Quitting smoking is one of the most daunting challenges you'll face in your life. It's an ]]>addiction]]> that is both physical and psychological, but quitting smoking can be done. In fact, you'll have plenty of company: almost 50 million Americans are former smokers.

There are certainly plenty of reasons to quit when you consider smoking's fatal link with ]]>lung cancer]]>, ]]>emphysema]]>, and ]]>heart disease]]>, and the harmful effects of second-hand smoke on your family. Even the tobacco companies admit that there might be a relationship between smoking and death.

You've seen the warnings. Heard the discussions. Received the advice. Listened to your kids nag you about it. You know you should quit smoking, but where do you start? Knowing what you are up against can help you form a successful plan to quit smoking...

The Mind and Body Connection

Smoking is addictive—both physically and psychologically. The physical addiction can be traced to the nicotine in each cigarette. It hooks you just as completely as its more disreputable cousins, such as heroin and cocaine, say researchers, and the withdrawal symptoms—cravings, ]]>anxiety]]>, nausea, cramps, ]]>depression]]>, and dizziness—are similar.

Like these other drugs, nicotine surges through the bloodstream and gives smokers a high—a quick jolt that makes them think they feel better. But, in the meantime, what really happens is that smokers develop a tolerance for nicotine, which is why they go from a couple of butts a day as a teenager to 2½ packs a day as an adult.

The psychological addiction is, in its own way, just as bad. Smoking becomes second nature, like blinking or breathing. If you consider that one pack of cigarettes can turn into 150 to 200 puffs a day, seven days a week, 52 weeks a year, you'll see how hard it is to de-program yourself.

The Key to Quitting

"You know, there's no magic bullet, no device that will make it easy," says Jenny Duffey, who smoked for 13 years before quitting in 1989, and has written a book and taught seminars on quitting. But you can quit. In fact, one million Americans quit smoking every year.

"The thing to keep in mind is that almost everyone who quits has to try more than once," says Anne Davis, MD, a past president of the American Lung Association. "You shouldn't be discouraged. It's more rare to quit on the first try than on the fifth. Some people have to try as many as 10 or 11 times."

The key to quitting, say the experts, is patience, perseverance, and having a plan.

How to Do It

Keep these points in mind when you quit:

Know Why You're Quitting

Pick a reason that you believe in, be it for your family or for yourself. If you don't believe in your reason, it's that much harder to stop.

Change Your Environment

Worry about not smoking for just one day, and not for the rest of your life. Besides, it gets easier to stave off the desire the longer you don't smoke. The nicotine will be gone from your system in three to five days, and after about a month the worst of the withdrawal symptoms will go away.

Taper Off

Some studies show that a majority of permanent quitters achieved their goal by quitting “cold turkey.” But it doesn't make you any less of a man, says Dr. Davis, to try tapering off instead. "It doesn't mean you are weak and don't have will power," she says. "What it means is that you realize there are other approaches that will work better."

The key to tapering off is to cut down the number of cigarettes you smoke each day. One way to do this, says Duffey, is to delay the first cigarette of the day. She recommends the two-hour approach. If you have your first smoke at 7 a.m., try holding out until 9 for a couple of days. Then, push it back until 11, and so on. By the end of four weeks, you won't be smoking at all. Whether you taper or quit cold, your goal must be the same: abstinence. If you choose to taper, don’t let the process give you an excuse to delay the final step of quitting entirely. Set a quit day and stick to it.

Overwhelm the Addiction

Think about the things that lead to lighting up, and don't do them. Get rid of the ashtrays at home. Don't pick up matches at a restaurant. Don't come back from lunch 15 minutes early to sneak in a cigarette break. Avoid places where smoking is part of the atmosphere.

Practice the Three D's

Delay, Deep Breathing, Drink water. When you feel like a smoke, delay. Try to think of something else. Breathe deeply, and count to ten slowly as you do so. Drink water; aim for eight eight-ounce glasses a day, which helps flush the nicotine out of your system. Do something else: chew gum, tap a pencil, or crack your knuckles until the craving passes.

Keep a Diary

This technique, which has also been used effectively with people who eat too much, is surprisingly effective. Each time you feel like a cigarette, write down the time of day, what you're doing, and how badly you want a drag on a scale of 1 to 3, with 1 for the worst craving. A diary, says Dr. Davis, helps you to learn to unlearn the almost Pavlovian responses that make you want to smoke.

"Just because you fail once doesn't mean you can't quit smoking," says Dr. Davis. "Half the battle is knowing that it may require several attempts, and feeling confident that you'll eventually succeed."

Discuss Medication

You may want to discuss with your doctor a medication called ]]>varenicline]]> (Chantix). It is a novel type of treatment that works by stimulating the release of low levels of dopamine in the brain.

Nicotine in the cigarettes causes dopamine to be released, resulting in the positive feelings associated with smoking. At the time of smoking cessation, a drop in dopamine levels is related to the many withdrawals symptoms. By stimulating the release of this chemical in the brain, varenicline helps to reduce the signs and symptoms of withdrawal.

Varenicline also blocks nicotine receptors in the brain, so it helps you stay away from cigarettes. If you go back to smoking while taking the medication, nicotine will not be able to stimulate the brain's receptors the way it did in the past, making the habit much less pleasurable.

Based on the research available so far, it appears that varenicline works better than placebo and buproprion. Its intake has been associated, however, with some side effects. The most frequently reported include: nausea, ]]>headache]]>, ]]>insomnia]]>, bad dreams, and changes in the way food tastes.

Although, varenicline may be a good option for a lot of people, it definitely is not a magic pill. You still need to be very committed to quitting. Talk to your doctor if you are interested in taking the medication.

Work with Your Doctor

For the best results, work with your doctor. Together, you can test your lung function and compare the results to those of a non-smoking person. The results can be given to you as your lung age. Finding out your lung age right after having the test done may help you to stop smoking. ]]> * 1]]>

Your doctor can also discuss with you all of your options, such as:

  • Over-the-counter nicotine patches, gum and lozenges
  • Prescription nicotine inhalers or nasal sprays
  • Prescription antidepressant bupropion
  • Alternative therapies, like hypnosis and acupuncture
  • Smoking cessation classes
  • Self-help programs
  • Group behavior therapy—This may be more helpful than self-help programs. ]]>*²]]>

Trying a combination of these options may work best for you. For example, using a nicotine patch and going to group therapy may help you to become smoke-free.

Reward Yourself for Succeeding

Quitting is hard and you deserve a reward for meeting your short-term goals like being quit for one week, two weeks, or a month. Give yourself something you really want but have been putting off getting. Remember how much money you’re saving by not buying cigarettes. Just make sure you don’t reward yourself with high-calorie food or a smoke!