You'd love to stop smoking. The health reasons are a mile long and your body is (between coughs) telling you that it's time. But you have fears about quitting smoking. Will you gain weight? How can you manage stress and cravings? Will you lose your smoking buddies?
Don't let such worries keep you from quitting. Some are false or exaggerated. Others can be overcome. But, you can calm your concerns and finally leave cigarettes behind.
Fear: I'll Get Stressed Out if I Can't Smoke
Smoking a cigarette can feel like stress relief -- which is much needed, especially during the pandemic.
"People are dealing with unprecedented levels of stress. Everybody is stressed out," says Pamela Ling, MD, an internist and director of the Center for Tobacco Control Research and Education at the University of California in San Francisco.
"For some people, they feel like smoking a cigarette is how they cope."
Yet this is a false idea, Ling says. Yes, nicotine in your cigarettes can create a sense of well-being, relaxation, and improved concentration. But these are only short-term feelings, rewards your brain gives you for feeding it the nicotine it craves. The more time between cigarettes, the more edgy and stressed out you'll feel. In the long run, smoking increases stress and anxiety.
If you can quit for a year, research shows you likely will feel better emotionally than when you smoked, says Michael Fiore, MD, an internist and director of the Center for Tobacco Research and Intervention at the University of Wisconsin at Madison.
"The average smoker a year after quitting is less depressed, less anxious and their mood is improved," Fiore says.
To help you ease quitting-smoking stress, try things such as deep breathing, meditating, and reciting affirmations (such as, "I am strong enough to beat this."). FDA-approved medications can help, too, Ling says. These include nicotine replacements (available as patches, gum, lozenges, sprays or inhalers) or two anti-smoking drugs: bupropion (Zyban) and varenicline (Chantix).
Fear: I'm Going to Gain a Lot of Weight
Weight gain after quitting smoking is real for most people, Fiore says. But the gain averages only between 5 and 10 pounds.
To prevent stop-smoking pounds from piling on, you may need to exercise more, while ditching the doughnuts and chips. You can also avoid sugar cravings by drinking more water and chewing sugarless gum.
Another option: a 3-month bupropion prescription. This drug is known to ease withdrawal without weight gain, Ling says.
Keep in mind that adding a few extra pounds pales in comparison to the good quitting does for your body.
"The health effects of a small amount of weight gain is really outweighed by all the benefits of quitting smoking," Ling says.
Fear: I Can't Take the Awful Withdrawal Symptoms
It's true that nicotine withdrawal symptoms can be powerful and unpleasant, though this varies from person to person.
- Feel restless or jumpy
- Be irritable
- Have trouble concentrating
- Feel sad
- Have trouble sleeping
- Have intense cravings for cigarettes
To lessen these symptoms, Fiore recommends over-the-counter, 2-milligram nicotine mini-lozenges, which he says can be "remarkably helpful."
Some people try e-cigarettes (vaping) to help decrease nicotine, but research has shown mixed results. The FDA does not recommend e-cigarettes for this purpose.
Keep in mind withdrawal symptoms for most people peak within the first 3 days. The first week is usually the worst. Most symptoms are gone within -- at most -- 2 or 3 months, Fiore says.
Fear: I Will Have to Give Up Other Habits I Enjoy
The longer you've smoked, the more likely you are to have developed pleasurable habits involving smoking. You may be used to a cigarette with coffee or alcohol, after a meal, or after sex. Or you may have daily routines associated with smoking, such as driving to work.
If you quit, you may find yourself triggered -- that is, craving a cigarette -- when reminded of these experiences.
Managing triggers is a key to quitting smoking. But this doesn't mean giving up what gives you pleasure, Fiore says. It is possible to disassociate smoking from the activities and habits you enjoy.
To do this, try substituting another activity for smoking, such as chewing carrots, apples, celery, or gum. Breathing exercises may help, as can medications. You also may need to temporarily avoid or change routines and other triggers.
