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So Long, Cigarettes: How to Quit Smoking

You've heard it so many times: Cigarettes are dangerous -- for smokers and their children. And yet almost one out of every three kids in this country still lives with at least one smoker. Of course, being a smoker doesn't make someone a bad parent. Most moms and dads really want to quit, but smoking is a powerful addiction. Believe it or not, inhaling nicotine has an even stronger effect on the brain than injecting heroin or snorting cocaine.

"I finally realized that I was scheduling my days around my cigarettes and not my young children," says Maureen Upchurch, of Greensboro, North Carolina, who quit two years ago. "When they sat down for lunch, I'd run outside for a relaxing cigarette break and they'd get frustrated that I wasn't there. I felt like I was married to smoking."

For stressed-out parents, giving up smoking can seem particularly tough -- but it's also especially beneficial. "Quitting is as important for your family's health as buckling your child into his car seat," says Susanne Tanski, MD, a smoking researcher and assistant professor of pediatrics at Dartmouth Medical School, in Hanover, New Hampshire. "You wouldn't dream of not strapping him in, even though the odds of being in an accident are actually very low. The odds of getting lung damage from secondhand smoke are much higher."

Almost 40 percent of women smokers stop during pregnancy, but up to 70 percent relapse after their baby is born, says Cheryl Healton, DrPH, president of the American Legacy Foundation, a nonprofit organization devoted to protecting children and adults from smoking. Most smokers actually try to quit between eight and 11 times before they succeed. "Every time you quit, you're one step closer to becoming smoke-free," says Dr. Healton, a former three-pack-a-day smoker.

To help you triumph over tobacco, Parents has teamed up with Legacy to create a special quit plan for moms and dads, powered by the group's online cutting-edge program, Become an Ex. Continuing in our March and April issues and at parentsquitforgood.com, we'll help you identify your smoking triggers, find new ways to get through your day without cigarettes, and avoid gaining weight along the way. Going cold turkey isn't the most effective strategy: Research has shown that you can at least double your odds of success if you plan ahead before you quit, take advantage of nicotine replacement or other medications, and get support. At parentsquitforgood.com, you can share your challenges and trade tips with other readers. Whether you smoke a pack a day or light up only occasionally, there's never been a better time to quit -- and start spending all that money on something worthwhile.

 

Not only does smoking cause lung cancer and heart disease, but many of the 4,000 chemicals in cigarettes increase your risk of stroke, breast cancer, secondary infertility, low back pain, and heartburn (and then there are the premature wrinkles and bad breath). If you think you're healthy, ask your doctor to do a spirometry test that measures your lungs' functional age. Many 35-year-old smokers have the lungs of a 70-year-old.

Inhaling secondhand smoke -- which contains arsenic, carbon monoxide, and formaldehyde -- is undeniably risky for children. Smokers' kids have higher rates of respiratory infection, ear infection, severe asthma, and even SIDS. "Despite what you may think, there is no safe level of exposure for secondhand smoke," says Richard D. Hurt, MD, director of the Mayo Clinic Nicotine Dependence Center, in Rochester, Minnesota. Even if you never smoke in rooms where your children play, tiny particles cling to your clothes and circulate through your house. And while no parent wants her child to become a smoker, kids whose parents smoke are twice as likely to light up themselves when older. Quit now to break the cycle.

With all the time commitments and craziness that come along with raising children, how can you handle giving up smoking now? Cigarettes may seem like an integral part of every aspect of your life -- influencing your identity, your choice of friends, the structure of your day, and the way you manage to squeeze in a little "me" time.

"I used to look forward to my 'good job' cigarette after my kids' bath and bedtime rituals, and I was convinced I couldn't make it through without it," says Laura Lathan, of Phoenixville, Pennsylvania, whose daughters are 6 and 4. But when she quit last February, she found that she actually had more energy for the evening routine.

It's understandable to worry about what will replace a drag during those times when your kids are acting up, you're late to work, or you're panicked about your credit-card bills. "But it's important not to use parent stress as an excuse to keep smoking, because you'll always have tensions in your life," says Jodi Prochaska, PhD, a researcher at the University of California, San Francisco Tobacco Control Program. "Smoking doesn't really take away your stress -- it just relieves symptoms of nicotine withdrawal. You can learn healthier ways to cope."

 

The first step is to set a quit date and write it on your calendar in ink. Even if you're psyched to start today, it's best to choose a day between two weeks and one month from now. Then follow this series' essential preparations.

