If you’ve ever tried to quit smoking and failed, you’re not alone. Data from the Centers for Disease Control and Prevention shows that fewer than 1 in 10 adult smokers succeed in quitting cigarette smoking each year. If you need more evidence of how difficult it is to quit, a study in the British Medical Journal found that it may take smokers 30 or more attempts to quit smoking before they are actually successful.
Don’t let these figures put you off! It may be difficult to quit cigarette smoking, but at the Wellington Medical Group, our aim is to make sure that you are armed with the best possible tools to succeed in achieving your goal of quitting smoking. Follow our top 10 tips for quitting cigarette smoking, and simply click on the links below to book an appointment to see one of our specialists in smoking cessation.
1. Set a quit date
You’re setting yourself up for failure if you decide to stop smoking a) at the beginning of December when festive season is just kicking off, b) when you’re going through a divorce and are moving house at the same time or c) when you have a strict deadline to meet and need to work into the wee hours of the morning.
Unless you have the willpower of a superhero, it is going to be difficult to stop smoking under stressful circumstances or at a time when it’s almost impossible to avoid smoking triggers.
No time is ever ‘the right time’, but by setting a quit date that allows you to avoid the stressors, people or behaviours that normally tempt you into having a cigarette, you will maximise your chances of success.
Having said that, don’t keep moving your quit date because circumstances aren't perfect. Choose a date to stop smoking and diarize it. A study in The BMJ that assessed approaches to smoking cessation found that there was not much difference between the success of people who decided to quit smoking abruptly and those who decided to follow a step-down approach (reducing the number of cigarettes smoked over time), as long as they had committed to a quit date. So, set a (quit) date with yourself.
2. Share your intention (but carefully)
You are more likely to succeed in quitting if you share your intention to quit with someone whose opinion you respect. A 2020 study in the Journal of Applied Psychology showed that we are more likely to achieve our goals if we share them with someone whom we respect or whose opinion of us we value.
Contrary to what popular opinion often suggests, it can be counterproductive to share your goal all over social media. Yes, sharing your goal publicly may make you feel more accountable, but according to researcher Peter Gollwitzer, widely sharing identity-forming goals (in your case: ‘I am going to stop smoking’) actually makes you less likely to achieve them. The reasoning goes something like this: when you tell a whole bunch of people of your intention to stop smoking, you receive a heap of positive feedback that then lulls you into a false sense of achievement and makes you less likely to enact the real behaviours necessary to stop smoking.
It’s complicated, we know! The bottom line? Choose a select few people whose opinions you value, and tell them of your intention to quit cigarette smoking.
3. Plan ahead
But not too far ahead. Leave it too long and you’ll be bored of your goal before you even start.
Setting your quit date a few weeks into the future gives you time to plan your strategy for stopping smoking. Research has shown that a combination of medication and behavioural counselling improves the likelihood of quitting smoking. Planning ahead allows you to set this up before you actually quit, increasing your chances of success.
If you are planning on using medication to help you quit smoking (see tip #4), you may need to make sure that you have this ready so that you can start the medication on, or a few days before, your quit date. Make an appointment with one of our smoking cessation experts to help you set up your individual plan.
4. Use medication
Some people have a weird belief that using medication to help you quit smoking is cheating. We say that quitting smoking is hard enough as it is, so use whatever help you can get! There is ample evidence that using medication to help you stop smoking increases your chances of success.
Currently, the most commonly used medications are varenicline (brand name Champix) and bupropion (brand name Zyban). These medications are not the same as nicotine replacement therapy (see tip #5), as they reduce the urge to smoke rather than decrease the withdrawal symptoms. They act centrally on the brain to downregulate nicotine receptors, which takes away the urge to smoke.
An exciting new drug that is being tested in trials is cytisine, which, interestingly, is found naturally in some indigenous New Zealand plants.
As with all medications, there are possible side effects and contraindications to use, so the best approach is to chat to one of our smoking cessation doctors about which medication would best suit you.
5. Nicotine replacement therapy (NRT)
NRT has been around since the 1980s, but it is still an effective aid in helping you to stop smoking. NRT can come in various forms, including gum and patches.
In a review of studies looking at smoking cessation interventions for adults, nicotine patches improved continued abstinence from smoking at 6 months, and nicotine gum improved continued abstinence from smoking at 12 months. NRT is encouraged by the New Zealand government as part of its attempts to help people to stop smoking.