Fear: I'll Lose My Friends Who Smoke
It can be tough to be around people who smoke when you're trying to quit. You may need to set boundaries with friends, asking them not to smoke around you.
This is especially difficult if you live with a smoker. It’s best to ban indoor smoking. If that's a no-go, try making a no-smoking zone where you can stay. Even better, get your spouse or partner to quit with you, if possible.
You also may consider adding nonsmoking friends to your circle. Fiore says his institute's research shows that after a year, former smokers have expanded their social networks.
"It just makes practical sense," Fiore says. Given that only 14% of Americans smoke, "There are a whole lot more nonsmokers out there than smokers." If you're not smoking, you can be more open to relationships with nonsmokers.
Fear: I've Been Smoking Too Long for Quitting to Do Any Good
If you're like most smokers, you started in your teens. By middle or older age, you may fear you've already done permanent damage. So why bother quitting?
"No matter what age you're at, you're going to feel better when you quit," Fiore says.
That's because quitting smoking helps your health, regardless of how long you've smoked. Some changes, such as lower blood pressure, begin within 30 minutes of quitting, Fiore says. Within a month, you can breathe better. Within a year, your risk of heart attack and stroke drops 50%. If you quit at 60, you'll cut your risk of dying in the next 15 years in half compared to a smoker's, Fiore says.
Plus, Fiore says, "It's not just more time, it's improved quality of life."
Fear: I've Already Failed Before and Will Fail Again
Many ex-smokers try many times to quit before succeeding -- perhaps as many as 30 times or more, according to a 2016 study.
"If someone has tried to quit and it's not successful, people will say, 'I feel like a failure. I feel disgusting,'" says Emma Brett, PhD, who studies addiction and co-leads smoking cessation groups at the University of Chicago. The idea of trying again "can be intimidating," she says.
She encourages framing your past attempts as learning experiences. "You gain more information about what works and what doesn't. That can be used to inform that next attempt -- and hopefully make it more successful."
Combining counseling and medications doubles your chances of success, studies show. Ling advises having a plan first, rather than impulsively quitting cold turkey.
Fear: I Can’t Afford Stop-Smoking Programs and Drugs
Quit-smoking counseling and drugs are covered under the Affordable Care Act. Also, free government resources abound, including:
- 1-800-QUIT-NOW (1-800-784-8669), staffed by trained quit-smoking coaches who may be able to give you free quit-smoking medications
- Smokefree.gov, a website run by the National Cancer Institute offering tips and tools
- A quit-smoking daily text messaging service (text QUIT to 47848)
Check with your doctor for more help. Whatever you do, don't let your quit-smoking fears hold you back from a healthier, smoke-free life.
Photo Credit: AndreyPopov / Getty Images
American Cancer Society: “Help for Cravings and Tough Situations While You’re Quitting Tobacco.”
American Lung Association: “Tobacco cessation treatment: What is covered.”
British Medical Journal: "Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers."
CDC: “Burden of Cigarette Use in the U.S.: Current Cigarette Smoking Among U.S. Adults Aged 18 Years and Older,” “Youth and Tobacco Use.”
Emma Brett, PhD, psychiatry post-doctoral fellow, University of Chicago.
Mental Health Foundation: “Smoking and mental health.”
Michael Fiore, MD, founder and director of the University of Wisconsin Center for Tobacco Research and Intervention, Madison, WI.
Monday Campaigns: “Stop-smoking affirmations to help you stay quit.”
National Cancer Institute: “Handling Nicotine Withdrawal and Triggers When You Decide to Quit Tobacco.”
National Health Service: “Stopping smoking for your mental health.”
Pamela Ling, MD, director of the Center for Tobacco Control Research & Education; acting director of the Smoking Cessation Leadership Center at the University of California, San Francisco.
Smokefree.gov: “Managing Withdrawal.”
U.S. Department of Health & Human Services, Office of the Surgeon General: “Smoking Cessation: A report of the Surgeon General: Smoking cessation by the numbers.”
FDA: “Want to quit smoking? FDA-approved products can help.”