Congratulations on taking the first step to becoming a non-smoker !
This Quit Kit has been developed to show why your decision to quit smoking is the best
choice for you and for those around you. The kit will also provide you with plenty of ideas
on how to quit and to stay a non-smoker.
The Quit Kit contains:
•
‘Quit because you can’ booklet, which includes a step-by-step guide to quitting.
•
‘Products to help you Quit smoking’ brochure which outlines products known to be
effective in aiding quitting. This brochure includes information on Nicotine Replacement
Therapies and prescribed medications.
•
‘You can Quit’ pocket guide, which you can carry with you, and which contains simple
messages and hints on how you can stay a non-smoker.
•
‘Quitline’ brochure – an information brochure about the Quitline service, explaining
how the friendly, expert Quit advisors can provide you with information and advice
about quitting smoking for yourself or your family or friends, and how the Quitline
is now able to provide ongoing support during your quit attempt.
•
‘Choosing the best way to Quit’ booklet to guide you through the maze of assistance
and medications available to help you quit and find what works for you.
Please do not hesitate to call one of the advisors on the Quitline (13 7848) any time
of the day for further support and advice on becoming and staying a non-smoker.
This service is available to help you through this period of becoming smoke free.
We wish you every success in your decision to stop smoking.
Yours sincerely,
Prof Jim Bishop
Chief Cancer Officer
Cancer Institute NSW
Dr Denise Robinson
Chief Health Officer
NSW Department of Health
Cancer Institute NSW
Level 1, Biomedical Building, Australian Technology Park
Eveleigh NSW 2015
PO Box 41, Alexandria NSW 1435
tel (02) 8374 5600 fax (02) 8374 5700
www.cancerinstitute.org.au
NSW Health
73 Miller Street, North Sydney NSW 2060
Locked Mail Bag 961 North Sydney NSW 2059
tel (02) 9391 9000 fax (02) 9391 9101
www.health.nsw.gov.au
Quit because you can
YES – you can quit smoking
Over the years we’ve learned a
lot about how to quit smoking
from the people who know
– Australians who have stopped
smoking for good. What we
have learned is here in your
Quit because you can book.
It’s got the facts that show
quitting is the right choice. It also
has plenty of ideas about how you
can quit.
Keep this book handy, so you can
refer to it as you go through the
different stages of quitting.
Like all good things, it’s going to
take some time and effort for you
to quit smoking, but millions of
smokers in Australia have already
stopped. You can too.
Make the book work for you.
Write in it. Underline the parts
that really mean something to you.
Flick to the Checklist pages to jog
your memory on important points.
You need to know
Chemicals in cigarettes change the way some medications work. See your
doctor before quitting if you are taking medication.
We know that stopping smoking can be stressful. If you have suffered from
depression, anxiety or another mental illness, ask your doctor’s advice
before quitting.
CONTENTS
Step 1 Deciding to quit
Smokingkills
Cigarettesarefullofpoisons
Smokingcausesdisease
Moregoodreasonstoquit
Decidingtoquitchecklist
Step 2 Getting ready to quit
4
4
4
7
9
11
12
Understandyournicotineaddiction12
Knowwhyyousmoke
15
Planwaystodealwithquitting
15
Setadatetoquit
17
Managingyourweight
18
MyQuittingPlan
19
Step 3 Quitting
20
Youareready
20
Chooseanapproachthatwillwork 20
Understandwithdrawalsymptoms 20
Copingwithcravings
23
Quittingchecklist
27
Step 4 Becoming a non-smoker
Yournew,smokefreelifestyle
Doingsomethingaboutstress
Tipsforthetoughtimes
Becominganon-smokerchecklist
Coping with setbacks
28
28
31
33
35
36
Warningsigns
36
Ifyouhaveacigarette
38
Ifyougobacktoregularsmoking 38
Quitting support and services
39
STEP 1 Deciding to quit
Cigarettes are full
of poisons
Do you know why you want to stop
smoking?
You know smoking is bad for you
– but do you know how bad?
Tobaccosmokecontainsover4000
chemicals.Aswellastarandnicotine,
thereisalsothegascarbonmonoxide
(foundincarexhaustfumes),ammonia
(foundinfloorcleaner)andarsenic
(foundinratpoison).
People who have quit say it’s
important to be clear about your
reasons. Work out what reasons
are important for you.
Cancer
Smoking kills
Atleast69ofthechemicalsintobacco
smokeareknowntocausecancer.
Cancerscausedbytobaccoincludeof
thelung,mouth,throat,oesophagus,
stomach,pancreas,kidneys,bladder,
cervixandbonemarrow(myeloid
leukaemia).
Everyyear,about19,000Australians
diefromdiseasescausedbysmoking.
Aboutone-thirdofthesedeathsoccur
inmiddleage.Oneintwolifetime
smokerswilldiefromtheiraddiction.
Your lungs
Toxicgasesdamagecilia,thetinyhairs
thatarepartofyourlungcleaning
system.Tar,thesolidparticlesin
tobaccosmoke,coatsyourlungslike
sootinachimney.Smokeirritatesyour
lungs,sotheyincreasetheamount
ofmucustheymake.Overtime,your
smallairwaysswellupandletlessair
intoyourlungs.
FACT 1
Twelve hours after stopping, almost all
nicotine is out of your system. In about five
days, most nicotine by-products have gone.
4
Deciding to quit
1
My kids made faces
every time they saw
the pack. They thought
the diseases on the
pack would happen to
me. It made me think
about it too.
M A r K , 4 2 Y E A r S .
Your blood
All cigarettes are toxic
Manychemicalsfromtobaccosmoke
passthroughyourlungsintoyour
bloodstream.Theygoeverywhereyour
bloodflows.Carbonmonoxiderobs
yourmuscles,brainandbody
ofoxygen.
Itdoesn’thelpifyousmokeweaker
tastingcigarettessuchasthose
labelled‘fine’,‘smooth’or‘refined’.These
cigaretteshaveholesinthefilterthat
letinairtodilutethesmoke.Butyou
stillendupinhalingthesameamount
ofchemicalsasyouwouldfrom
strongertastingcigarettes.Soyoudo
thesameamountofdamage.
Everycigaretteyousmoketemporarily
increasesyourheartrateandblood
pressure,andnarrowsthesmallblood
vesselsunderyourskin.Itslowsyour
bloodflow,reducingoxygentoyour
feetandhands.Yourfingersandtoes
becomecolder.
Your heart and brain
Chemicalsfromsmokemakeyour
bloodcellsandbloodvesselwalls
sticky,allowingdangerousfatty
depositstobuildup.Thisslowly
blocksyourbloodvessels,starving
yourtissuesofoxygen.Blockedblood
vesselsinyourheartorbraincan
disableorkill.
FACT 2
Quitting smoking at any age will result
in major and immediate health benefits.
This applies to people with and without
diseases caused by smoking.
6
Deciding to quit
1
Smoking causes disease
– a good reason to quit
Lung canceriscausedbychemicals
intar.Mostlungcancersarecaused
bysmoking.Smokingdamagesa
genecalledp53,andstopsitfrom
protectingyourcells,allowinglung
cancertodevelop.
Smokingharmsalmosteveryorgan
inyourbodybutbecauseithappens
gradually,youprobablydon’t
notice.Thestrainputonyourbody
bysmokingoftencausesyearsof
suffering.
Heart diseaseandstrokesarealso
morecommonamongsmokersthan
non-smokers.Oneinthreedeathsfrom
heartdiseaseinpeopleunder65are
causedbysmoking.
Emphysemaisanillnessthat
slowlyrotsyourlungs.Peoplewith
emphysemaoftengetbronchitisagain
andagain,andsufferlungandheart
failure.
Peripheral vascular disease (PVD)
occurswhenbloodvesselsinyourlegs
orarmsbecomeblocked.Itcausespain
andsomesmokersenduphavingtheir
limbsamputated.
Tobaccosmokecanleadtodisabilities
suchasblindness,hipfracturesand
painfulstomachulcers.
Thesearejustafewoftheharmful
effectsofsmoking.
C a n C E r i n a Lu n g s ta i n E D
by ta r .
This lung, removed from a smoker,
shows a lung cancer (white tissue) blocking
the main air passage to the right lung. The
tumour extends to the outside of the lung.
Picture courtesy of the Prince Charles Hospital,
Departments of Pathology and Medical Photography.
7
A cross-section of a healthy
blood vessel.
Fat deposits have reduced
the space inside the blood
vessel by three-quarters.
