It is final. I am quitting smoking!

This brochure is designed for those who are 
ready to try to quit smoking

Print this brochure, rather than read it on the screen

So, you have decided to try stop smoking? Congratulations on an excellent decision! This brochure contains advice based on the experience of hundreds of ex-smokers who have participated in our surveys. In reading, consider how they have come to free themselves from cigarettes and how you can follow their example.

Reasons to quit smoking

To successfully quit smoking, you must be well-convinced of the validity of the decision. Start by making a list of the reasons why you want to quit smoking. You can then put this list in a visible spot.

The reasons why I want to quit smoking

___________________________     _____________________________

___________________________     _____________________________

Here is what some ex-smokers told us about their experience of quitting. Imagine the day when you can express the same point of view!

• "I'm proud of myself."

  ___________________________     _____________________________

  ___________________________     _____________________________

  Here is what some ex-smokers told us about their experience of quitting. Imagine the day when you can express the same point of view!

• "I'm proud of myself."
• "I feel the satisfaction of having won the battle."
• "I don't impose my smoking on those around me."
• "This valorizes me in the eyes of those around me." "My family is very pleased."
• "I have more energy." " I am in better shape."
• " I feel fresher when I wake up in the morning."
• "I am less tired."
• "I breathe better." "I can do sports more easily."
• "I have rediscovered tastes and smells."
• "I have more money available." "I save 25 Dollars a week (a fill-up at the gas station).
• "I do not always have to think to bring cigarettes with me."
• "I have better breath." "The smell on my clothes has disappeared."
• "I don't always have to be preoccupied about my lungs."
• "I do not cough anymore." "I do not have headaches anymore." "One gets sore throats less often.

The advantages of quitting smoking for your health:

• In stopping smoking, you immediately lower the associated critical risks to your health. Whatever your age or state of health, it is NEVER too late to quit smoking.
• People who have quit smoking before the age of 50 cut in half their risk of dying in the next fifteen years, as compared to those who continue to smoke.
• Women who quit smoking before becoming pregnant or at the beginning of their pregnancy reduce the risks to the child and to themselves.
• Parents who stop smoking reduce the risks of respiratory diseases for their children (asthma, infections, etc.), in addition to the risks of sudden infant death (SIDS).
• If you have already a disease caused by tobacco, stopping smoking reduces the risks of complications of this disease.

A few strategies to prepare yourself to quit smoking

We know it is not easy to quit smoking. But we also know that you are capable of quitting smoking, just like thousands of other ex-smokers. Most ex-smokers were not successful at stopping the first time, but needed an average of 4 attempts. Try again and again, and you will finally succeed. Just like in all other domains, practice makes perfect. To succeed, you will need to properly prepare your attempt to quit. Here are the techniques that ex-smokers have used during this step of preparation.

Get support

Many ex-smokers have said that the help of those around them was an essential element of their success. Look around for people you can trust and talk with them about your intention to stop smoking. Watch out for certain smokers, though, as they can be jealous of you. Mostly try to get support from non-smokers. If your spouse smokes, encourage him or her to stop smoking. If your spouse stops smoking, this will decrease your risk of relapsing.

Ask for professional help

The help of a professional significantly improves your chances of success. Some possibilities are:

• Asking your doctor. He or she can help you or show you where to go.
• Asking a specialist in smoking cessation.
• Participating in a group-quitting program (e.g., the 5-day Plan).

Try it out

To learn how to deal with nicotine wihdrawal and cravings, you can stop smoking for a few hours, then for a half-day, then for a whole day. These brief periods without cigarettes can prepare you to definitively stop smoking and increase your confidence in your capacity to resist cigarettes. To avoid cravings and other withdrawal symptoms during these brief periods without cigarettes, you can use a nicotine replacement product (patch, chewing gum, nasal spray, etc.).

