think about using medications.
The nicotine patch or gum, and medications such as Zyban (bupropion) and Chantix (varenicline) greatly reduce your cravings and double your chance of success. Talk to your doctor.
Help yourself cope.
Drink a lot of water to help with cravings. Exercise to get rid of stress and improve your mood and health; a fast walk often does the trick.
Get your mind off smoking.
Talk to a friend when you feel like smoking. Get busy with a simple task, eat a healthy snack, take a walk, or chew gum. Stay away from places and situations you associate with smoking.
Stay away from that first cigarette.
Having even one can make you start up again. Cravings will decrease the longer you don’t smoke. If you can quit for 3 months, you’ll likely quit for good.

Quit Smoking Medication

80% of people who stay quit for 3 months will remain smoke-free. Smokers who use quit smoking medication for 6 weeks to 3 months are more likely to be successful. Many smokers relapse if they stop using medication too soon.

Nicotine Withdrawal Symptoms

Many people have one or more of the following withdrawal symptoms when they stop using tobacco:

Depressed mood
Insomnia/sleep problems
Irritability
Anxiety
Difficulty concentrating
Restlessness
Decreased heart rate
Increased appetite/weight gain

Nicotine Replacement Therapy

When quitting smoking, many people use nicotine replacement therapy (NRT) because it decreases nicotine withdrawal symptoms and doubles the chance of quitting smoking successfully. NRT delivers nicotine to the body at a slower and steadier rate compared to smoking. The nicotine delivered in this way helps the smoker stop using cigarettes as a way to get nicotine.

Although NRT is very safe, you should talk to your doctor before using it if you have had a recent heart attack, have an irregular heart beat, uncontrolled blood pressure, are under the age of 18, or are pregnant.

Some people use two different forms of NRT at the same time or use NRT with a non-NRT medication. Research has shown that combining different forms of smoking cessation medications can increase your success of quitting smoking.

Nicotine Replacement Therapy Medications And How To Use Them

Nicotine Patch: You can buy this without a prescription. You put the patch on a clean, dry area of skin on your upper body that isn't covered with hair, such as your upper arm, back or side. Nicotine slowly enters your body throughout the day. If you smoke a pack a day (20 cigarettes), you could start with a 21 mg patch so that you would get about the same amount of nicotine that you’re used to getting from your cigarettes. The patch comes in 7 mg, 14 mg, and 21 mg for 24 hours or 10 mg and 15 mg for 16 hours.
The most common side effects of the patch are skin redness and vivid dreams. To avoid skin redness put the patch on a new area of your skin each day. To avoid vivid dreams do not sleep with the patch on.
Approximate cost: $4.00-$4.50 per day.

Nicotine Gum: You can buy this without a prescription. You chew the gum until you taste it and then lodge it between your gum and cheek. The nicotine enters your body through your mouth lining. Avoid eating acidic foods 15 minutes before chewing the gum, and do not eat or drink while using it. The gum comes in 2 mg and 4 mg per piece. If you smoke a pack a day and you choose to use NRT gum only, you could start with a 4 mg dose and use the gum at regular intervals throughout the day. Some smokers use up to 1 piece of gum every 2 hours.
The most common side effects are hiccups and mild mouth irritation.
Approximate cost: $6.25-$7.00 per day.

Nicotine Lozenge: You can buy this without a prescription. You suck the lozenge and the nicotine enters your body through your mouth lining. Avoid eating acidic foods 15 minutes before sucking on the lozenge, and do not eat or drink while using it. The lozenge comes in 2 mg and 4 mg. If you smoke a pack a day and you choose only to use the NRT lozenges, you could start with a 4 mg dose and use the lozenge at regular intervals throughout the day. Some smokers use up to 1 lozenge every 2 hours.
The most common side effect is mild mouth irritation.
Approximate cost: $4.00-$4.50 per day.

Nicotine Nasal Spray: You need a prescription from your doctor to get this medication. You spray the nicotine into your nose. Talk to your doctor about proper use, dosage, and side effects.
Approximate cost: $5.00-$15.00 per day.

Nicotine Inhaler: You need a prescription from your doctor to get this medication. You puff on a nicotine cartridge that is inserted into a mouthpiece that looks like a cigarette filter. The nicotine enters your body through your throat lining. Talk to your doctor about proper use, dosage, and side effects.
Approximate cost: $6.00-$16.00 per day.

While using NRT, if you experience fast heart beat, headache, or upset stomach, these could be signs of too much nicotine in your body. Stop using the NRT and talk to your doctor.

Nicotine Free Quit Smoking Medications

Zyban (Bupropion): You need a prescription from your doctor to use this. ZYBAN does not have nicotine. It reduces cravings and withdrawal symptoms. Smokers with depression benefit most from this medication. ZYBAN is a pill, and is taken twice a day. Talk to your doctor about proper use, dosage, and side effects.
Approximate cost: $3.00-$4.00 per day.

Chantix (Varenicline): You need a prescription from your doctor to use this. CHANTIX does not have nicotine. It reduces cravings and helps with withdrawal symptoms. Heavy smokers benefit most from this medication. It works by preventing nicotine from binding to receptors in the brain, which prevents the reward of smoking. CHANTIX is a pill and is taken twice a day. Talk to your doctor about proper use, dosage, and side effects. Approximate cost: $3.00-$4.00 per day.