Name:______________________

Voluntary health agencies such as the American Cancer Society, the American Heart Association and the American Lung Association offer smoking/tobacco cessation materials and classes. There are also many commercial stop-smoking programs. Tobacco cessation programs vary in their approaches. Different programs emphasize cognitive behavioral education, behavior modification, relaxation techniques, hypnosis or aversive conditioning techniques (such as rapid smoking). The effectiveness of some of these programs is often increased when used in conjunction with nicotine gum or nicotine patches. However, most former tobacco users report that they were able to quit without a formal cessation program.

Many smokers and chewing tobacco users, particularly high school males, are able to quit "cold-turkey," stopping abruptly with no tapering off. Generally, this method is effective only for highly motivated individuals.

In an effort to wean themselves from nicotine, some smokers employ techniques called "nicotine fading." These techniques include using low-tar and low-nicotine brands of cigarettes, smoking fewer cigarettes and inhaling less deeply, as well as smoking the cigarettes only halfway down. Smokers who do not completely quit but who use these techniques consistently do lower their tar and nicotine levels. For chewing tobacco users, the fading approach often involves substituting gum or hard candy throughout the day between regular chews.

Clearly, certain smoking cessation methods will be more effective for some people than others. Part of the key to quitting tobacco use is knowing the reasons one uses tobacco, so specific strategies can be employed. If a smoking/tobacco cessation program is tailored to match the reasons one uses tobacco, the quitting process will be easier.

Quitting Strategies Based on Reasons for Use

Reason: Tobacco use gives me more energy and/or stimulates me.

Effective Strategies:

• Get enough rest to feel fresh and alert.
• Avoid getting bored, which can make you feel tired.
• Take a brisk walk instead of smoking.
• Eat regular nutritious meals to keep up your blood sugar.
• Take a short nap.
• Exercise regularly to raise your overall energy level.
• Drinks lots of cold water to refresh yourself.

Reason: I like to touch and handle cigarettes/chewing tobacco.

Effective Strategies:

• Pick up a pen or pencil when you want to reach for a cigarette or smokeless tobacco.
• Play with a coin or handle nearby objects.
• Put a plastic cigarette in your hand or mouth.
• Hold a real cigarette if the touch is all you miss.
• Eat regular meals, so you don't confuse the desire to eat with the desire to put a cigarette in your mouth.
• Play a computer game or card game to keep your hands busy.
• Eat low-fat, low-sugar snacks such as carrot sticks, bread sticks or rice cakes.
• Suck on sugar-free hard candy.

Reason: Tobacco use gives me pleasure.

Effective Strategies:

• Enjoy the pleasures of being tobacco free-such as how good food tastes; how much easier it is to walk, run or climb stairs; and how powerful it feels to be in control of the urge to smoke.
• Spend the money you save on cigarettes/tobacco products on another kind of pleasure such as a shopping spree or a night out.
• Remind yourself of the health benefits of quitting-giving up tobacco can help you enjoy life's other pleasures for many years to come.

Reason: Smoking/tobacco use helps me relax when I'm tense or upset.

Effective Strategies:

• Use relaxation techniques to calm down when you are angry or upset; deep breathing exercises, muscle relaxation and imagining yourself in a peaceful setting can make you feel less stressed.
• Exercise regularly to relieve tension and improve your mood.
• Take action to deal with the situations that cause you stress.
• Avoid unnecessary stressful situations.
• Get enough rest and build time for something enjoyable into every day.
• Take a long, hot bath or shower; have a massage; lie in a comfortable chair outside; listen to your favorite relaxing music.

Reason: I crave cigarettes/tobacco and am dependent (physically or psychologically) on nicotine.

Effective Strategies:

• Ask your medical practitioner about using a nicotine patch or nicotine gum to help you avoid withdrawal symptoms.
• Go "cold turkey." Tapering off probably won't work for you because the moment you put out one cigarette, you begin to crave the next.
• For smokers, keep away from cigarettes completely. Get rid of ashtrays. Destroy any cigarettes you have. Try to avoid people who smoke and smoke-filled places.
• Tell family and friends you've quit using tobacco.
• Remember that physical withdrawal symptoms last about two weeks. Hang in there, you can do it!

Reason: Smoking/tobacco use is a habit.

Effective Strategies:

• Cut down gradually. Smoke fewer cigarettes (or use fewer "chews" each day) or only smoke cigarettes halfway down. Inhale less often and less deeply. After several months, it will be easier to stop completely. For chewing tobacco users, discard the tobacco even though it still has flavor.
• Change your tobacco use routines. Keep your cigarettes/chewing tobacco in a different place. Smoke with opposite hand. Do not do anything else while smoking. Limit tobacco use to certain places, such as outside or in one room of the house (but not your bedroom).
• When you want a cigarette or a chew, wait one minute. Do something else instead of smoking.
• Be aware of every cigarette you smoke or every piece of tobacco you chew. Ask yourself, "Do I really want this cigarette/tobacco right now?" You will be surprised at how many you can easily pass up in a day's time.
• Set up a date for quitting tobacco altogether and stick to it.