FACT 3
Within a day of quitting, the level
of carbon monoxide in your blood has
dropped dramatically. Your body can take
up and use oxygen more easily.
8
The vessel is blocked by
a clot.
Pictures courtesy
Boehringer Ingelheim GmbH
photo Lennart Nilsson/Albert
Bonniers Förlag AB
Deciding to quit
1
More good reasons
to quit
Fertility. Menwhosmokearemore
likelytohaveproblemsgettingor
maintaininganerection,duetothe
effectsofsmokingontheblood
vesselsinthepenis.Smokingmay
affectspermquality.
your body’s self defence.Smoking
suppressesyourimmunesystem,so
youarelessprotectedagainstthe
fluandotherillnesses.Evenyoung
smokershavemorecoughs,phlegm,
wheezingandchestinfectionsthan
non-smokers.Smokersalsotendto
havemoreseveresymptoms.
Womenwhosmokearemorelikelyto
missperiodsandhavemorepainful
periods.Theymaytakelongerto
conceiveandaremorelikelytohave
amiscarriage.
babiesborntomotherswhosmoked
inpregnancyaremorelikelytobe
premature,stillbornordieshortly
afterbirth.Ababyexposedtotobacco
smokehasahigherriskofdyingfrom
SIDS(suddeninfantdeathsyndrome).
Money.Inaway,givingupsmoking
islikegettingapayrise,morethan
$3000*ayearifyousmoke20
cigarettesaday.
Fitness. Smokingmakesitharderto
getenoughoxygentoyourmuscles
duringexercise,soyoutiremore
quickly.
Childrenofparentswhosmokeare
morelikelytogetpneumoniaand
bronchitisintheirfirstyearoflife.
Theyaremorelikelytosufferfrom
meningococcaldisease,asthmaand
middleearinfection(acommoncause
ofdeafness).Theyarealsomorelikely
tobecomeregularsmokersthemselves.
your appearance.Wrinklesaroundthe
eyesandmouthdevelopearlier,and
tarstainsyourfingersandteeth.
Confidence.Onceyousucceed,you
willhavemoreconfidencetotakeon
otherchallenges.
* At the time of publication.
9
try tHis
Evennowyoumightstillbewonderingwhetheryoureallydowanttoquit.Take
yourtimeinthinkingaboutyourreasonsforwantingtosmoke,andyourreasons
forwantingtostop.
Listallyourreasonsonbothsidesandcirclethethreemostimportantitemson
eachlist.Thenputastarnexttotheonereasonthatismostimportanttoyou–
justonestar,notoneforeachlist.
Why I want to smoke
Why I want to quit
Yourdecisionmightbeaveryclose
one,oronesidemaywinbya
landslide.Theimportantthingisto
decidewhichyoumostwanttodoand
actonthatdecision.
FACT 4
Itiscommontosetouttoquitwith
apartofyoustillwantingtosmoke.
Youneedtoacceptthis,andcommit
yourselftoquitting.Workouthow
youcangetthethingsyougotfrom
smokinginotherways.
Quitting reduces your risk of stroke and
heart attack. This is especially important
for women who smoke and take the
contraceptive pill: their risk of death from
heart attack increases dramatically with age.
10
Deciding to quit
1
Deciding to quit checklist
g I will reduce my risk of heart attack.
g I will reduce my risk of cancer.
g I will feel fitter and my skin will look better.
g Within 12 hours, my body will be free of nicotine.
g I will set a great example for the children around me.
g My lungs will start to recover and be able to clean themselves properly.
g I will have more money to spend any way I choose.
g I will give myself a confidence boost by quitting cigarettes.
try tHis
From the following list, tick the things you are looking forward to when you are a nonsmoker. Add your own ideas in the space provided.
c Having more energy to play sport or keep up with the kids.
c Knowing I’m back in control and no longer addicted.
c Freedom from the hassle of always checking that I have enough cigarettes.
c Reducing the risk of getting sick from cancer or heart disease.
c
c
c
c
c
11
STEP 2 Getting ready to quit
1. Understand your
nicotine addiction
Most people are not 100% sure
about quitting and many are
worried about how they might
cope without cigarettes. This is
normal. Don’t put off quitting
because you feel this way – there
is lots of help to get you through.
Nicotineistheaddictivedrugin
tobacco.Afteryou’vebeensmoking
forawhile,yourbodygetsusedto
nicotineandreliesonittofeelnormal.
Doyouhaveanyofthesesignsof
nicotineaddiction?
Planningcanhelpyouunderstandwhy
yousmokeandsetupsomequitting
strategies.
Ifyou’vetriedtoquitbefore,remember
thethingsthatworkedforyouand
thethingsthatdidn’t.Youcanuse
whatyoulearnedtomakeyourplan
stronger.
g
Yousmokeyourfirstcigarette
within30minutesofwakingup.
g
Yousmokemorethanten
cigarettesperday.
g
Youhavecravingsandwithdrawal
symptomswhenyoutrytoquit.
4.Setadatetoquit
Nicotineaffectsthechemicalsinyour
brain,andafterapuff,youmayfeel
goodforamomentortwo.Itproduces
differenteffectsonthebodyatthe
sametime.Itmaymakeyoufeel
relaxedormorealertbutthisdoesn’t
lastlong.
FACT 5
Whensmokersstop,mostgetcravings.
It’snormaltofeelanxious,hungry
andirritable,andfindithardtofocus
onwhatyouaredoing.Evenafter
successfullygivingupsmoking,most
smokerswhotrytojusthavean
occasionalcigarettequicklyreturnto
regularsmoking.
Therearefourthingsyouneedtodo:
1.Understandyournicotineaddiction
2.Knowwhyyousmoke
3.Planwaystodealwithquitting
After quitting, your sense of taste and
smell begin to improve. Your breath, hair
and clothes will smell fresher.
12
Getting ready to quit
2
I really wanted to
travel but smoking
cost too much.
A friend quit too and
saved up with me.
V I C K Y, 2 4 Y E A r S .
try tHis
Smoking Record
g You can learn about your habit while you prepare to quit.
g Make a Smoking Record sheet like the one below and carry it with you everywhere.
Each time you have a cigarette, or feel a craving, fill in the date, time, occasion or
activity, what you are feeling and how much you feel the need for a cigarette, using
the point system below.
1 = I could do without it
2 = I feel like it
3 = I need it
4 = I really need it
5 = I’m desperate for it
g Even after a couple of days, you’ll have a good idea about what makes you want to
smoke, the times you smoke and the importance of each cigarette. These are your
smoking ‘triggers’.
g You can also use the Smoking Record after you have quit to learn more about
your cravings. The more you know, the better you can plan for staying stopped.
Example of Smoking Record
14
3. Plan ways to deal
with quitting
Allsmokershavetheirownsmoking
habits.Thesehabitsareusuallytied
tocertainmoods,activities,events,
placesorpeople.Theymaybequite
strongbonds.
Somepeopleseequittingasaprivate
battlebetweenthemselvesand
cigarettes.Butgettinghelpisnota
signofweaknessorlackofwillpower
–it’sasmartwaytoquit.
Someofthemostcommonreasons
whypeoplesmokeare:
g
addiction:tosatisfythecravingfor
nicotineoracigarette
g
emotions:feelingstressed,upset,
angry,frustrated,boredorhappy
g
pleasure:toenjoysomethingeven
moreortorewardyourself
g
social pressure:feelingpartofthe
crowd,bondingwithothersmokers
g
habit:feelinglikesmokingwhile
doingthingsortakingabreak.
Therearetwotypesofhelptoinclude
inyourplan:
g
getsomecoaching
g
usequittingmedications.
Get some coaching
Acoachgivesyoustructure,
motivation,support,newskillsand
confidence.Itismuchhardertoget
thesethingswhenyoutrytoquiton
yourown.Gettingacoachwillgiveyou
amuchgreaterchanceoflong-term
success.
Beinginthesesituationsafteryou
havequitwillusuallytriggercravings.
Knowingwhatmakesyouwantto
smokecanhelpyouplanhowtocope
intriggersituations.
Themoretimesyouhavetriedtoquit
andthelessconfidentyouare,the
morecoachingyouarelikelytoneed.
FACT 6
After four weeks without smoking,
exercising will be easier because more air
is getting into your lungs.
15
2
Getting ready to quit
2. Know why you smoke
Here are some good coaches:
Ifyouhaveasthma,diabetesorother
healthproblems,itcanbeuseful
todiscussquittingwithahealth
professional.
