Two factors are important when stopping smoking-motivation and dependence. If you lack motivation to stop smoking, or if you are motivated by others then this needs to be tackled first. Ask yourself how you feel about your smoking and how you feel about stopping. If you feel that your smoking is a problem and that you would like to stop you then need to tackle your dependence on smoking. This means setting a stop date, stopping smoking, dealing with withdrawal symptoms and staying off cigarettes! Ask yourself how difficult it would be for you to stop.

Why should I stop smoking?

Smokers die younger on average than non smokers. Smokers suffer from diseases such as emphysema that causes perpetual breathlessness, heart disease causing chest pain on exercise, heart attacks, stroke causing paralysis of limbs and speech, blood vessel disease leading to amputation of legs. Smoking causes cancer including lung, bladder, throat and mouth cancer.

Children suffer

Parents who smoke are more likely to have low birth-weight babies who are at higher risk of developing high blood pressure, diabetes and strokes as adults. Adult diseases are influenced by factors occurring in the womb on the unborn child. Children whose parents smoke suffer from asthma causing cough and breathlessness, glue ear causing deafness and are exposed to a risk of cancer due to passive smoking. The children of parents who smoke are more likely to smoke themselves.

Smoking gives you bad breath, may upset your partner, costs money and is socially unacceptable. Work out how much you will spend during the next year on cigarettes and then think about what else the money would buy.

How should I stop smoking?

Set yourself a stop date that you are comfortable with. You should stop completely. There is no evidence to suggest that giving up gradually is easier. People who wish to quit but continue to smoke occasionally are at higher risk of resuming regular smoking than those who stop completely. Some smokers who cut down the number of cigarettes compensate by increasing the amount of smoke they inhale. They keep nicotine levels up with deeper and more frequent puffs. Cutting down gradually may cause nicotine withdrawal effects. This may sap your will power to stop completely and makes continuing smoking more attractive.

Nicotine replacement

Nicotine replacement in the form of patches or chewing gum is available from the chemist. The cost is comparable to that of cigarettes so you should not be worse off financially. Using the patches or gum may enable you to stop smoking without experiencing severe nicotine withdrawal. It should then be easier to cut down gradually the amount of gum or patches that you use.

The patches and gum are not magic cures; you still need determination to stop smoking. Because the patches and gum supply nicotine at a lower dose and slower rate than smoking they are not as satisfying as smoking. However, they help take the edge off the discomfort some people experience when stopping smoking.

The gum may be unpleasant to use initially but if you persist with it this settles. Users of nicotine gum should make sure that they are using enough. A few sticks a day will not provide sufficient levels of nicotine. Take the full recommended dose; you want to receive the full benefit.

Withdrawal symptoms

Withdrawal symptoms do not affect all people who stop smoking, but between 50% and 80% may experience some discomfort. The severity is dependent on your previous level of nicotine intake which is why heavy smokers, in particular, may benefit from nicotine replacement.

The urge to smoke decreases with time

The most common withdrawal symptom is the urge to smoke. This usually declines over the first few weeks but some ex-smokers experience an urge to smoke several months after stopping. These urges tend to decrease in frequency and you should concentrate on this positive aspect when confronted with an urge to smoke; it gets easier the longer you stay off cigarettes. Increased appetite and weight gain are common. One year after stopping, ex-smokers, on average have put on 3kg in weight. This is not due to replacing the pleasures of smoking with eating, but rather catching up with what your weight would have been had you never smoked.

Mood changes such as irritability, anger and depression usually settle within three or four weeks. Impaired concentration also tends to settle over the first three weeks; clearly it would be less than ideal to stop smoking whilst preparing for exams, for example.

Other withdrawal effects include a decrease in your heart rate and an increased warmth of the skin. Non smokers also clear caffeine from their body more slowly. After stopping smoking tea and coffee drinkers may experience side effects from high caffeine levels. These include tremor, palpitations and abdominal discomfort. This may be countered by reducing the amount of caffeine you take by making tea and coffee weaker or reducing the number of cups that you drink.

Will anything else help?

There is little evidence that other methods suggested as helping smokers stop are effective. These include acupuncture, hypnosis, rapid smoking or substitution of other "habits" for smoking. Stopping smoking is for you, by you and requires your effort.

You can do it!

Hillingdon PCT are funding a Smoking Cessation Service. This is available at one of your local pharmacies (in Eastcote - Green Light Pharmacy) or by self-referral or a doctor's referral to the Smoking Cessation Clinic at Hillingdon Hospital

Check these links for further help and advice. Or phone the Quitline on Freephone 0800 00 22 00.