© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Listen to the Cancer.Net Podcast: Tobacco Use, adapted from this content.
Most smokers want to quit. Although it can be difficult, many people are successful, and a variety of treatment options and resources exist to help you reach your goal.
First, though, it is important to dispel common misconceptions about smoking cessation (quitting smoking).
Myths about quitting smoking
Myth: Smoking is a personal choice.
Fact: Although more than half of all Americans who ever smoked quit, tobacco contains the addictive chemical nicotine, and many people experience nicotine dependence for a long time after they start smoking.
Myth: Smokers can quit by themselves; a doctor's advice isn't needed.
Fact: Doctors provide support, information, and any necessary drug therapies to help people to quit.
Myth: Most smoking cessation treatments have a low success rate.
Fact: Although very few people successfully quit smoking without any medication or other support, there are treatments that can significantly improve smoking cessation rates. Among people with cancer, quit rates often exceed 50%.
Myth: Quitting smoking is not helpful for a person diagnosed with cancer.
Fact: Quitting smoking can improve the results of treatment and a person's overall health, survival rate, and quality of life.
Myth: Quitting smoking is too stressful for patients undergoing cancer treatment.
Fact: Although nicotine dependence is hard to break because the withdrawal process can be uncomfortable, the benefits of quitting smoking outweigh the discomforts.
A variety of treatments and resources are available for people who want to stop smoking, including medications and counseling. Your likelihood of successfully quitting is greater if you use a comprehensive plan that includes steps such as setting a quit date, developing strategies to deal with smoking triggers, and building a network of support. Talk with your doctor about which approach may work best for you.
Using medication can at least double your chances of quitting smoking. Three types of medication have been approved by the U.S. Food and Drug Administration (FDA) to treat nicotine dependence:
Nicotine replacement therapy (NRT). NRT is the most widely used medication. It has mild side effects and is available in various forms (as gum, a lozenge, a patch that you place on the skin, an inhaler, and a nasal spray) over the counter and by prescription. NRT reduces symptoms of nicotine withdrawal and craving. Your doctor will help find the appropriate dose for you, based on your current smoking habits.
Bupropion (Wellbutrin, Zyban). This antidepressant medication may be used to reduce withdrawal symptoms. It can help even if you are not depressed. Common side effects include dry mouth and insomnia (difficulty falling asleep or staying asleep).
Varenicline (Chantix). This medication reduces withdrawal symptoms and prevents nicotine from having a pleasant-feeling effect on the brain if you start smoking again. Common side effects include nausea, vivid dreams, constipation, and drowsiness.
Although not FDA-approved for nicotine dependence, the antidepressant medication called nortriptyline (Aventyl, Pamelor) and a medication for high blood pressure called clonidine (available under several brand names) may help people quit smoking, according to several clinical trials. However, both have potentially serious side effects and may not be appropriate for many smokers.
Research to find new medications to help people quit smoking is ongoing. In addition, researchers are working to develop effective nicotine vaccines.
Ask your doctor which medication may be best for you.
In addition to medication, counseling increases your chances of successfully quitting smoking. Consider talking with your doctor about getting a referral to meet with a professionally trained smoking cessation counselor or mental health therapist if you experience the following circumstances:
- Several of your attempts to quit have been unsuccessful.
- You have severe feelings of anxiety or depression.
- You don't have enough support from family and friends in your effort to quit smoking.
- You also have a dependence on alcohol or other substances.
Telephone and web-based smoking cessation counseling is free and available to every U.S. resident through a variety of sources. Some of these sources have online programs to help you create a plan and track your progress.
- State-based counseling and information
Hours may vary.
- Smokefree.gov - a resource created by the National Cancer Institute (NCI)
8 AM to 8 PM ET, Monday through Friday
LiveHelp (live online assistance)
8 AM to 8 PM ET, Monday through Friday (Hours may vary, so check the website before calling.)
- The American Lung Association's HelpLine and Freedom From Smoking Online program
7 AM to 11 PM, seven days a week, CT
- The American Cancer Society's Quit for Life program
24 hours a day, seven days a week (except Thanksgiving, Christmas, and the Fourth of July)
Other resources to help you quit smoking
In addition to the groups listed above, a number of other government agencies and nonprofit organizations have websites with helpful information and online smoking cessation programs.
- The Centers for Disease Control and Prevention website provides information on smoking and tobacco use, along with resources to help you quit smoking.
- The FDA website offers a guide to smoking cessation products.
- The U.S. Environmental Protection Agency website encourages people to create smoke-free homes.
- The U.S. Department of Defense has a website associated with the campaign Quit TobaccoâMake Everyone Proud, which helps active service members and veterans quit tobacco use.
- State health department websites provide information about local resources.
- The websites of the American Cancer Society and the American Heart Association have guides to quitting smoking.
- The American Legacy Foundation offers the free, online EX Plan program to help people stop smoking, which was developed in collaboration with the Mayo Clinic.
- The Nicotine Anonymous website connects people with group support to achieve abstinence from nicotine through the twelve-step program.
Meanwhile, applications for your iPhone—such as MyQuit Coach, My QuitLine, QuitPal and Smokefree QuitGuide - provide tools to help you plan to quit smoking, find support, and track your progress. Learn more about mobile apps.
Questions to ask your doctor
Your doctor is your partner in your effort to quit smoking. Ask for help understanding the consequences of tobacco use, ways to stop using tobacco, and local resources available to help you reach your goal. Consider asking your doctor the following questions:
- How is smoking hurting my health?
- What are the health benefits of quitting smoking?
- How will smoking or tobacco use affect how well the cancer treatment works? Will I experience more or different side effects from treatment if I continue to smoke or use tobacco?
- What medications are available to help me stop smoking?
- What behavioral changes do I need to make to stop smoking?
- How can I avoid or reduce the triggers that make me want to smoke?
- What smoking cessation resources are available in my community?
- How can family and friends help me?
- How often should you and I discuss my progress?