Call the Quitline on 13 7848 (13 QUIT)
TheQuitlineisaconfidential
telephonequittinginformation
andadviceservice.Professional
telephoneadvisors,whounderstand
thechallengesofquitting,provide
strategiesandsupporttohelpyouquit.
Thisisforthecostofalocalcall(except
mobiles).
Use quitting medications
Theseproductsaresuitablefornicotine
addictedsmokers.
Quittingmedicationsreduce
withdrawalsymptomssuchascravings,
irritability,moodswingsandanxiety.
Theyusuallydonotstopwithdrawal
symptomsaltogether.Mostpeople’s
smokingislinkedtohabitsand
emotions.Soyouarelikelytostillget
somecravingsinsituationswhere
youusedtosmoke.rememberthat
coachingcanhelpyouhandlethese
timesandadjusttolifewithout
cigarettes.
Go online with the QuitCoach
ThisisavailableontheInternetat
www.QuitCoach.org.au.Youanswer
questionsandtheQuitCoachgivesyou
theideasandsuggestionsthatwillbe
mostusefultoyou.TheQuitCoachcan
helpyoubeforeandafteryouquit.
Therearetwokindsofmedication:
Talk to your doctor, pharmacist or
other health professional
Doctorsandpharmacistsaregood
sourcesofadviceaboutquitting,
especiallyforadviceonquitsmoking
medications.Youneedtoseeadoctor
ifyouwanttouseprescriptionquitting
medications.
g
nicotinereplacementproducts
g
prescriptionmedications.
Nicotinereplacementproducts,such
asthepatch,gum,lozenge,tablet
andinhaler,workbyreplacingsome
ofthenicotineyouusuallygetfrom
cigarettes.Nicotinebyitselfhasnot
beenshowntocausecancer.Because
nicotineproductsremovealltheother
dangerouschemicals,theyaremuch
saferthansmoking.
Ifyouhavesufferedfromamental
illnessoraretakingmedicationfor
one,itisimportanttoseeyourdoctor
beforequitting.
16
4. Set a date to quit
Prescriptionmedications,suchas
bupropionandvarenicline(Champix),
mustbediscussedwithyourdoctoras
theyarenotsuitableforeveryone.
Unlessthereisaverygoodreason,
makethedatewithintwoweeksfrom
now.Chooseaneasydaytostop,one
whenyouwillnotbeundermuch
pressure,butwillhaveplentyto
occupyyourself.
Gather information
Practise quitting
Talktootherpeoplewhohavequit
abouthowtheydidit.Therearesome
usefulwebsites(seeinsidebackcover).
remember,differentthingsworkfor
differentpeople.
Onceyouhavepickedadatetoquit,
sticktoit.Beforeyouquit,youmight
setyourselfsomesmallergoalstosee
howyouwouldgo.Tryquittingfor
onlyoneday.Oryoucouldexperiment
bynotsmokingattimeswhenyou
normallywould,suchaswhenyou’re
outwithfriendsorhavingabreakwith
othersmokersatwork.Thiswillhelp
youworkouthowmuchyouneedto
prepareforthesesituationswhenyou
quitcompletely.
Get help from friends and family
Thesupportandencouragementof
friendsandfamilyisimportant,but
sometimesotherscanhinderyour
efforts.
Ifyoudotalktoyourfriendsandfamily
aboutyourquitting,explainhowthey
canhelp–forexample,bynotoffering
youcigarettesiftheysmoke,orby
beingpatientifyouareabitirritable
atfirst.
try tHis
Throw away all cigarettes, lighters and
ashtrays in your home and car. If your
partner smokes, suggest that he or
she stops too, or only smokes outside
the house.
Quittingwithafriendcanbeusefulas
youcanhelpeachotherthroughthe
hardtimes.
FACT 7
Most smokers want to quit. Research
shows that more than 75% of smokers
have made at least one attempt to quit.
17
2
Getting ready to quit
Yourdoctororpharmacistcanexplain
toyouhowtousetheseproducts.
Managing your weight
Tips to help manage your weight
Thebestapproachistofocusonhow
youlookandfeelphysically,rather
thanyourweight.
Differentpeoplegaindifferent
amountsofweightduetostopping
smoking.
Butyoucantakeactiontohelpkeep
weightgainlow,startingwith:
g
Exercise.Doingsomemoreexercise
canhelpkeepyourweightdown
andhelpyoubeatcravings.
g
Cookingwithandeatinglittle fat.
g
Limithowmuchalcoholyoudrink.
Alcoholicdrinkscancontainalotof
energy.
Makingsmallchangeseveryweekcan
beeasierandlongerlastingthantrying
tomakealotofchangesatonce.
Ifworryingaboutweightgainis
stoppingyoufromquitting,talktoa
healthprofessionalwhocanhelpyou:
g
getadvicefortheissuesthatare
importanttoyou
g
makeahealthyeatingandexercise
planthatsuitsyourlifestyle.
Seeyourdoctor,whocanalsorefer
youtoadietitianorotherspecialist.
Youcanalsofindadietitianatthe
DietitiansAssociationofAustralia
websiteatwww.daa.asn.au.
18
g
Usethetimeandmoneyyou’ve
savedfromnotsmokingtoplan
andcooktasty,healthymeals.
g
Don’ttrytosticktostrictdiets.
Constantboutsofhungerwill
undermineyoursuccessatquitting.
g
Trynottomissmeals,especially
breakfast.
g
Limitsugarytreats,suchassweet
drinks,lollies,biscuitsandcakes.
g
Preparesomehealthysnacks–
celeryandcarrotsticksorvegetable
strips,wholefruits(notfruitjuice)
andnuts.
g
Berealistic–allowyourselfsome
treatsoccasionally.
g
Ifyouusefoodtohelpyoudeal
withfeelings,suchasdepressionor
loneliness,tryotheractivitiesthat
makeyoufeelbetter.
g
Emotionaleatingand‘binge’eating
cansometimesbedifficulttodeal
withbyyourself.Forhelpand
support,considerseeingahealth
workerwhospecialisesinpeople’s
relationshipswithfood,suchasa
psychologist.
g
Ifyouarefemale,tryquitting
smokinginthefirstweekafteryour
periodhasstopped,asyoumay
havelesswithdrawalsymptoms
andeatlessatthattime.
My Quitting Plan
g My main reasons to quit:
g My three main triggers to smoke:
g My main strategies to avoid smoking:
g The coaching I will get:
g The quitting medication I will use:
g My quit date is:
____/____/_______
Keep a copy of your plan with you as a reminder.
Add to it if you find you need new strategies to deal with difficult times.
19
2
Getting ready to quit
Write out your Quitting Plan. Use your Smoking Record to help you.
STEP 3 Quitting
Understand withdrawal
symptoms
Now it’s time to put all your work
into practice and quit.
You are ready
g
You’vemadeyourdecisiontoquit.
g
Youhaveanyextrainformationor
supportyoufeelyouneed.
Withdrawalsymptomsaretheway
yourbodyreactswhenitstopsgetting
nicotineandalltheotherchemicals
intobaccosmoke.Thinkofthemas
recoverysymptoms.
g
You’vedoneyourplanning.
g
You’vesetyourquitdate.
Commonrecoverysymptomsinclude:
g
Cravings.Eachonelastsashort
time,butmaybestrong.Overtime,
cravingswillhappenlessoften.
g
Feelingsofirritability,frustration,
depressionoranxiety.
g
Feelingsofrestlessnessand/or
difficultyconcentrating.
g
Changedsleepingpatterns.
g
Increaseinappetiteandweight
gain.
Stick to your decision
You’redoingtherightthing.
Choose an approach
that will work for you
Ifyouarequittingbyyourself,thebest
approachistostopcompletelyand
suddenlyonyourquitdate.
Somepeoplealsoreport:
g
Coughing,sneezingorsorethroat.
Considergettingsupportfroma
quittingcoach,suchastheQuitline,
andusingaquittingproduct,suchas
nicotinegum.
g
Mouthulcers.
g
Upsetdigestionanddisturbed
bowel.
g
Headache,earache,deafnessor
feelingoff-colour.
FACT 8
Usually,youwon’thaveallofthese
symptoms,andthosethatdoaffect
youwillrarelylastmorethanafew
weeks.
Even though withdrawal symptoms can
be hard to go through, remember they
are actually a good sign. They show your
body is adjusting to being free from the
chemicals in tobacco smoke.
20
Quitting
3
Mates at work
thought I couldn’t do
it, but I used patches
and that made it
easier than last time.
