Quitting Smoking

Congratulations! By checking out this website you have taken an important step towards quitting smoking. This site presents tips, work sheets, programs and resources designed to help you create a plan to quit smoking that is right for you.

§ Benefits of Quitting § How Ready Are You to Quit Smoking § Creating a Quit Plan § Methods of Quitting § Quitting During Pregnancy § Myths and Facts about Tobacco Use § Quitting Smoking and Weight Gain § The Driven to Quit Challenge

Are you a teen or young adult who wants to quit smoking? Check out our Youth Site So You Want to Quit Smoking... A Guide to what is available in Waterloo Region

Benefits of Quitting

The list of health risks due to smoking is long, but the benefits of quitting are immediate.

§	20 Minutes After Quitting Your heart rate drops.
§	12 hours After Quitting Carbon monoxide level in your blood drops to normal.
§	2 Weeks to 3 Months After Quitting Your heart attack risk begins to drop. Your lung function begins to improve.
§	1 to 9 Months After Quitting Your coughing and shortness of breath decrease.
§	1 Year After Quitting Your added risk of coronary heart disease is half that of a smoker’s.
§	5 Years After Quitting Your stroke risk is reduced to that of a nonsmoker’s 5-15 years after quitting.
§	10 Years After Quitting Your lung cancer death rate is about half that of a smoker’s. Your risk of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases.
§	15 Years After Quitting Your risk of coronary heart disease is back to that of a nonsmoker’s.

Stage 1:	Pre-contemplation (not thinking about quitting) You are not thinking seriously about quitting (for all kinds of reasons) and are not interested in any kind of help.
Stage 2:	Contemplation (thinking about quitting but not ready to quit) During the second stage, you are thinking about quitting sometime within the next six months.
Stage 3:	Preparation (getting ready to quit) You are getting ready for your quit date. You draw on past experiences with quitting to prepare yourself for your quit date in the near future.
Stage 4:	Action (quitting) You have quit recently. You continue to actively work at quitting by using different techniques.
Stage 5:	Maintenance (remaining a non-smoker) This is the last stage. It involves being able to successfully maintain your smoke-free status.

Creating a Quit Plan There are many different ways people try to quit smoking such as “cold turkey,” self-help materials or group support. The most effective way to quit smoking is to use a combination of counselling (either group or individual), nicotine replacement therapy and pharmacotherapy (medication such as ZybanTM or ChampixTM ). If you are thinking about quitting: Get Ready Set a quit date and stick to it Make a list of your reasons for quitting Think about past quit attempts – what worked and what did not work? Understand why you smoke. Monitor your smoking for a few days using a simple tracking sheet. It is a quick and easy way to recognize your smoking “triggers” (that is, activities that you associate with smoking). Get Support and Encouragement Tell your family, friends, and co-workers you are quitting Talk to your health care professional about quitting strategies (e.g., Nurse, Nurse Practitioner, Physician, Pharmacist) Find out about quit counselling available in Waterloo Region Call the Smokers Helpline at 1-877-513-5333 or go to the Smokers Helpline online at www.smokershelpline.ca Learn New Skills and Behaviours When you first try to quit, you will need to change your daily routines (e.g., cut down or try to avoid caffeine and alcohol, stay away from people who are smokers, avoid common hang outs or places you would have smoked). Use this planning sheet to help you make a plan for avoiding your triggers to smoke. Decide what activities or things you will do to cope with trigger situations or cravings. Try the 4 “D”s: Drink water Delay, the craving will pass Distract yourself by doing something else Deep breathing techniques (see below) DEEP BREATHING EXERCISE Deep breathing can be done anytime, anywhere. Deep breathing provides extra oxygen to the blood and causes the body to release endorphins, which are naturally occurring hormones that reenergize and promote relaxation. Slowly inhale through your nose, expanding your abdomen before allowing air to fill your lungs. Hold for 4 seconds. Reverse the process as you exhale. Do this exercise for 3 to 5 minutes whenever you feel tense. Find out if Nicotine Replacement Therapy (NRT) is an option for you. Using NRT can double your chances of quitting smoking. NRT is available over the counter without a prescription. There are multiple brands of NRT. Talk with your health care professional about which NRT product might work best for you: Nicotine replacement skin patch Nicotine replacement chewing gum Nicotine replacement inhaler For information on Nicotine Replacement Therapy, go to: Centre for Addiction and Mental Health http://www.smokefreeltc.ca/auxiliary/NRT.aspx Ontario Medical Association http://www.oma.org/Health/tobacco/stopsmoke.asp Ask your health care professional if medications can assist you in your quit attempt. Varenicline (ChampixTM) is a new medication that works in two different ways: 1) stimulates the release of a chemical in your brain which helps to reduce cravings and withdrawal symptoms; 2) attaches to nicotine receptors in your brain, blocking the effects of nicotine. For more information read the patient information sheet. Be Prepared for Relapse or Difficult Situations If you slip and have a cigarette, don’t worry. Refer back to your reasons for quitting and keep at it. Use positive self-talk. You can do it! Plan for withdrawal symptoms. These are signs that your body is becoming healthier. Here is a list of some common withdrawal symptoms and how you can plan to cope with them. Practice the 4 “D”s Use your experience from previous quit attempts to help you cope with triggers. Stay connected with your support networks (e.g., Smokers Helpline, a “quit buddy”, family and friends).