Use favorable occasions

Many events can prompt you to think about your smoking habit: colds, bronchitis, pregnancy, the birth of a child, the illness of a smoker around you, etc. You can use these occasions to stop smoking, but do not wait too long: the "magic moment" when quitting is easy does not exist.

Abstain absolutely from picking up a cigarette after having stopped smoking

Very often, taking one cigarette leads to a relapse. After quitting, it is VERY IMPORTANTto avoid taking even just one drag of a cigarette.

Evaluate your addiction level

• If you smoke more then 10 cigarettes per day,
• or if you smoke less than 60 minutes after you get up,
• or if you felt withdrawal symptoms the last time you tried to quit,

then we strongly recommend that you use a nicotine substitution product (patch, chewing gum, nasal spray, etc), beginning the first day without cigarettes. These products attenuate or even eliminate withdrawal symptoms. They multiply your chances of success by 2 to 3.

If you used nicotine replacement therapy during your previous quit attempt but failed to quit on this occasion, then you can use the new drug bupropion, which may help you quit smoking the next time.

Keep a smoker's journal

Many ex-smokers have found that keeping a journal has helped them to better control their smoking and to break their habits. They have said that this opened their eyes about a habit that they thought they understood. Why not do the following experiment for a few days? Keep a photocopy of the journal (see last page) in your packet of cigarettes and fill it out before you light each cigarette. Each night, re-read your journal and think about it.

Quitting all at once or little by little?

You can stop smoking "cold turquey" or reduce the number of cigarettes you smoke each day . Most ex-smokers stopped all at once. We recommend this method. However, in order to be effective, this method requires adequate preparation, as described in this brochure. If you prefer the progressive method, here is how you do it.

The progressive method

The progressive method is mostly recommended for people who smoke more than 20 cigarettes per day. After cutting back their consumption to 15 to 20 cigarettes a day, these people should stop smoking right away, in a single step, because it is an illusion to think that they will be able to go for long before just building up their consumption again.

Cut back on the cigarettes that are easiest to skip

The Smoker's Journal helps you cut back on cigarettes you light automatically, without thinking. Do only smoke the cigarettes that seem really necessary to you.

Space out the time between cigarettes

Gradually increase the time between each cigarette, up to the point where you are capable of remaining without smoking for several hours or for an entire evening.

Abstain from smoking from time to time

• Try to keep from smoking for as long as possible in the morning.
• Go out for 1 or 2 hours without taking cigarettes with you.
• Try to not smoke for fifteen minutes after having a coffee.
• To prepare yourself to resist cigarettes after a meal, you could rehearse the following exercise for a couple of days: just stay at the table after the meal for 15 minutes without smoking. Rehearsing this scene several times will help you disrupt the association between the end of the meal and the cigarette.

Buy only one pack at a time

Avoid keeping reserves and buying cartons of cigarettes.

Change your habits

• If you use to smoke just after waking up, take a shower or immediately prepare your breakfast instead.
• If you have the habit of smoking after you have eaten, leave the table immediately after the meal.
• If you have the habit of smoking in certain chair, avoid sitting in it for a while.

Limit the places and the occasions where you smoke

Designate some places where you are allowed to smoke and avoid smoking anywhere else (e.g., in your car, in your apartment, in the presence of children, in the presence of non-smokers).

Luck favors the prepared!

You will increase your chances of success if you prepare yourself to overcome the difficulties that you can run into after you stop smoking. Think in advance about ways to deal with these:

1. about the situations that give you the urge to smoke.
2. about the case, where, by accident, you pick up one or a few cigarettes.
3. about withdrawal symptoms.

1) High risk situations

Certain situations are particularly conducive to smoking. It is useful to recognize these situations and to prepare a strategy to resist the urge to smoke in each before you get there. For this, start by filling out the questionnaire that follows. You can also read our advice on management of risk situations in our brochure entitled "I just quit smoking."

2) If by accident, you pick up some cigarettes again,

Right away, prepare an emergency plan in case you pick up some cigarettes again, because if you do not respond immediately, you strongly risk starting smoking again.