D AV I D, 3 1 Y E A r S .
Quitting and stress
Somerecoverysymptomswillcome
andgooverthefirstweek.Most
aregonewithintwotofourweeks;
heavysmokersmayhavesymptoms
forlonger.Theemotionalsymptoms
–suchasirritabilityorfrustration–
fadeasyourbodyadjuststobeing
nicotinefree.
Somepeoplefeelmorestressedin
thefirstmonthorsoaftertheyquit.
Thismaybepartlyduetocoping
withrecoverysymptoms.Also,it
takestimetosettleintonewroutines
andbecomecomfortablewithnew
waysofmanagingwithoutcigarettes.
However,otherpeoplehaveamore
positiveexperienceofstopping
smoking,andfeelmoresatisfied.
Youmaygetoccasionalcravings(the
urgeordesiretosmoke)longafter
otherrecoverysymptomshavegone.
Thesecravingsaretriggeredbybeing
insituationswhereyouusedtosmoke
(seeStep4:Becoming a non-smoker).
Afewmonthsafterquitting,most
peopletendtofeelasgoodas,or
betterthan,whentheyweresmoking.
Ifyouhavetroublewithcertain
withdrawalsymptoms,planhowyou
couldcopeorworkaroundthem.For
example,warnyourfamilyyoumight
becrankyforafewweeksandaskfor
theirpatience.
Themorewithdrawalsymptomsyou
have,themoreyouwillbenefitfrom
usingquittingproducts.
FACT 9
Within four to six days of quitting, your
cilia (the hair-like cleaning system in your
lungs) begin to recover and remove the
mucus in your lungs so that you can cough
it up. The mucus may be brown from tar.
22
Coping with cravings
Trythesetips:
Fewsmokerscanquitwithoutfeeling
theurgeordesiretosmoke.Thefirst
weekafteryouquitcanbethehardest,
ascravingscanbemorefrequent
andintense.
Therearefourmainwaystodealwith
cravings.
Makeyourhomeandcar
smokefree.Ifthat’snotpossible,
haveatleastonesmokefreearea
foryourself.
g
Makeitharderforyourselftoget
cigarettes.
g
Askothersnottosmokearoundyou.
g
Useplaceswhereyouarenot
allowedtosmokeas‘protection’
untilthecravingpasses.
g
Avoidsituationsthatwillbetough
whilecravingsarestillintenseand
frequent.
2. Changingyourenvironment.
3. Usingcopingthoughts.
4. Changingwhatyoudo.
1. Using quitting products
t r y t H E 4 D s:
Nicotinereplacementproductsand
prescriptionmedicationsworkby
makingcravingslessstrong.Theywork
bestwhenyoucarefullyfollowthe
instructions.Makesureyoudon’tstop
themtooearly.
g
Delayactingontheurgeto
smoke.Don’topenapackorlight
acigarette.Afterafewminutes,
theurgetosmokewillweaken,
especiallyifyoudothefollowing:
g
Deep breathe.Takealongslow
breathin,andslowlyoutagain.
repeatthreetimes.
Cravingsoccurmostcommonlyin
situationsthatremindyouofsmoking.
g
Youcanreducehowoftenandhow
stronglycravingsoccurbymaking
yourenvironment‘quittingfriendly’.
Drink water.Sipitslowly,holding
itinyourmouthalittlelongerto
savourthetaste.
g
Do something else.Takeyourmind
offsmokingbytakingaction–put
onsomemusic,goforawalkor
ringafriend.
2. Changing your environment
23
3
Quitting
1. Usingquittingproducts.
g
3. Using coping thoughts
g
Thinkabouthowgooditwillfeel
toshowpeoplewhodoubted
you,thatyouhavesucceededat
quitting.
g
Setshort-termgoalssuchastaking
onedayatatime.
g
Talktosomeoneabouthowyou’re
feeling.
g
Challengenegativethoughts.Ifyou
thinkacigarettewouldbenice,tell
yourself‘No,I’mnotgoingtobe
suckeredback.’
Thewayyouthinkaboutquittingcan
helpyouresisttemptingsituations.
Trythesetips:
g
Usepositive‘self-talk’.Tellyourself
‘Icanquit’or‘Idon’tneedcigarettes’
or‘Icanfindbetterwaystocope’.
g
Breakyoursmokingthought
patterns.Stopthoughtsthatlead
youtowanttosmokeandchange
themtosomethingelse.
g
remindyourselfofyourmain
reasonstoquit.Carrysomething
withyouthatwillhelpyoustay
motivated,suchasanoteor
picture.Thinkofthingsyouwant
todoasanon-smoker.Usethe
Deciding to quit checklistonpage11.
g
Thinkofthebenefitsofquitting
andthepositivechangesinyour
lifesinceyoustopped.
g
Focusyourmindonsomething
else–trydistraction,meditation,
thinkingofimagesorfantasies.
4. Changing what you do
Toquit,youneedtolearnnewwaysto
copewiththingsthatusedtotrigger
yoursmoking.(referbacktopage15:
Know why you smoke).Asyoubecome
betteratdoingthingsinsteadof
smoking,yourcravingswilltendnotto
happenasoftenorbeasstrong.
FACT 10
Quitting reduces your risk of lung cancer
if you do not already have the disease.
After ten years, the risk is halved.
24
g
g
Congratulateyourselfeverytimeyou
beattheurgetosmoke.remember
totreatyourselfoccasionallywiththe
moneyyou’vesaved,suchaswitha
movie,anewCD,flowersoramealout.
Refuse offers of cigarettes
Youhavetherighttorefuseacigarette
andcandosowithoutupsetting
others.Practisesaying‘Nothanks,
Idon’tsmoke’toprepareyourselfin
casesomeoneoffersyouacigarette.
Useotherthingstokeepyour
handsormouthbusy.Tryfiddling
withkeys,beads,astressball,
mobilephoneorjewellery.Try
chewingsugarfreegum,eatinga
healthysnackordrinkingwater.
Stay on track
Ifyouareunsureofwhattodoin
somesituations,askorwatchwhat
non-smokersdo.
Don’tletotherpeopletalkyouinto
havingacigarette.It’syourdecision
–don’tletotherspressureyou.Tell
them‘No’likeyoumeanit.
Just one WILL hurt
Caffeine
Having‘justone’isthewaythatmost
peoplegobacktoregularsmoking.
Quittingmeansresistingtheurgeto
smokeevenonecigarette,despitethe
cravings,thehabit,thepressureand
yourownemotionalreasons.
Tea,coffee,coladrinksandchocolate
allcontaincaffeine.Caffeinemaymake
yourestless,irritableandsleeplessfor
awhile.Withoutnicotine,yourbody
retainsmorecaffeine.Tryandreduce
theseproductsandhavenon-caffeine
drinks.
25
3
Quitting
g
Reward yourself
Inthefirstfewweeks,changeyour
routinesthatarestronglylinked
tosmoking.Takeallyournormal
breaksbutwithacupofherbal
teaorotherdrinkinsteadofa
cigarette,orholdyourcupinyour
otherhand.Trycleaningyourteeth
straightafterameal,sittingina
differentchairtowatchTV,and
havingashowerassoonasyou
getup.
Smoking and alcohol
try tHis
Manypeoplefindithardtoresist
smokingwhendrinking.Cravingsare
oftenstrongerwhenyouaredrinking
andsocialising.Alcoholmayweaken
yourresolveaboutgivingupsmoking.
Youneedtoplanforsocialoccasions.
Go back to your Smoking Record and
Quitting Plan for ideas to deal with
cravings.
During the first week, make changes to
your plan if you need to. Did you use the
ideas you wrote down? How are they
working? Do they need changing? Are
there any triggers you hadn’t thought
of? Are there any new situations that you
hadn’t planned for?
Somestrategieswhengoingoutwith
friendsare:
g
Gotoasmokefreevenue.
g
resolvebeforeyougooutnot
tosmoke.
g
Haveaquittingbuddyornonsmokingfriendwithyouassupport.
g
Avoidalcoholforafewweeksafter
youquit,especiallyinsituations
whereyouwouldhavesmoked.
g
Ifyoudodrink,cutdownonhow
muchyoudrinkbyalternating
alcoholicdrinkswithglassesof
water.Also,changeyourdrinkto
somethingyoudon’tusuallyhave
toremindyourselfthatthingsare
different.
g
Tellyourselfit’sokaytogohome
earlyifthecravingsbecometoo
hard.Youcanaffordataxiwiththe
moneyyou’vesavedbyquitting.
