Cigarette smoking is very addictive and can have long-term, adverse health effects. But there is hope for those who want to quit thanks to innovative apps, help lines and proven coping strategies.
In 2019, more than 30.8 million Americans smoked, according to the US Centers for Disease Control and Prevention. That was almost 12.5% of Americans 18 and older.
Smoking is also the No. 1 leading cause of preventable death in the United States, accounting for nearly 1 in 5 deaths.
Cigarettes have chemicals that can make this addiction particularly insidious. When they enter the lungs, they can cause harmful effects like bronchitis, said Jonathan Bricker, professor in the public health sciences division at the Fred Hutchinson Cancer Research Center at the University of Washington in Seattle.
Over time, smoking can eventually lead to lung cancer, which has less than an 18% survival rate within 5 years of diagnosis.
Fortunately, lung cancer can be prevented if you stop smoking and learn to “stay quit,” said Dr. Panagis Galiatsatos, director of the Tobacco Treatment Clinic at Johns Hopkins Medicine in Baltimore, Maryland.
Here are six actions you can take to help you or a loved one quit smoking and enjoy a healthier life:
1. Focus on how to ‘stay quit’
The goal should not be to quit smoking; rather, it should be on how to “stay quit,” Galiatsatos said. He said he’s had patients who say they’ve quit many times, but that they’ve not been able to permanently stop.
He recommends people break up their larger goal of quitting into smaller goals.
For example, learn your different triggers that could make you want to smoke. That way, you can be mindful and find solutions for those actions.
2. Make each time you quit a learning experience
Most people who smoke quit eight to 12 times, because of the addictiveness of cigarettes, before they successfully quit for good, Bricker said.
Because relapse is so common, Bricker tells his patients to find a lesson they can take from each experience.
“People will say things like, ‘I learned how powerful these cravings are, or I learned how seeing my friend smoke was a big trigger for me, or I learned that stress in my life was a big trigger,’ ” Bricker said.
Patients should approach quitting from the viewpoint that the more things they learn from their relapses, the greater their chance is of quitting permanently, he said.
3. Use phone lines and apps for support
Support groups for people who want to quit smoking are dwindling, so Bricker recommended calling a quitting help line to get outside assistance.
The CDC funds a tobacco cessation hotline, 1-800-QUIT-NOW (784-8669), which is free to US residents in all states, plus the District of Columbia, Guam and Puerto Rico. Your call goes automatically the quit line in your state or territory.
Callers are connected to coaches who help smokers create a plan to quit and give them advice when facing withdrawals and cravings.
Currently, state cessation hotlines only reach about 1% of people who smoke, which the CDC largely attributes to the lack of funding to promote the service.
Bricker’s team at Fred Hutch helped to create the app iCanQuit, which was supported by a grant from the US National Institutes of Health.
The app focuses on acceptance and commitment therapy, which encourages people to accept their emotions and thoughts instead of pushing them away. The tool also offers resources for quitting and handling cravings when they arise, Bricker said.
4. Speak to your medical provider
People who want to quit smoking can talk to their medical provider to come up with a treatment plan filled with multiple strategies, Galiatsatos said.
Doctors can prescribe medication to curb cigarette cravings and make them more manageable, he said. It’s a short-term solution to help train your brain to not crave cigarettes as strongly, Bricker added.
The medications doctors provide will depend on your specific situation, Bricker said. The prescriptions tend to be minimal at first then escalate depending on the severity of the addiction.
5. Support people addicted to smoking
Galiatsatos said he’s never come across a patient who doesn’t already know that smoking is bad, so he recommends avoiding that argument when appealing to a love one who smokes.
“If you are really serious about helping your loved one quit, you have to approach it as pro-smoker and anti-smoking,” he said.
When trying to help someone who smokes, make it clear that you are approaching the situation with no stigma or judgment, Galiatsatos said.
Once trust is established, he recommends friends and family members offer to help smokers find resources on how to quit smoking.
Medical providers should also be supportive of their patients who smoke, Galiatsatos said.
If patients feel judged by their doctors for smoking, they might just lie about it. And that doesn’t help anyone, he said.
Even when patients don’t feel motivated to quit smoking that day, it’s important to outline the different treatment options so they have the resources later.
6. Address the root cause of the issue
Many times when people smoke, it’s to cope with some underlying issue in their lives such as stress or anxiety, Galiatsatos said. When they face those emotions while quitting, it’s instinctive for them to turn to cigarettes.
If you’ve always relied on cigarettes to be that coping mechanism, and you don’t have a replacement, that’s all we’re going to see,” he said.
To combat this challenge, Galiatsatos recommended that people who are trying to quit smoking go to behavioral counseling. They will be able to better identify why they smoked and work to find healthier ways of processing those emotions.
Why is smoking so addictive anyway?
Cigarettes are filled with chemicals such as nicotine, which are chemically enhanced to drive that addiction, said Galiatsatos.
The chemically enhanced nicotine closely resembles the common neurotransmitter acetylcholine, which helps control muscle movement and other brain functions.
When the nicotine fits into the acetylcholine receptors, your body releases dopamine, the “feel-good” brain chemical. When the dopamine goes away, people begin craving another cigarette.
“I always tell people this is the most insidious addictive molecule known to man because it doesn’t just overdose you,” said Galiatsatos, who is also a volunteer medical spokesperson for the American Lung Association.
It rewires the smoker’s brain over years and years, and “by the time someone realizes it’s robbing them of their health, it’s incredibly hard to break that addiction.”
Despite the daunting effort it takes, never forget — it is possible to overcome this addiction and enjoy better health.