• Remind yourself about your commitment not to smoke.
• Avoid scolding yourself.
• Consider this accident as a normal event of the quitting process, as a learning experience, not as a failure.
• Get help from your friends and family.
• Think about it. Analyze the reasons that prompted you to pick up some cigarettes.
• Above all, avoid starting to smoke on a regular basis again. Do not buy cigarettes, and throw away all cigarettes in your possession.

3) Withdrawal symptoms

In the course of quitting, many smokers feel symptoms of withdrawal. These symptoms diminish after a few days, then disappear. Products that contain nicotine (patch, chewing gum, nasal spray) and the drug bupropion strongly reduce these symptoms, or even eliminate them altogether. The table below details the symptoms and suggests ways to deal with them.

Use products that contain nicotine

Nicotine is a drug that causes a physical dependence and unpleasant withdrawal symptoms when you stop absorbing it. Nine out of ten daily smokers are dependent on nicotine and will feel these symptoms when they quit smoking.

By reducing withdrawal symptoms, or even by eliminating them altogether, nicotine-containing products increase your chances of successfully quitting by 2 to 3 times. Many scientific studies have demonstrated the effectiveness of these products. We strongly recommend that you use them. They will render your attempt to quit much more comfortable.

These products exist in 5 different forms. Depending on the country where you live, all forms are not available and some forms are available only with a prescription from a doctor.

• The patch diffuses nicotine slowly through the skin all day long. Use it for the entire time recommended, between 6 and 12 weeks.
• Chewing gums are effective if you follow the instructions strictly (chew with the specified technique, take the number of pieces specified, use for the entire time recommended).
• Nasal sprays immediately relieve withdrawal symptoms and make the need to smoke disappear.
• Inhaler replaces the smoking rituals (gestures and inhalation).
• Sublingual tablets melt slowly under the tongue.

Here are the reasons given by participants of our survey as to why they prefer not to use these products, as well as responses that we gave to them:

"I do not like the idea of using a medication to help me quit smoking."

• It is not shameful to use a medication to free yourself from a drug - like nicotine - that causes physical dependence.

"These products do not work."

• Though many scientific studies have shown these products are effective, they do not guarantee success. The use of these products does not free you from the efforts of changing your habits.

"I can stop smoking just fine without these products. Willpower is enough."

• A poorly placed sense of pride can lead you to a relapse. These products can double to triple your chances of success. Have as many winning cards on your side as possible!

"These products cost too much."

• It is true that these products are expensive (The patch costs 180 Swiss francs per month). It is, however, much less than what you spend each year to smoke.

"I'm afraid of the side effects of these products."

• These products have very few side effects, and the effects are banal. The patch can trigger itching or temporary, localized reddening of the skin. The spray can cause temporary irritation of the nasal membranes. It is important to know that the nicotine patch, nasal spray, inhaler, sublingual tablet and chewing gum are not dangerous to your health. In particular, the risk of cardiovascular accident is not increased for people who use these products. This also applies to patients with heart disease.

"I'm not dependent on the nicotine."

• These products increase your chances of success even if you smoke only 10 cigarettes per day. Start by accepting the idea that if you smoke more than 5-10 cigarettes per day, you will be dependent on the nicotine. A good way to see if you are dependent is to stop smoking for 24 hours. People who feel absolutely no withdrawal symptoms in the course of these 24 hours are probably not very dependent. Others will benefit a lot from using nicotine-containing product.

"My problem is not the physical dependence, but getting rid of an old habit."

• It will be easier for you to attack the other aspects of your smoking habit if the problem of physical dependence is resolved by using products that contain nicotine.

Alternative products and methods

With the exception of some antidepressants (bupropion), the effectiveness of pharmaceutical products other than the ones that contain nicotine is not scientifically established. In particular, neither homeopathic products nor products which change the taste of tobacco (e.g., silver acetate products) are effective. The same is true for herb-based products. The "gadgets" that you find at pharmacy counters (e.g., cigarette holders, etc.) are also ineffective.