  • Make a list of your five biggest reasons for quitting, and read it often.
  • For five days, keep a log of every cigarette you smoke, along with the time of day, the intensity of your craving, what else you were doing, and how you felt. Look at your list to see your most common smoking triggers.
  • In the days before you quit, try to separate smoking from those triggers. For instance, if you have a strong urge for a cigarette whenever you drink coffee, wait until you've finished your cup before lighting up.
  • Think about what you'll do instead of smoking. You could treat yourself to a long shower when your baby naps, or take the kids for a walk after dinner. Stock up on sugarless gum, mints, and raw veggies to keep your mouth and hands busy, and buy a water bottle you like. Although quitters tend to gain 10 pounds on average, it's not inevitable.
  • Strategize about stress. When your house is a mess or things heat up at work, you can take deep breaths rather than a smoking break. If you get bored, plan to call a friend or start a craft project with the kids. Frustrated? Vent by writing in a journal.
  • Research smoking-cessation aids. You'll need to start certain medications a week or two before your quit date. If the one you choose requires a prescription, you can ask your regular doctor -- or even your child's. A growing number of pediatricians are now trained to help parents quit, says Jonathan Klein, MD, director of the American Academy of Pediatrics' Julius B. Richmond Center of Excellence, which focuses on protecting children from secondhand smoke.
  • Call 800-QUIT-NOW to get one-on-one counseling (your call will be routed to your state's quitline), and also ask your spouse and friends to encourage you. You might think it's better to quit secretly -- after all, if you fall off the wagon, who'll know? But recent research has found that people who have social support are actually 50 percent more likely to succeed. "Tap into as many outlets as you can, as long as they all guide you in a positive direction," says Dawn E. Wiatrek, PhD, director of the American Cancer Society Quitline, which oversees several state quitlines.
  • As your quit day approaches, throw out everything related to smoking in your home and car. Air out your clothes, and whiten your teeth so you'll want to keep them looking good.

Going through this process will make quitting easier, but you should still expect the first weeks to be tough. "You've developed many nicotine receptors in your brain, and when they're deprived of nicotine, they'll rebel by causing physical symptoms such as irritability, insomnia, or trouble concentrating," says Dr. Hurt. Increasing your daily exercise by taking brisk walks or bike rides is one of the best strategies for several reasons. It will help you sleep better, boost your mood, focus your thinking, burn calories, and remind you of what you're moving toward: a healthier future.

Experts say that tobacco dependency is a medical problem like high cholesterol or high blood pressure, and it should be treated like one.

Therapy: Nicotine patch (nonprescription)
Action: Provides steady dose through your skin.
Pros: Avoids peaks and valleys; helps you wean gradually. Doubles success rate.
Cons: Side effects may include irritated skin, muscle aches, insomnia, and nausea.
How you use it: Put a new patch on your back or arm daily starting with full strength (15 to 22mg) for four weeks, then reducing, for a total of three to five months.

Therapy: Nicotine gum or lozenge (nonprescription)
Action: Delivers nicotine through mouth membranes.
Pros: Gives immediate relief; keeps mouth busy. Doubles your chance of success.
Cons: Possible side effects for gum: mouth sores, racing heartbeat. For lozenge: insomnia, gas, heartburn.
How you use it: Chew up to 20 pieces of gum (for a half hour each) for up to six months. Suck up to 20 lozenges per day for up to 12 weeks.

Therapy: Bupropion (Zyban or Wellbutrin, prescription pill)
Action: Acts on brain chemicals to lessen withdrawal symptoms and reduce the urge to smoke.
Pros: Minimizes irritation. Can be combined with nicotine replacement. Doubles your odds for success.
Cons: Can't be used if you have a history of eating disorders or seizures. Side effects could include dry mouth and insomnia.
How you use it: Take one to two 150mg tablets per day, starting one to two weeks before your quit date and then continuing for up to 12 weeks.

Therapy: Varenicline (Chantix, prescription pill)
Action: Interferes with nicotine receptors in the brain.
Pros: Can quadruple your odds of success.
Cons: Side effects may include nausea, insomnia, and, rarely, suicidal thoughts.
How you use it: Take 0.5mg once or twice a day in the week before quitting, and then 1mg twice daily for up to 24 weeks.

Diana

Diana Castillo
San Antonio, Texas
Kids: Bruno, 8, and Marco, 7

"This is the first time I'm trying to quit. I was recently diagnosed with high blood pressure, and I went online to research health issues caused by smoking. I cried reading cancer patients' journals -- about the pain of chemo and how their toddlers wondered why their mom wasn't strong enough to go to the park. I don't want to be terminally ill. I want to see my kids grow up to be responsible adults and enjoy my empty nest with my husband one day because he's my best friend."
Years smoked: 20
Cigarettes per day: 10 to 15
Triggers: Driving, finishing a meal, coffee, taking a break from work, hanging out with friends, concentrating

Sandy

Sandy Baugh
Huntsville, Alabama
Kids: Alex, 10, and Justin, 7 (at left)

"I started smoking to seem cool, and it became part of my identity. My grandfather died of brain cancer when my dad was 16. The night I decided to quit, I'd had a headache for three days and smoking made it 100 times worse. A million scary thoughts ran through my head. I wanted to see my sons graduate, get jobs, have children! I was tired of covering up my breath and using perfume to hide the smell. I realized that the only thing I was getting out of smoking was a huge headache and a nail in my coffin."
Years smoked: 21
Cigarettes per day: 10
Triggers: Experiencing stress, being around friends who smoke, feeling bored

Amy

Amy Meyer
Marion, Iowa
Kids: Andrew, 1 year

"I quit when I was pregnant. I went back to work part-time when my son was 4 months old. Several months later, we had horrible flooding in our city. It was very scary, and I bummed a few cigarettes from my neighbor, but then I started buying my own packs. I kept it a secret from my husband at first because I knew it would upset him. Smoking gives me two minutes to myself that I wouldn't take otherwise -- but I don't want to do it anymore, and I know that I shouldn't be doing it."
Years smoked: 10, on and off
Cigarettes per day: 6 to 10
Triggers: Disagreements with my husband or relatives, feeling overwhelmed, being bored, needing a little break

 

Originally published in the February 2009 issue of Parents magazine.

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