§ Group Programs
§ Individual Counselling
§ Self-help Materials and Quitting on Your Own
§ Other Options

1.	Group Programs A group program is designed to be used by a number of individuals. It takes place in a group meeting format and usually has a designated group leader. Group programs are often more successful because of the support and motivation offered by group members. To find about group programs in Waterloo Region call our Tobacco Information Line, 519-883-2279.
2.	Individual Counselling Talk to a health care professional, (e.g. Nurse, Pharmacist, Physician), or employee assistance program provider about quitting smoking.Check the yellow pages for names of psychologists, social workers, psychiatrists, or health consultants that can help you quit smoking. Costs will vary. Services may be covered under some insurance plans. Telephone Support and online quit support The Canadian Cancer Society's Smokers' Helpline 1-877-513-5333 provides one-to-one telephone support to help you quit smoking. Smokers' Helpline online provides you with quit tools such as a quit meter, quit buddies and an online quit chat group for support. Check it out at www.smokershelpline.ca
3.	Self-help Materials The following organizations provide self-help materials and informatin on quitting smoking. Information is subject to change. Details about specific programs should be confirmed with the organization directly. Region of Waterloo Public Health does not endorse any one agency or resource. Tobacco Information Line (Region of Waterloo Public Health) 519-883-2279 Smokers’ Helpline 1-877-513-5333 Cancer Information Service 1-888-939-3333 Canadian Cancer Society (Waterloo Region) 519-886-8888 Lung Association of Ontario 1-800-972-2636 Heart and Stroke Foundation of Ontario 1-888-473-4636 Heart and Stroke Foundation of Ontario (Waterloo Region) 519-571-9600 Internet Sites General Cessation http://www.gosmokefree.com http://www.cancer.ca/tobacco http://www.on.lung.ca http://www.heartandstroke.ca http://www.quitnet.com http://www.cdc.gov/tobacco/index.htm http://www.habitrol.com http://www.nicodermcq.com http://www.zyban.com Other Places to Get Information § Region of Waterloo Public Health (Resource Centre) e-mail: phrc@region.waterloo.on.ca § Family doctors, nurse practitioners, and other health professionals § Dental offices § Pharmacists § Health Clinics § Community Information Centre § Community centres § Library (Video and self-help book resources) § Smoking Cessation Support Groups § Supportive friends and family

• Different types of hypnotherapy are used to try and help people quit smoking. Some methods try to weaken people’s desire to smoke, strengthen their will to quit, or help them concentrate on a quit program. At this point in time, there is not enough evidence from good quality research studies to show whether or not hypnotherapy can help people trying to quit smoking.

• Acupuncture is a traditional Chinese therapy, generally using needles to stimulate certain points on the body. Acupuncture is used with the aim of reducing the withdrawal symptoms people experience when trying to quit smoking. Related therapies include acupressure, laser therapy and electrical stimulation. At this point in time, there is not enough evidence from good quality research studies to show that acupuncture and related therapies increase the number of people who successfully quit smoking.

Quitting Before or During Pregnancy If you are thinking of having a baby or are already pregnant and you smoke, you may want to check out Pregnets.org and the pre-and post-natal smoking issues site. These Canadian web sites are designed to provide support to women making the decision to quit for their own health and the health of their baby.

§	Myth: Light cigarettes are better for me. Fact: There is no such thing as “light” or “mild” cigarettes. These words will soon be removed from packaging. Although the words will be removed, the Tobacco Industry is still using marketing tactics such as lighter package colours on packaging to advertise so-called “lighter” brands. Light cigarettes have filters that change how you smoke. So you may drag deeper or more often to get your nicotine hit. You are still inhaling the same amount of deadly toxins that regular cigarettes contain.
§	Myth: If I quit smoking, I will gain weight. Fact: 1 in 5 quitters won’t gain weight at all – and for those that do, the average weight gain is 5-7 pounds. It is important to remember that weight gain is in your control: drinking water, healthy eating, chewing sugar-free gum and exercising are all good ways to combat your cravings and keep your weight down.
§	Myth: Smoking harms only me. It is my right to smoke. Fact: There is no “right to smoke”; smoking begins as a choice and often leads to an addiction that puts other people at risk. Second-hand smoke is harmful for your friends, family and other people around you. In fact, second-hand smoke is the third major cause of preventable death (kills 425 people/year in Ontario). If you smoke while pregnant, you have a higher risk of miscarrying, having a low-birth weight baby and having your infant die from Sudden Infant Death Syndrome (SIDS).
§	Myth: Cigarettes put me in a good mood. Fact: While smokers feel an immediate “hit,” that rush is very quickly followed by depression and fatigue as your body craves more nicotine. In other words, your good mood is quickly replaced by a bad one. This is the cycle of nicotine addiction.
§	Myth: Nicotine Replacement Therapy (NRT) is not safe if I have heart disease. Fact: NRT has been shown to be safe for most people who suffer from heart disease. Be sure to consult with your physician before using NRT.
§	Myth: Smokeless tobacco is less harmful. Fact: Also called spit tobacco, chewing tobacco, chew, snus, dip and plug, smokeless tobacco comes in two forms: snuff and chewing tobacco. Smokeless tobacco is addictive: holding an average size dip or chew in the mouth for about 30 minutes produces as much nicotine as three cigarettes. While the health risks are lower than for cigarettes, a number of serious health consequences are associated with smokeless tobacco use, including an increased risk for oral cancer and possibly other head and neck cancers, soft tissue lesions including leukoplakia, and periodontal disease.