FACT 11
All States and Territories have legislated
for restaurants and cafés to be smokefree.
In many States and Territories there are
smokefree areas in licensed premises as
well. Remember to ask.
26
Quitting checklist
g I am aware that withdrawal symptoms are a good sign and show that my body is
getting rid of the poisons and chemicals in my system.
g I have planned how to handle the places and events that I know make me want
to smoke.
g I will congratulate myself every time I beat the urge for a cigarette.
g I know I have the right to refuse a cigarette and can do so without upsetting others.
g I will keep my hands busy by doing something, or by fiddling with a pen, phone
cord, mobile phone or some beads.
g Even if I decide to have alcohol, I will stick to my decision to quit.
g I know it’s okay to avoid situations that will be tough while cravings are still intense
and frequent.
g I am telling myself ‘I can deal with this craving’ and I am talking myself out of
smoking by thinking of the good things about being a non-smoker.
27
3
Quitting
g I will remind myself of my reasons to quit to make it easier to refuse cigarettes.
STEP 4 Becoming a non-smoker
Once you have beaten your urges
to smoke and you are getting them
less often, you are ready for Step 4.
Find new habits to take the place
of smoking
Smokersusecigarettesformany
things.Forexample,toconcentrate,
socialise,relax,fillintime,when
hungry,asarewardandtocopewith
feelingssuchasstress,angerorgrief.
Quittingisn’toverjustyet.Thenext
stageislearningtoenjoyandvalue
yournewsmokefreelifestyleand
startingtothinkofyourselfasanonsmoker.
remember,it’snormaltogetcravings
insituationswhereyouusedtosmoke.
resistingcravingsisanecessarystepin
makingthemgoaway.
g
Whatdidyouthinkcigarettesgave
you?Lookatyourlistonpage10.
g
Canyoudoeachofthesethingsas
wellaswhenyouusedtosmoke?
Ifyouansweryes,thisprovesthat
smokingwasn’treallyusefulinthis
situationandthatyouhaven’tlostout
byquitting.
Your new, smokefree
lifestyle
Ifyouanswerno,it’sreallyimportant
totryoutnewwaystoreplacethose
thingsyoufeltsmokinggaveyou.Try
funandrelaxingactivitieswiththe
timeandmoneyyou’vesavedfrom
quitting.CalltheQuitlineifyouneed
ideas.Once you find things that work,
make them a part of your regular
routine.
Gettingridofsmokingisabigchange
inyourlife.Learningtoenjoyandvalue
lifewithoutcigarettesisthenextstep.
Forsomepeoplethiscomesnaturally,
whileothersfinditharder.
Thissectiondescribeswhatmight
happenaftercravingsdiedownand
howtobecomesomeonewhono
longerneedscigarettes.
FACT 12
There are now more Australians
who have quit smoking than there
are Australians who smoke.
28
Becoming a non-smoker
4
My skin has improved,
my cough has gone
and I’m feeling great.
C H r I S T I N E , 3 4 Y E A r S .
Coping with stress
try tHis
Ifyouusedsmokingtodealwithstress
(asmostsmokersdo),thenyouare
likelytogetcravingstosmokenext
timeyou’restressedout.Takeyour
timebeforereacting.remember,
havingacigaretteisnotgoingtomake
theproblemgoaway.
Think about a sudden crisis that
happened in your past when you were
smoking. Imagine going through it now,
but without smoking. What strategies
could you use?
resistingcravingsandusingother
strategiestocopewillmakeyouless
likelytohavestrongcravingsinfuture
stressfulsituations.
Stopping quitting medication
Ifyouusednicotinereplacement
productsandcravingsbecometoo
strongafteryoustopusingthem,start
usingthemagainforawhilelonger.
Asanon-smoker,you’velearned
newskillsandhaveshowngreat
determination.Howelsecanyouget
thesupportyouneedinsteadoffalling
backonacigarette?Istheresomeone
youtrustwhoyoucouldtalkto?Do
youhavenew,relaxingactivitiesthat
helptaketheedgeoffthings?
The quitting blues
Somepeoplefeelsadaboutstopping
smoking.Eventhoughpeoplewant
tostop,theymayfeeltheyarelosing
somethingthathasbeenpartoftheir
life,sometimesabigpart.Thisisa
normalreaction.Itusuallypasses,but
itmaytakesomework.
Ifyouarefindingittough,trytostop
yourselffromdwellingtoomuchon
missingsmoking,asthiscanbringon
cravings.Focusinsteadonthebenefits
quittinghasbroughtyou.
Ifthesefeelingscontinueandyou’re
havingdifficultycoping,speaktoyour
doctor.
FACT 13
Within two months of quitting,
the blood flow to your hands and
feet improves.
30
Doing something about stress
List below the main sources of stress in your life. Now think about how much control
you have or want to have over these sources of stress. Next to each of these, write the
number 1, 2 or 3 depending on whether you believe it is possible for you to:
1. Get rid of the source of stress altogether.
2. Make changes to reduce the stress.
3. Learn to cope with the situation as it is.
For example, you might decide to try to accept and learn to cope with the peak hour
traffic. This means you will continue to drive in peak hour and you will find ways of
dealing with the stress.
SOURCES OF STRESS
1, 2, or 3
31
IDEAS, PLANS, STRATEGIES
4
Becoming a non-smoker
There are no right or wrong answers. Another person may make different choices for the
same situation.
Confront old smoking situations
Thishappensbecauseyoureturn
toasituationthatislinkedtoyour
pastsmokinghabit,evenifyoudon’t
recogniseitatfirst.Forexample,you
mightstartcravingacigarettewhen
visitingaplacewhereyouusedtolive
whenyouwereasmoker,orwhenyou
meetupwitholdfriendswithwhom
youusedtosmoke.
Whileyouwerequittingyoumayhave
avoidedriskysituationssuchaspeople
orplaceswhereyouusedtosmoke.
Whenyou’reready,preparefor
andfacethesesituationswithout
smoking.Themoretimeyouspend
inoldsmokingsituationswithoutthe
cigarette,thelesslikelyyouwillbeto
getcravings.Intime,you’llfeelmore
andmorelikeanon-smoker.
Drawonthestrategiesyouused
whenyoufirstquittodealwiththese
situations.
Ifyouusedaquittingproductto
helpyouquit,youalsoneedtoprove
toyourselfthatyoucancopeinold
smokingsituationswithoutthis
extrasupport.
Social pressure
Ifyourfriendsorfamilyaremaking
quittingharderforyou,explainto
themhowyoufeel.Spendtime
relaxingwithpeoplewhoaregladto
seeyoulookingafteryourhealth.
Sudden strong cravings
Occasionally,youmightgetacraving
‘outoftheblue’,evenyearsafter
quitting.Thisisnormalanddoesn’t
meanyouarefailingatquitting.
FACT 14
After eight weeks without smoking,
your immune system improves.
32
Tips for the tough times
try tHis
g
1. BREATHE DEEPLY AND SLOWLY
4. MANAGE YOUR WORKLOAD AND TIME
g Set achievable goals.
g Don’t take on more than you can
handle.
g Ask for help if you need it.
g Keep some distractions on hand for
boring times e.g. music or a stress
ball when stuck in traffic or queues.
5. TAKE CARE OF YOUR FEELINGS
g Talk to others about your problems
– don’t keep your feelings bottled
up.
g Try to be around people who
support you.
6. DO THINGS YOU ENJOY
g Write in a journal or draw.
g Do nice things for yourself
occasionally.
g Do something you enjoy every day.
7. EXERCISE
This can be as simple as getting off the
bus one stop early and walking the extra
distance or using stairs instead of lifts.
33
4
Becoming a non-smoker
2. RELAX YOUR BODY AND YOUR MIND
LIKE THIS:
g Lie down or sit in a comfortable
position.
g Close your eyes and take a few
deep breaths.
g Tighten your feet and toes, hold
them tight for three seconds, then
relax them. Repeat this exercise
with your leg muscles, your stomach
and your arms and shoulders.
g Think about something relaxing,
perhaps lying in the shade of a tree
on a hot day … a gentle breeze
brushes your skin … the leaves
rustle quietly … nothing to do just
now except close your eyes and let
your mind drift …
g When you are relaxed and ready,
open your eyes and bring the good
feelings with you.
3. LOOK AFTER YOUR BODY
g Get enough sleep.
g Eat sensibly and well.
g Do some gentle stretches to relieve
muscle tension.
Ask a friend for a neck and shoulder
massage.