Just do it!

After you have prepared, it is time to do it! Start by making a firm decision to stop smoking Many ex-smokers have confirmed that this firm self-commitment made the difference between successful and unsuccessful attempts to stop smoking.

Set a quit date

It is very import to set a date to stop smoking - and to stick with it. Many smokers wait for the "ideal time." They tell themselves "I will stop on my next vacation, when I have found a job, after my exams, " or "I have too much to worry about right now." The ideal moment will never come. Since you have already decided to quit smoking, what are you waiting for? Would you prefer to wait until you have contracted a fatal smoking-related disease? Take the initiative and fix a date to stop in the next 30 days.

Prepare yourself for your quit day

When the day comes that you fixed to stop smoking, throw away all your cigarettes, and do not save any. Hide all of your matches, lighters and ashtrays. Talk about your attempt to quit with people you trust. Ask your family, your friends and your colleagues to support you and to be understanding if you are in a bad mood. Ask smokers to respect your decision.

Make a contract with yourself

Why not sign a contact with yourself like the one below? This can help you stick with your decision.

For people who have already tried unsuccessfully to stop smoking

Relapsing is a normal phenomenon, a part of the process of stopping. On average, ex-smokers have made 4 serious attempts to quit before finally quitting for good. Keep trying again and again. Just like everything else, it takes practice to get to where you want to go. Remind yourself that your attempt to quit has given you the experience necessary to increase you chances of really quitting the next time around. Having relapsed does not signify that you are incapable of quitting. It only means that you did not react well in a nunfavorable situation. You have been capable of going for several days or months without cigarettes. This proves that you are fully capable of living without smoking. Tell yourself that your next attempt to quit will be different from the previous one, as you will this time be better prepared with the advice and information found in this series of brochures!

Think about the circumstances of your relapse and of how to better resist cigarettes under similar circumstances.This will help to have more success the next time. For this, fill out the following questionnaire:

1- Under what circumstances did you start to smoke again? (date, hour, place, with whom, what activity, what was your mood?).

_____________________________________________________________________

2- What triggered your urge to smoke?

_____________________________________________________________________

3- The next time, how will you resist the urge to smoke under similar circumstances?

_____________________________________________________________________

What now?

Ensure that you have properly prepared your attempt to quit smoking by filling out the following check-list:

We can help you

We can give you individualized advice to help you stop smoking. For this, you should respond to our questionnaire and return it to us. In return, you will receive a personal evaluation report, based on your answers to the questionnaire. If you would like, you can receive a series of evaluations, updated from time to time. You can order this material from the address found on the first page If you have access to the Internet, you can obtain all of this material from the following site: http://www.stop-tabac.ch. All of this material is free of charge.

Prevent from relapse

To prevent a relapse, read our brochures entitled "I just stopped smoking" and "Ex-smokers, persevere." In it, you will find ways to resist smoking in risky situations.

Smoker's Journal

Photocopy and cut out this journal. Over a few days, fill it out before lighting each cigarette. At night, go over it and think about it.

Review of the day of (date): _________________

The situations where the urge to smoke was strongest: ________________________________

The most effective strategies to resist in these situations: _______________________________

* Mood: neutral, worried, stressed, angry, depressed, content, relaxed, tired, bored.

** Intensity of the urge to smoke: none=0, very weak=1, moderate=2, strong=3, extreme=4.

Where to find help and information about quitting smoking?

Internet

• Individualized advice given by a system-expert: http://www.stop-tabac.ch.

• The Center for Disease Control's Tobacco Information and Source Page is put out by the Office on Smoking and Health.

