5 Steps to Quit Smoking

Contemporary ClinicApril 2016
Volume 2
Issue 2

No matter your age, quitting tobacco can benefit you and those around you.

Q: Why Should I Quit?

Quit for yourself, even if you’ve smoked for years. Smoking is addictive and one of the leading causes of preventable disease and death in the United States. Smoking kills more than 480,000 Americans each year, or about 1315 individuals every day.1It also damages the heart, lungs, and blood vessels, and many cancers—including those of the lung, throat, bladder, mouth, larynx, esophagus, and stomach—have been linked to smoking. Smoking causes 90% of all lung cancers and 80% of all deaths from chronic obstructive pulmonary disease.2It also increases the risk for cancer, even if it is not the direct cause.

Smoking also increases the risk for the following common diseases:1

  • Coronary heart disease
  • Stroke
  • Diabetes
  • Stomach ulcer
  • Osteoporosis

Your risk for heart attack, stroke, and many cancers will be reduced greatly after 1 to 5 years when you’re smoke-free. Quitting also decreases your risk for lung diseases such as emphysema.

Quit for your family, especially your children. Family members exposed to secondhand smoke are at risk for developing cancer and heart disease. Secondhand smoke is responsible for 41,000 deaths each year.1Babies and children exposed to secondhand smoke are at risk for asthma, ear infections, respiratory infections, and sudden infant death syndrome. Women who smoke during pregnancy increase the risk for ectopic pregnancy, preterm delivery, low birth weight, and birth defects.

Q: How Do I Quit?

It is difficult to quit smoking. You may have setbacks, but if you continue to try, youcando it. The key to successfully quitting is preparation.

Step 1: Commit to a Quit Date.

Choose a quit date within the next 2 weeks. Avoid choosing a day when you know you will be busy, stressed, or tempted to smoke such as a night out with friends who are smokers.

Identify your reasons for being smoke-free. Write down the reason(s) you are quitting (eg, to be healthier or to keep your family safer) and place it where you will see it every day.

Circle your quit date on your calendar and write it down where you will see it every day. This will remind you that quitting is your decision. Let your friends and family know that you are planning to quit. Explain to them how they can help, such as by not smoking in your presence or reminding you of why you are becoming smoke-free.

Step 2: Create a Smoke-Free Environment.

Creating a smoke-free environment will not only help you stop smoking, but also reduce the amount of secondhand smoke to which your family and friends are exposed.

Spring clean for tobacco. Go through every room in your house, garage, car, office, pockets, purses, and secret hiding places to look for cigarettes, cigarette butts, ashtrays, lighters, and any form of tobacco. Don’t forget to look outside for butts and ashtrays. Don’t just throw the tobacco out; destroy it so you won’t be tempted to take it back.

If you live with a smoker, ask him or her to smoke outside the house only. Meanwhile, get rid of the smell of tobacco. Wash your clothes, towels, and sheets and vacuum the carpets in your home and car, placing air fresheners in each area. Don’t let anyone smoke in your house, and avoid going to places where others smoke.

Step 3: Evaluate Your Smoking Triggers.

Recognizing your triggers is the first step toward learning how to deal with them without smoking. Smoking triggers consist of 3 types of situations that bring on the urge to smoke.

Most individuals have at least 1 of each type of the following triggers:

  • External situation triggers include being around others who smoke or being in a situation where you smoke automatically even though you may not even really feel like having a cigarette such as while watching TV or driving.
  • Internal emotional triggers include feeling depressed, stressed, anxious, or bored.
  • Internal nicotine craving triggers occur when you crave the taste of a cigarette or are having withdrawal symptoms.

You won’t be able to avoid all smoking triggers, so it’s important to make a plan for how to handle cravings once the triggers happen. Planning ahead makes it easier to control the urge when it comes. A plan will keep you focused, motivated, and confident in your ability to be smoke-free.

Step 4: Make a Plan to Beat Smoking Urges, Triggers, and Cravings.

Remind yourself of the reasons you want to be smoke-free. You can’t just get up and walk away from an internal trigger, but there are many things you can do, such as using controlled breathing, listening to calming music, or practicing guided imagery. Cravings come and go, but 1 puff won’t help; it will only intensify the craving.

Most cravings last less than 10 minutes, and although this feels like a long time, the following strategies can keep you from turning to tobacco:

  • Wait it out. Read, listen to music, or play on your phone for 15 minutes until the craving passes.
  • Use existing coping mechanisms. You probably don’t smoke in restaurants or movie theatres, so you already have many skills you can use when cravings start.
  • Identify individuals who will encourage and support you. Tell them about your designated quit date and ask them to help you quit. This includes not smoking around you or helping you take your mind off smoking. Getting help from important individuals in your life makes it easier to stop smoking.
  • Be assertive in asking others to stop actions that interfere with your efforts to quit smoking.
  • Change your routine. If you smoke when you first get up, go brush your teeth instead. If you smoke when you drive, bring some celery sticks to munch on. If you always smoke after a meal, take a walk instead. By changing your routine, you will be less tempted to smoke. For the first few weeks after you quit smoking, try to avoid places where others are smoking or places where you used to smoke.
  • Use healthy substitutes. Replace smoking with a substitute behavior such as chewing gum or sucking on a cinnamon stick. Keep your hands busy by squeezing a ball, doing needlework, or rubbing a “worry stone.”
  • Exercise can help manage both cravings and stress. A 20-minute walk can go a long way toward fighting the craving and improving your health and will distract you from urges.
  • Practice controlled breathing. If you can slow down your breathing, you can slow down your body and quiet your mind, easing the craving. To do so, follow these steps:Sit down and relax if you can. If you can’t stop what you’re doing (if you’re driving, for example), you can still practice controlled breathing.Breathe in through your nose, counting slowly to 5. Send air as far down into your lungs as you can.Pause and hold your breath to the count of 5.Exhale as much air as you can easily while slowly counting to 5 or higher.After you’ve exhaled completely, take 2 breaths in your normal rhythm, and then repeat these steps.

Step 5: Know Your Resources and Get Professional Help.

Plan on using multiple support options to help you remain smoke-free. The following are a few to consider:

  • Quit lines: Quit smoking counselors are always available at 1-800-QUIT-NOW (1-800-784-8669).
  • Quit smoking apps: Mobile apps can help you prepare to quit, provide support, and track progress.
  • SmokefreeTXT: This text messaging service provides support.
  • Support groups: Visit your county or state government’s website to see if quit smoking programs are offered in your area, or contact other online support through many pharmacies.

Talk to your health care provider about quitting, as well. He or she can assist with OTC and prescription medications to help you quit smoking.

Final Word

No matter your age, quitting tobacco can benefit you and those around you. Quitting can be difficult, but help is available. You can do it!

Serena J. Stutzmanis a board-certified family nurse practitioner who works as a clinical educator at Walgreens Healthcare Clinic.


  1. Centers for Disease Control and Prevention. Cigarette smoking in the United States. CDC website. http://www.cdc.gov/tobacco/campaign/tips/resources/data/cigarette-smoking-in-united-states.html. Updated December 14, 2015. Accessed March 11, 2016.
  2. Centers for Disease Control and Prevention. Health effects of cigarette smoking. CDC website. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/. Updated October 1, 2015. Accessed March 11, 2016.
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