What if you do gain weight?
try tHis
Ifyouputonafewkilos,trynottobe
toohardonyourself.Concentrateon
yourresolvetogiveupsmokingand
thentackletheweightgain.Butdo
trytoeathealthyfoodsandgetsome
extraexercise.
Think about your plans at work and home
for the next few weeks. Can you make one
or two changes to reduce the pressure?
Talk about problems openly with those
involved.
Ifyouthinkweightgainisaproblem,
discussitwithyourdoctorordietitian.
remember,startingtosmokeagain
maynothelpyoulosetheweightyou
havegained.
refertopage18formoretipstohelp
youmanageyourweight.
The new you
Youmaystillseeyourselfasasmoker
who’squit.Starttothinkofyourself
asanon-smoker–thatis,someone
whoseesnorealuseforcigarettes.
Themorenon-smokingexperiences
youhave,themoreyou’llfeellikea
non-smokeroraproudex-smoker.
Congratulations!
FACT 15
In the long term, the average weight of
ex-smokers is similar to people who have
never smoked.
34
Becoming a non-smoker checklist
g I have changed my routine to suit my new smokefree life, with new hobbies, new
rewards or comforts, and new ways to enjoy life.
g I am exploring new ways to manage stress, such as discussing problems
or feelings with others, not taking on too much work, and looking after my body.
g I am finding new ways to relax, such as massage, deep breathing, and making time
to relax my mind and body.
g I will cope with cravings that happen ‘out of the blue’, and know that
I am still succeeding at quitting.
g I am planning how to cope with stressful situations. If I get stressed, I will take
time to think before I react, and remind myself of other ways to cope. I will ring the
Quitline if I think I need more support or ideas.
g I will take action if weight gain is really a problem. I will be kind to myself if I put on
a few kilos.
g I will appreciate the benefits of being a non-smoker and give myself credit for what
I’ve achieved.
g I am a non-smoker now!
35
4
Becoming a non-smoker
g I will prepare myself carefully before I return to risky places, people
or activities.
Coping with setbacks
Quitting can be hard. You might be
going along OK, but suddenly …
Watchoutforwarningsignsandget
helpfromtheQuitlineiftheystartto
builduporthingsgowrong.
Warning signs
try tHis
g
you keep on thinking ‘Just one
would be OK’ or ‘it’d be great to
smoke just one a month or one
a week’.
Butwhyweren’tyousmokingjust
oneamonthorjustoneaweek
beforeyouquit?Theansweris
becausetobaccoisextremely
addictive.That’swhyyou’vehad
toworksohardtoquit.Don’tlet
nicotinecontrolyouagain!
g
you’re really missing smoking
and question whether quitting is
worth the effort.
Sometimesquittingcanbereally
tough,butyoucangetthroughit.
Findotherwaystotreatyourself
andkeepdoingthingsthatyou
enjoyeveryday.
g
you take puffs of other people’s
cigarettes but excuse it as ‘not
really smoking’.
Youknowit’sonlyamatteroftime
beforeyoufindyourselfbuyinga
pack.Askyourfriendsnottogive
youcigarettes,nomatterwhat.
g
Remember, every craving only lasts
a few minutes. You can fight it off:
delay, deep breathe, drink water or
do something else.
g
Remind yourself of how far you have
come. Do you really want to have to
start all over again?
g
List your reasons for quitting on a
card that you can carry with you.
Read the reasons whenever you feel
the urge to smoke.
g
Reward yourself for staying stopped.
Do things you enjoy.
g
Have you found replacements for all
the things you used cigarettes for?
Think of what you can do to enjoy
life without cigarettes.
FACT 16
Smoking rates among both men and
women are going down. Rates for men have
almost halved in 50 years; 79% of adults
aged 14 years and older do not smoke.
36
TO N Y, 4 9 Y E A r S .
Coping with setbacks
I had a big night and
ended up having a few
smokes. I didn’t even
enjoy them. It felt like
I’d failed but I haven’t
lit up again. So I guess
that’s success.
If you have a cigarette
try tHis
Don’tletonecigaretteleadyouback
tofull-timesmoking.Thinkofhowlong
youhavegonewithoutacigaretteand
saytoyourself:‘I’mdeterminedtogive
up.Afterall,Ihaveonlyslippedup
once.Inthepast,Iwouldhavesmoked
20aday.Iamdeterminedtoquit.’
If you are smoking again:
reviewyourQuittingPlanandrevise
ifnecessary.Formorehelp,callthe
Quitlineon137848(13QUIT).
If you go back to regular
smoking
Don’tdespair.Begintoplanforyour
nextattempt.
Mostpeoplewhohavesuccessfully
quitsmokingforgoodhavemade
severalseriousattempts.Itmaytake
youawhiletolearntobeanonsmoker.
Althoughyoumaybefeeling
disappointed,youshouldtakepride
inwhatyouhaveachieved.Everyday
thatyouspentsmokefreemadeyour
bodyhealthierandhelpedtobreak
yourhabitandweakenyouraddiction.
g
Plan another date to give up as
soon as possible. If you have lost the
urge to quit, go back to your reasons
for quitting in the first section of
this book.
g
Make a note of what you learned
from your recent quit attempt. What
situations did you need to prepare
for? What strategies worked best?
g
If you have made your home and car
smokefree, keep them that way.
g
Call the advisors at the Quitline.
They understand that quitting for
good can take a few tries. They
won’t judge you, but will discuss
your experiences of quitting with
you and offer help with what you
decide to do next.
FACT 17
After 12 months of not smoking, your
increased risk of heart disease is down to
almost half that of a smoker’s. Fifteen years
after stopping, this risk is almost the same
as for a non-smoker.
38
30
Quitting support and services
Quitline 13 7848 (13 QUIT)
Advice on use of nicotine replacement
products
TheQuitlineisaconfidentialtelephone
informationandadviceservice,
availablethroughoutAustralia.Forthe
costofalocalcall(exceptmobiles),
professionaltelephoneadvisors
provideencouragementandsupport
tohelpyouquit.Theyarefriendly,
helpfulandnon-judgmental.
Advisorshavebeentrainedinhealth,
educationorpsychologyandsmoking
cessation.Theyknowthehealth
effectsofsmokingandunderstand
thequittingprocessandhowdifficult
quittingsmokingcanbe.Quitlinecan
provideadviceonappropriateuseof
nicotinereplacementproductstohelp
youbeattheaddiction.Properuse
ofproductscanoftenbethekeyto
successfullyquittingforgood.
Quitline services
Free callback service
Language services - NSW only
Thecallbackserviceisavailablefor
smokerswhowouldlikeongoing
supportwiththeireffortstoquit
smoking.Uptosixfollow-upphone
callscanbescheduledthroughout
themostdifficultperiodofquittingat
timesthatsuityoubest.Thisservice
canhelptokeepyoumotivatedandon
trackandcandoubleyourchancesof
successfullyquittingforgood.
InadditiontotheEnglish-speaking
Quitline(137848),therearenowseven
dedicatedlinestoassistpeoplewho
speakthefollowinglanguages:
Arabic:1300784803
Chinese(CantoneseandMandarin):
1300784836
Italian:1300784861
Vietnamese:1300784865
Korean:1300784823
Greek:1300784859
Spanish:1300784825
Help with planning
ForinformationabouttheMulticultural
HealthCommunicationServiceplease
seethewebsite:www.mhcs.health.nsw.
gov.au
39
Support and services
Ifyouwanttoquitsmoking,aQuitline
advisorwillaskquestionsaboutyour
smokinginordertoassistyoutotailor
apersonalquitplanthatsuitsyour
needs.Anadvisorcandetermineyour
levelofnicotinedependencyand
lookatwhatstrategiesarelikelytobe
effectivetosuityourlifestyle.
4 WAYS to avoid a cigarette
even when you’re desperate
1
2
3
4
Call the Quitline on 13 7848 (13 QUIT)
Remember how far you have come
Do some light exercise
Remember the 4Ds:
Delay
Deep breathe
Drink water
Do something else
NSW Department of Health
Locked Mail Bag 961, North Sydney NSW 2059
Telephone (02) 9391 9000
SHPN: (CHA) 100519 ISBN 978-1-74187-600-0
NSW Department of Health Revised November 2010
® The Quit, Quitline and QuitCoach logos are
registered trademarks of the Cancer Council Victoria
Printed by a carbon neutral process using world’s best practice ISO14001 Environment Management Systems.