• The QuitNet is an online resource and support center for smokers struggling to quit and for those ex-smokers working to stay quit. http://www.quitnet.org/

• Nicotine Anonymous offers meeting information, a twelve step program, and motivational slogans. A great thing is that there are no fees for joining. http://rampages.onramp.net/~nica/

Additional Internet Links

GENERAL LINKS

• Tobacco BBS

• Smoking From All Sides

• NicNet: Nicotine and Tobacco Network

• A Capsule History of Tobacco

HEALTH-RELATED LINKS

• The Centers for Disease Control and Prevention

• CDC Tobacco Use and Prevention Information

• Food and Drug Administration

• American Cancer Society

• American Lung Association

• American Lung Association: Smoking and Tobacco Control

DOCUMENTS AND LITIGATION

• CourtTV Tobacco Cases

• Tobacco Control Archives - The Brown & Williamson Collection

• Tobacco Litigation (The Wilmington Institute)

• Andrews' Publications: Tobacco Industry Litigation Reporter

• Tobacco on Trial: The Newsletter of the Tobacco Control Movement

ANTI-SMOKING SITES

• The Master Anti-Smoking Page

• The Foundation for a Smoke-free America

• Nicotine Anonymous

• Americans for Nonsmokers' Rights

• ASH - Action on Smoking and Health

• National Center for Tobacco Free Kids

NEWSGROUPS

• alt.smokers

• alt.support.stop-smoking

• alt.support.non-smokers

• alt.support.non-smokers.moderated

Articles and Publications

• Major Depression Linked To Stages Of Smoking - MHN Reading Room

• Psychiatrists use Antidepressants to Treat Smoking Addiction - MHN Reading Room

• Smoking As Drug Dependence - The Harvard Medical School Mental Health Letter

• Smoking Contributes to Mental Decline in Elderly - MHN Reading Room

• Smoking Found to Increase Sight Risk - USA Today

Products For Sale

• LifeSign - Smoking cessation program.

• The Quit Smoking Company

• Quit'em - Stop smoking focus cards

Software

• Smoke Free Stats - Free software to help you quit cigarettes.

Treatment & Support Services

• Addiction Alternatives - Dr. Marc Kern

• Neighborhood Tobacco Recovery Network - Calgary, Alberta, Canada

Video

• Message to Youth - A NEW VIDEO

• Straight Talk About Tobacco, a live talk by Patrick Reynolds, was recently made available on video. Filmed before 2,000 middle and high school students, this powerful, multimedia presentation helps motivate youth to stay tobacco free, and to resist the onslaught of tobacco advertising and peer pressure.

The stages of change

• Most smokers pass through 5 steps (or stages) before they become confirmed ex-smokers.

• We have designed a brochure for each of these 5 stages, as well as a brochure for those who have restarted smoking after trying to quit (relapse).

• These brochures can be ordered from the address located on the first page.

• If you are in the Preparation stage (you have decided to stop smoking in the next 30 days), this is the brochure you should read first.

• You get the most out of these brochures if you make notes on them, if you underline the important passages and if you take note of the main points.

This brochure was created at the Institute of Social and Preventative Medicine of the University of Geneva, with the support of the Swiss Cancer League, the Swiss National Science Foundation, the Swiss-Romande Lottery, the Geneva Department of Social Action and Health, the Swiss Federal Office of Public Health, The Swiss Foundation for Health Promotion, Pharmacia & Upjohn, the Swiss Pulmonary League, the Cipret-Genève and the Jura Canton Health Service. We thank the Swiss Association for Smoking Prevention (at) for it help and support.

Copyright (c) Jean-François Etter 1999. All rights reserved.

Author: Jean-François Etter

Translated from French into English 1 March, 1999 by MCART.org

Your donations will allow us to distribute these brochures and to pursue our prevention programs and our research on smoking prevention. Send donations to the Postal Account CCP 12-7003-9, Faculté de médecine, CH-1211 Geneva 4, Switzerland. Do not forget to indicate: "Fonds 2428 - IMSP."

If you have an Internet site, we appreciate your linking to the site http://www.stop-tabac.ch