Smoking Cessation

Methods

Withdrawal symptoms

During the quitting period, quitters have to resist the tobacco craving and may experience some temporary withdrawal symptoms due to the sudden drop of nicotine level. Common withdrawal symptoms include Anxiety, hot temper, depression, emotional, poor concentration, insomnia, constipation, cough, dry mouth and throat, Increased appetite and etc. These symptoms usually reach a peak of intensity in the first week after smoking cessation and then gradually decline in 2-4 weeks. Followings are some recommendations to fight cravings

1. Determination and actions to quit

Preparation and ready to quit:

• Get prepared by understanding own smoking status, finding activities, places and things that trigger smoking desire, reviewing the previous experience of failure in quitting.
• Identify adequate quitting method reference from the Smoking Cessation Booklet  (Chinese version only)
• Set a quit date and adhere to quit
• Inform your family, friends and colleagues that you are quitting smoking and ask for their support and encouragement.

Actions to resist craving:

• Whenever you want a cigarette, wait! Slow down your action and recall your reasons of quitting. In a few minutes, you will get over your urge.
• Do not underestimate the impact of simple steps like deep breathing and drinking water which will help you defeat your urge to smoke. You can also relieve stress and regain concentration by taking a deep breath slowly.
• When you quit smoking, you may sometimes feel emptiness in your hand without holding a cigarette. You are suggested to bring along a decompression ball or a pen with you and play with them in spare time to divert attention, which helps rectify your behaviours associate with tobacco use.
• Do some stretching exercises, cultivate new interests and hobbies, such as planting, reading, playing chess or go for a walk to divert your attention on the urge.

Say firm and avoid relapse:

• Build up healthy lifestyle, included maintaining a balanced diet, moderate physical activity and mental health.
• Avoid joining activities and visiting places that trigger smoking craving.
• Say no to all invitations of smoking from surroundings.
• Declare and celebrate the success with family, friends and colleagues

2. Medication for smoking cessation

The World Health Organization stated that these medications can double or triple the likelihood of successfully quitting. Medications help ease withdrawal symptoms and reduce cravings to smoke, and usage period normally around three to six months. Smokers are advised to consult doctors or pharmacists before using these medications. They are available through the smoking cessation services for free. Some can be purchased over-the-counter from pharmacies. They can be divided into two categories: nicotine replacement therapy (“NRT”) and non-nicotine medication.

Nicotine replacement therapy (“NRT”)

Nicotine Patch

When using the patch, apply one patch per day to clean and dry skin on the chest, back, upper arms, hips, etc. Keep it at all times including swimming and showering. Change the location daily to avoid skin irritation.

Nicotine Gum

Chewing nicotine gum is different from chewing ordinary gum. The nicotine gum should be chewed slowly in around 10 to 15 times, until a strong taste released and then park it intermittently between the cheeks for absorption. When the taste gradually becomes lighter, repeat the process until the gum becomes tasteless.

Nicotine Inhaler

In addition to provide certain amount of nicotine for alleviating withdrawal symptoms, the design of nicotine inhaler assists smokers rectifying behaviours associate with tobacco use. A nicotine inhaler consists of a plastic suction tube and a nicotine-containing cartridge. To use nicotine inhaler, insert the cartridge into the suction tube to break the seal. The inhaler delivers nicotine to oral mucosa.

Nicotine Lozenge

Nicotine lozenges are candy-like and sugar-free, similar to normal lozenges and available in different dosages. Unlike normal lozenges, however, you do not chew or swallow the nicotine lozenge. It is absorbed through the mouth and slowly released into your body.

Points to note for using NRT:

• Smokers must keep their determination and perseverance for quitting successfully.
• Acidic beverages such as soft drink, coffee and fruit juice will affect the absorption of nicotine. Apart from water, do not eat or drink when using nicotine gum, inhaler and lozenge or 15 minutes before use.
• Patients with severe angina, serious cardiac arrhythmias or individuals suffering from acute myocardial event in the recent two weeks should consult their doctors before using NRT.
• Pregnant or breastfeeding women should be encouraged to quit with counselling first. A doctor should be consulted before considering to use NRT.

Non-nicotine medication

Varenicline

Varenicline is a drug for smoking cessation that contains no nicotine. It works at the same receptor in the brain as nicotine to help relieve the craving and withdrawal symptoms while at the same time blocking the reinforcing effects of nicotine.

3. Smoking cessation counselling and consultation

Join cessation class, group programmes and counselling from Quitline, or seeking medical consulation.

Questions and answers about the myth of smoking cessation

If I smoke in kitchen or balcony, family members would not be suffered. So, why I need to quit smoking?

Secondhand smoke and third hand smoke exposure causes numerous health problems to family, especially children. Tobacco toxins can persist on the surface of objects for months and cannot been eliminated by using fans or opening windows. These toxic residues follow the smoker back indoors and get spread everywhere. Therefore, no matter you smoke nearby your family or not, the hazards from third hand smoke still harm the health of your loved. To safeguard their health, quit smoking as soon!

If I switch to smoking e-cigarette or heated tobacco products, would this help me to quit smoking?

Alternative smoking products, included e-cigarette and heated tobacco products, are not recognized as the legitimate quit tools by the World Health Organization. Numerous researches found that nicotine levels of alternative smoking products are almost identical to conventional cigarette. These products extend the nicotine dependence, undermine smokers’ intention to quit. Some smokers even smoked both cigarette and alternative smoking products, and tobacco cravings become worse.

As the e-cigarette and heated tobacco products are odorless and with less harmful substance, if I switch to smoking them, would it be less harmful to me and others?

Both e-cigarette and heated tobacco products release harmful and carcinogenic substances such as nicotine, formaldehyde, acetaldehyde which are detrimental to health and highly addictive. Lower exposure to harmful substances does not mean less harmful or lower health risk. The scent may make bystanders less alerted and be exposed to toxicants of secondhand and third-hand smoke in a long time unconsciously.

If I only smoke during social gathering, would I still need to quit smoking?

Smoking causes immediate harmful effect to health. Tobacco smoke contains harmful substances such as nicotine, tar and carbon monoxide. A research found that social smokers’ risk for high blood pressure and high cholesterol is identical to those who smoke every day. Once you smoke daily or occasionally, smoking hazards always exist. Hence, the best way to be healthy is quitting smoking immediately. 

If I used to smoke for relieving from stress and unhappiness, would smoking cessation make me feel stressed out or depressed?

It's a wrong belief that smoking helps you relax. Smoking craving actually increase smokers’ anxiety and tension. When smokers haven't had a cigarette for a while, the smoking craving makes them feel irritable and anxious, due to interference toward brain from chemicals in cigarette. These feelings can be temporarily relieved when they smoke again, which make smokers wrongly associating the improved mood with smoking. In addition, in the first few days of quitting, people might feel uncomfortable, which caused by the withdrawal symptoms such as anxiety, depression, anger, frustration, and irritability. These symptoms usually decline in 2-3 weeks gradually. Once you adhere to smoke-free, your lifestyle will become healthier and more joyful.

The last time I tried to quit smoking, I failed. Does it mean I will never quit smoking successfully?

A lot of successful quitters kick the habit by several times of attempt. Therefore, it’s important to keep trying and determination, and figure out the adequate quitting methods in the process. If needed, you might seek support from smoking cessation counselling service. Keep in mind that you never fail unless you stop trying.