© Quit Victoria 2010
They are friendly, helpful, non-judgmental
Once you have nominated a Quit date,
and able to assist you at whatever stage you
a Quitline advisor can call you on the
are at in the quitting process.
following days to help you through the
The advisors can:
process of quitting:
n
give you advice about quitting smoking
n
the day before your Quit date
n
help you assess your level of nicotine
n
within the first two days after your
Quit date
dependence
n
provide strategies on preparing to
quit, preventing relapse and staying
a non-smoker
n
provide information on products
and services to help you quit.
The free and confidential callback service is
available for smokers who would like further
help with their efforts to quit smoking. Up to
six follow-up phone calls can be scheduled
throughout the most difficult period of quitting.
This service has proven to be very popular as it
can help to keep you motivated and on track.
n
within the first week of your Quit date
n
twice within the following three weeks.
The callback service can double your chances
of quitting for good and can be tailored to
meet your individual needs. You elect how
many callback phone calls you wish to receive.
You will also be offered a follow-up call
three months after your Quit date just to
check on your progress.
Remember, even if you have nominated
to participate in the callback service,
you are always welcome to ring the
Quitline 13 7848 and talk to an advisor
at any time.
CALL
SHPN (TH) 070227
© NSW Department of Health
February 2008
More help is
available to you
Quit smoking
13 7848
The Quitline on
is available 24 hours
a day, seven days a week,
every single day of the year
to receive a free Quit Kit.
There are now seven dedicated lines to assist
people who speak the following languages:
n
Arabic
1300 7848 03
n
Chinese (Cantonese and Mandarin)
1300 7848 36
n
Italian
1300 7848 61
When you first call you
will be offered a Quit Kit
The Quit Kit has been developed to show why
your decision to quit smoking is the best choice
for you and for those around you. The kit also
provides you with plenty of ideas on how to
quit and stay a non-smoker.
The Quit Kit contains:
n
The Quitline 13 7848 telephone advice
n
n
n
n
Monday to Friday
7am–10.30pm
n
n
Saturday, Sunday and Public
9am–5pm
If you wish to speak to an advisor but
call outside the hours of the advice and
information service, you can leave your
contact details and a Quitline advisor will
return your call the next day
The Quitline 13 7848 is a free, confidential
telephone based service primarily designed
to help smokers quit. The Quitline 13 7848
n
brochure which outlines products known
1300 7848 23
to be effective in aiding quitting.
This brochure includes information on
Greek
bupropion tablets (Zyban), varenicline
tablets (Champix) and nicotine replacement
therapies (NRT) such as patches, gum,
Spanish
lozenges, tablets and inhalers.
1300 7848 25
By calling the Quitline 13 7848 you can:
n
be sent a free Quit Kit
n
take advantage of talking to the specially
trained Quitline telephone advisors
n
A ‘Products to help you Quit smoking’
Korean
1300 7848 59
Holidays
A ‘Quit because you can’ booklet, which
includes a step-by-step guide to quitting.
1300 7848 65
and information service operates seven days
a week during the following hours:
Vietnamese
take part in the callback and
follow-up service.
n
A ‘You can Quit’ pocket guide that contains
simple messages and hints on how you can
stay a non-smoker.
n
A ‘Choosing the best way to Quit’ booklet
to guide you through the maze of assistance
and medications available to help you quit
and find out what works for you.
The Quitline advisors are specialists who have
can also provide assistance to the family and
By calling the Quitline 13 7848 you are
friends of smokers and others requesting
taking the best step available to help you
and smoking cessation. They know the health
information about smoking. A telephone
succeed in quitting for good. Getting expert
effects of smoking, understand the quitting
interpreter service is available to assist those
help to quit doubles your chances of remaining
process and are aware of the difficulties many
who are not fluent in English.
a non-smoker.
smokers face in quitting.
been trained in health/education/psychology
010062 ProductsQuit
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3:25 PM
Page 1
Other strategies
What type of products?
Medical products shown to be successful are.1
■
■
Other strategies that may help you when you decide to quit are:
■
Counselling.
■
Developing a quit plan which includes:
Nicotine replacement therapies (patch, gum, lozenge,
sublingual tablet and inhaler). All nicotine replacement
therapies are available over the counter in your local
pharmacy and can be bought without a prescription.
Some products may be more widely available in supermarkets etc.
Bupropion (Zyban) or varenecline (Champix) tablets.
These need to be prescribed by a doctor and are listed on the
Pharmaceutical Benefits Scheme, which makes them cheaper.
Correct usage of any of the above products has been shown to double
the chances of stopping smoking among heavy smokers. If you have
recently had a heart attack, are pregnant, or you are breastfeeding,
talk to your doctor before using these products.
1
Setting a date to quit.
2
Reviewing past experience to determine what worked and what did not work.
3
Identifying potential problems and ways to deal with them.
4
Enlisting the support of family and friends.
5
Quitting with a friend.
6
Reducing alcohol and caffeine use in the first two weeks.
7
Avoiding other people’s smoke.
■
Being mindful of stressful or negative events.
■
Call the Quitline 13 7848.
■
Visit www.quitnow.info.au or www.13quit.org.au
Products to help you
®
smoking
Things to remember
How does nicotine replacement therapy
(NRT) work?
It is the 4000+ toxic chemicals in tobacco smoke that are harmful.
The most harmful thing about the nicotine in cigarettes is that it keeps
you addicted to smoking. NRT works by replacing the nicotine obtained
from cigarettes with nicotine delivered by the patch, gum, lozenge,
sublingual tablet or inhaler.
■
The gum, lozenge and sublingual tablet slowly deliver the nicotine
through the lining of the mouth.
■
The patch slowly delivers the nicotine through the skin.
■
The inhaler delivers the nicotine a little faster through
the mouth.
Because these products deliver a constant low dose
of nicotine compared to cigarettes they:
■
■
reduce your body’s addiction to the
nicotine in cigarettes
reduce symptoms of withdrawal,
eg cravings, sleeplessness,
poor concentration and anxiety.
■
The first two weeks in quitting smoking can be difficult. During this
time most of the physical symptoms of withdrawal occur, after which
they diminish over time. At about three months most quitters have
become established non-smokers.
■
Many ex-smokers have made several attempts before they quit for good.
■
Planning will improve your chances of success.
■
The health benefits of quitting start within two hours
of giving up.
Quitting may not be easy.
Tobacco products are addictive
and it is easier to quit smoking
References
1 Silagy C, Lancaster T, Stead L, Mant D, Fowler G 2004,
Nicotine replacement therapy for smoking cessation
(Cochrane Review), In: The Cochrane Library, Issue 1,
Chichester, UK: John Wiley & Sons, Ltd.
2 Fiore MC, Smith SS, Jorenby DE et al 1994,
The effectiveness of the nicotine patch for smoking
cessation: a meta-analysis. JAMA; 271(24):1940–1947.
3 Fiore MC, Bailey WC, Cohen SJ, et al 2000,
Treating Tobacco Use and Dependence, Clinical
Practice Guideline, Rockville, MD: US Department of
Health and Human Services, Public Health Service.
SHPN (HP) 010062
© NSW Department of Health 2001
Reprint April 2004, January 2006, Updated February 2008
The Quit logo is a registered trademark of The Cancer Council Victoria.
For more
information
talk to your doctor
or pharmacist.
medical products available that
Call the
of success.1
for free, ongoing
advice and
support while
you quit.
with help. There is a range of
can double your chances
010062 ProductsQuit
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3:25 PM
Page 4
How to use NRT
Lozenge
The program recommended by the manufacturers is:
The following information is not intended to replace the Consumer Medicine Information
that accompanies the NRT. Remember to read the Consumer Medicine Information issued
in the NRT packaging before using the products.
This product works in the same way as nicotine gum; the nicotine is absorbed into
the bloodstream through the lining of the mouth. Because the lozenge is sucked until
it dissolves completely, up to 25 per cent more nicotine may be absorbed into the
blood than with similar dosages of gum. This means that it may be more effective
in reducing nicotine withdrawal symptoms.
■
6–12 cartridges per day for 12 weeks
■
3–6 per day for 2 weeks
■
1–3 per day for 2 weeks
■
Some ex-smokers may need longer treatment with NRT to avoid
returning to smoking, however, regular use of the NRT inhaler
beyond 12 months is not recommended.
Patch
The nicotine patch is an adhesive patch that you wear on your skin. It slowly releases
nicotine, which you absorb through your skin. The patch works by replacing some
of the nicotine you normally inhale from cigarettes.