NRT acts by reducing the symptoms of withdrawal. It replaces the nicotine that you would have gotten from cigarettes with a cleaner form of nicotine (minus all the other chemicals found in cigarettes). The aim is to slowly decrease your nicotine intake over 8-12 weeks. Nicotine is still addictive, so you can become addicted to NRT. It’s for this reason that it’s best to undertake your NRT treatment under the guidance of one of our doctors.
6. List your smoking triggers and habits
And replace them. Although smoking is addictive, it’s also a habit. The good news? You can break bad habits! It’s going to take a bit of homework, but it will be well worth it.
The typical habit is formed by repetition of a simple cycle (called the habit loop): trigger-behaviour-reward. The neural pathways become established so that whenever we are exposed to a certain trigger (e.g. a stressful situation), we automatically behave in a certain way (e.g. reach for a cigarette), which then leads to a reward (e.g. a temporary reduction of stress), which cements the neural pathways even more.
The key is to learn to break your habit loops.
Before your quit day, try to identify your smoking triggers. Write them down. Then try to think of alternative behaviours to replace reaching for a cigarette. Ideally, these would be positive behaviours, such as going for a short walk. You don’t want to replace one unhealthy habit with another.
You may need some help identifying your triggers and finding new behaviour and reward ideas, which is where seeing a therapist (tip #7) or joining a support group (tip #8) can be particularly helpful.
7. Book a therapy session
Or 10. Behavioural counselling has been shown to be as effective as medication in helping you to stop smoking. The good news is that the effect of medication and counselling may well be additive or multiplicative, meaning that using both interventions increases your chances of successfully quitting more than either single option alone.
Best outcomes seem to be with a weekly clinic appointment with a therapist, either with or without other smokers. Telephone support, however, has also been shown to be effective, suggesting that it may be more the result of the relationship with a therapist or counsellor that is important than the actual psychotherapy. Whatever the case may be, if you want to improve your chances of quitting, find a counsellor that you can connect with.
8. Find a support group (or app)
Joining a group of like-minded individuals who share the same goal as you can motivate you to stick to your goal. There is also an element of accountability in a support group.
For some people, a physical support group that meets on a regular basis yields the best results; however, this system doesn’t suit everyone. You may be shy, in which case meeting a group of strangers is likely to add to your stress instead of decrease it, or your life commitments may not allow for meeting up regularly. A great option in this case is to join an online support group such as Quitline – Quit Smoking.
Since we live in an age of devices and apps, why not use that to your advantage? There is some evidence to suggest that online programs providing chat services, text messaging support and mobile-phone-based support programs may increase your chance of success. Check out www.becomeanex.org for a start.
9. Inject some mindfulness into your life
Quitting starts in the brain. Literally. This study proves it, and it doesn’t mean it figuratively. Mindfulness training can actually alter the physical neural pathways in your brain to break entrenched circuits (read: habit loops).
For some reason, the effects seemed to be greatest in women, so this tip may be extra beneficial for you if you’re female.
A literature review of mindfulness interventions to assist in smoking cessation supported the use of yoga and meditation-based practices as candidates to assist in smoking cessation. This may be the result of both changes in neural pathways and decreased stress. Yoga and meditation are both well-established techniques for managing stress.
10. Cheat (treat) with dopamine
Remember the habit loop? Trigger-behaviour-reward. Well, the reward part is mediated by dopamine. That’s one of our strongest feel-good neurotransmitters.
Cheat (well, sort of) by manipulating your dopamine system. Reward yourself when you replace reaching for a cigarette with another, healthier habit. Positive reinforcement is the process of rewarding ‘good’ behaviour to entrench that behaviour. Eventually, with enough positive reinforcement, good behaviour becomes a habit.
The easiest reward (and one that our dopamine loves) is chocolate, but you don't want to fall into the trap of replacing every cigarette with an unhealthy snack, so you may need to think out of the box. A glass of water doesn’t give the same kick as a chocolate, we know, but perhaps if you manage to replace 8 cigarettes with 8 glasses of water, you can treat yourself to a massage or a movie. Get creative about ways to reward yourself.
The bottom line
Quitting smoking is difficult, and it’s even more difficult to do it alone. Why not maximise your chance of success and enlist the help of experts? Following our tips will get you some of the way, but integrating the tips with the knowledge, help, support and expertise of our dedicated smoking cessation team will ensure that you are well on your way to quitting cigarette smoking.
Click on the link or give us a call to enrol in our smoking cessation program today.
Johnsonville Medical Centre (04 920 8850)
Thorndon Medical Centre (04 473 5181)