■
If you smoke more than 10 cigarettes a day, start on the highest strength patch
– either the 15mg/16 hour patch, or the 21mg/24 hour patch.
1
Use one lozenge at a time.
2
Do not exceed 15 lozenges per day.
3
The lozenge should be moved around the mouth from time to time
and sucked until it dissolves (takes 20–30 minutes).
4
Do not eat or drink while sucking the lozenge.
■
If you smoke less than 10 cigarettes a day or weigh less than 45kg, start on either
the 14mg/24 patch or 10mg/16hrs.
5
For about six weeks, use one lozenge about every 1–2 hours.
6
For the next 3 weeks, use one lozenge every 2–4 hours.
■
Wearing a patch for 16 hours per day is as effective as wearing one for 24 hours per day.1
7
■
Using the patch for 8 weeks is as effective as longer courses and there is no evidence
that gradually reducing the dose is better than simply stopping use of the patch.1,2
If necessary, continue using 1 lozenge every 4–8 hours for 3 weeks
and then use a lozenge if strongly tempted to smoke for up to 12 weeks.
■
Some ex-smokers may need longer treatment with NRT to avoid returning to smoking,
however, regular use of NRT patch beyond 9 months is not recommended.
Withdrawal symptoms and side effects
Remember to
read and adhere to the
information on the pack
■
The lozenge comes in two strengths. It is easy to decide which one is suitable for you.
If you usually reach for your first cigarette of the day:
■ see your doctor or
pharmacist for more
information.
Some smokers confuse symptoms of withdrawal from tobacco
with the side effects of NRT. They may become tense, agitated,
depressed, have disturbed sleep or crave cigarettes when
using NRT. These can be symptoms of nicotine withdrawal.
This can happen when the nicotine from the NRT has not
properly replaced the nicotine from cigarettes. Different types
of NRT can be combined to enhance the success, for example
patch plus one of the following:
1
gum
2
lozenge
One patch is used per day.
3
sublingual tablet
2
Apply to clean, dry, smooth skin on arm or upper body, in the morning.
Sublingual tablet (Microtab)
4
inhaler.
3
Choose a different site each day to avoid skin rash.
Similar to the lozenge, nicotine is released and absorbed through the lining of the mouth
as the tablet dissolves. The levels of nicotine attained are similar to those of the 2mg gum.
Sublingual tablets may be useful in situations where chewing gum is inappropriate.
Some people do experience side effects, but these are usually mild.
Side effects can include:
■
You must use nicotine patches correctly for them to be effective in helping you quit.
1
Gum
■
Within 30 minutes of waking – use the 4mg.
Longer than that – use the 2mg.
■
a rash on the skin where the nicotine patch is worn. Moving the
patch to a new area of skin each day will help reduce skin irritation,
and there are also medicated skin creams available
Drinking is permitted while tablet dissolves.
■
hiccups, indigestion and mouth irritation.
4
Those who smoke less than 20 cigarettes per day should use one tablet per hour
(8–12 tablets per day will be adequate).
If you are concerned, talk to your doctor.
5
Those who smoke greater than this amount, or who have not succeeded using
one tablet should use two tablets per hour (16–24 tablets per day) the recommended
maximum number of tablets in one day is 40.
6
Full dose of tablets should be used for 3 months, then gradually reduced to zero.
7
Some ex-smokers may need longer treatment with NRT to avoid returning to smoking,
however, regular use of NRT sublingual tablet beyond 6 months is not recommended.
Nicotine gum is available in 2mg and 4mg strengths. Usually the 4mg strength is
recommended if you smoke 20 or more cigarettes in a day or are a smoker who has
not been able to quit smoking using the 2mg strength.
1
Tablet is placed under the tongue where it releases nicotine as it dissolves.
2
Tablet should not be swallowed, sucked or chewed.
3
■
Nicotine gum is NOT to be chewed like regular gum, but used as an oral patch.
■
Use gum regularly, for example, 1 piece per hour, as follows:
■
1
Chew 3–4 times, until you feel a tingling sensation or a ‘peppery’ taste.
2
Flatten it and place it between your cheek and gum.
3
Occasionally move the gum around your mouth and chew two or
three times to release more nicotine as needed.
4
Eating or drinking anything except water should be avoided for
15 minutes before and during chewing.3
5
■
■
■
Discard after 30 minutes.
Medical guidelines recommend you use the gum every 1–2 hours during the day,
for a period of 1–3 months.3
It is recommended that you do not chew more than 20 of the 2mg or 10 of the 4mg
pieces in one day.
Some ex-smokers may need longer treatment with NRT to avoid returning to smoking,
however, regular use of NRT gum beyond 12 months is not recommended.
Inhaler
This device consists of a plastic mouthpiece and cartridge containing a dose equivalent to
2mg of nicotine. It may be useful for those who miss the hand to mouth action of smoking.
■
The inhaler resembles a cigarette and the nicotine is inhaled through the mouth.
■
After 20 minutes of intense use with deep inhalations for continuous puffing you
will have used all the available nicotine in a cartridge.
Note. Some NRT products are safe to use in pregnancy and lactation
or following a heart attack or stroke. Call the Quitline 13 7848 for
more information.
Varenicline (Champix) and bupropion (Zyban)
There are two non-nicotine medications available in Australia that
help people stop smoking. Both bupropion (Zyban) and varenicline
(Champix) are only available on prescription from a doctor and are
available through the Pharmaceutical Benefits Scheme, therefore the
cost is subsidised. Talk to your doctor about the suitability of these
medications for you, as they each work in different ways and may be
unsuitable for some people. Use of these medications can increase
your chances of quitting smoking successfully.
This pocket guide
is to:
- remind you
about the
reasons why
you are quitting
Quit !
- encourage you
you CAN quit
for Life.
- inform you
about cravings
and other
withdrawal
symptoms
- remind you
about calling the
Quitting is a good idea
Smoking cigarettes can lead to many health problems
and early death. Smoking causes heart disease, cancers,
stroke and respiratory illness, reduces fitness and can
aggravate asthma and allergies.
Besides your health, there are plenty of other reasons
to stop smoking...
A pack a day smoker can save around $3,600 in one year
of quitting. Other reasons for you to quit...
- Concern for the health of your children/others close to you.
- Trying to have a baby or you or your partner are pregnant.
Other reasons you have:
Now is a good time to quit
Quitting at any age brings major and immediate benefits to
your health. Your body begins cleaning itself within hours of
your last cigarette and you will soon look better and have more
energy, because your blood
oxygen levels are higher.
A year after quitting, your
risk of dying from heart disease
has halved. In 10 years, your
risk of lung cancer is more
than halved and continues
to decline over time.
It’s important that you want to quit...
and feel confident you can succeed
The following tips may help:
- As soon as you quit,
call yourself a non-smoker.
- Get rid of your ashtrays,
lighters and anything else
that reminds you of smoking.
- Think about when and why
you have smoked, and plan
ahead for difficult situations.
Beating cravings
When you stop smoking, your body’s
cravings for nicotine will be strongest
the first two days after quitting, then
decrease over the next two weeks.
If you get through the first two weeks
you have a good chance of quitting
for good.
Medications to help control cravings are:
Nicotine replacement therapies
(gum, patches, lozenges, sublingual
tablets and inhaler). These can be
bought from a chemist, who can
explain how to use them.
Bupropion (Zyban™) is a
non-nicotine medication (tablet) that
needs to be prescribed by your doctor.
Even the worst cravings will last only
a few minutes – if you can resist them
for this period, they will pass.
Other symptoms of withdrawal
Most smokers will suffer
from some withdrawal
symptoms. These can
include restlessness,
mood changes, trouble
concentrating, irritability
or anger, anxiety, dizziness or headaches, tingling sensations,
muscle aches and sweating, digestive upsets and coughing.
Some of these occur because your body is adapting to the
absence of nicotine; some are signs that your body is cleaning
itself, eg coughing helps clear the lungs of tar and mucus.
Things to remember
- Research shows that drinking alcohol within the first
two weeks of quitting may reduce your chance of success.
- Try to cut down on coffee and cola for a few weeks after
quitting as, without nicotine, your body absorbs twice as
much caffeine, which can make you feel anxious.
- Successful quitting usually takes a number of attempts.
A slip-up does not mean that you have failed. Don’t be hard
on yourself – work out how you will manage that situation
differently next time. Practice saying “No thanks, I don’t
smoke” and remind yourself of your reasons for quitting.
Quitline is a confidential telephone service providing
information, support and advice for quitting.
You can call
for the cost of a local call
from anywhere in Australia.