1. Quitting Smoking
• How to stop smoking …
for good!
Hongbiao (Hank) Liu MD PhD
1-26-2013

2. • Leading the News
• Study: Smoking can take at least ten years off life
expectancy.
• Two studies on smoking and mortality published this
week in the New England Journal of Medicine received
significant coverage from print and online news sources,
and from two national news broadcasts. One study was
led by Dr. Prabhat Jha of the Center for Global Health
Research in Toronto, while the other study was led by
Michael J. Thun of the American Cancer Society. Both
studies found that quitting smoking helped to reduce
the risk of death associated with smoking - a point that
most reports focused on. Additionally, much of the
coverage discussed the finding that women are now as
likely to die from smoking-related illnesses as men.

3. NBC Nightly News (1/23, story 10, 0:25, Williams) reported, "good news and bad news
on the smoking front. From the New England Journal of Medicine, they state flat out,
smokers lose at least one decade of life expectancy over nonsmokers on average."
CBS Evening News (1/23, story 9, 0:25, Pelley) reported, "A new study is finding that
smoking is taking a much greater toll on women than it used to."
USA Today (1/23, Payne, 1.71M) reports that one of the studies found that "people who
smoke take at least 10 years off their life expectancy." The article adds, "on the other hand,
those who kick the habit before age 40 reduce the excess risk of death associated with
continued smoking by about 90%, according to the study in Thursday's New England Journal
of Medicine." According to USA Today, "the study examined data from the U.S. National
Health Interview Survey between 1997 and 2004.”
New York Times (1/23, O'Connor, 1.68M) quotes Dr. Tim McAfee, an author of the study and
the director of the CDC's Office on Smoking and Public Health, as saying that the findings
"paint a much more dramatic picture of the horror of smoking. These are real people that are
getting 10 years of life expectancy hacked off - and that's just on average."

4. The Washington Post (1/24, Vastag, 489K) reports that the other study found that
"smoking-related deaths among women have soared in recent decades. For the first time
since research on smoking and health began in the 1950s, the rate of smoking-related
deaths is now nearly equal between male and female smokers.”
The Los Angeles Times (1/24, Khan, 692K) reports that "in the early 1960s, women
smokers were 2.73 times more likely to die from lung cancer than their nonsmoking
counterparts; by 2010, they were 25.66 times more likely to die of the disease, Thun
found.”
WebMD (1/18, Boyles) notes that "both studies were supported by the National Institutes
of Health." Also covering the story are the Wall Street Journal (1/24, Winslow, Subscription
Publication, 2.29M), the AP (1/24, Marchione), and the NBC News (1/23, Rettner) "Vitals"
blog.

7. Live longer and healthier
20 minutes after quitting:
• Your heart rate drops
12 hours after quitting:
• Carbon monoxide levels in your blood
drop to normal
Source: CDC Office on Smoking and Health,
National Center for Chronic Disease Prevention and Health Promotion

8. Live longer and healthier
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 Source: CDC Office on Smoking and Health,
National Center for Chronic Disease Prevention and Health Promotion

9. Live longer and healthier
1 year after quitting:
• Your added risk of coronary heart disease
is half that of a smoker’s
5 -15 years after quitting:
• Your stroke risk is reduced to that of a
nonsmoker
Source: CDC Office on Smoking and Health,
National Center for Chronic Disease Prevention and Health Promotion

10. Live longer and healthier
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
Source: CDC Office on Smoking and Health,
National Center for Chronic Disease Prevention and Health Promotion

11. Live longer and healthier
15 years after quitting:
• Your risk of coronary heart disease is back
to that of a nonsmoker’s
Source: CDC Office on Smoking and Health,
National Center for Chronic Disease Prevention and Health Promotion

12. Steps to quitting
1. Get ready
2. Get support
3. Learn new skills and behaviors
4. Get medication – if recommended
by your doctor – and use it
correctly
5. Be prepared for cravings and
withdrawal symptoms

13. Steps to quitting
Step 1: Get Ready
• Set a quit date
• Get rid of all cigarettes and ashtrays at
home, work, and in your car
• Keep a diary of when and why you smoke
• Call 1-800-QUIT-NOW for free materials
• Tell friends and family you’re going to stop

14. Steps to Quitting
Step 2: Get Support
• Your chances of success increase if you
have a support network
• Ask friends, family, and coworkers for their
support in helping you quit
• Ask others not to smoke around you or
leave cigarettes out in the open

15. Steps to quitting
Step 2: Get Support
• Talk to your family physician about
tobacco’s effects on the body, choosing a
quit plan, and dealing with withdrawal
• Get individual, group, or telephone
counseling

16. Steps to quitting
Step 3: Learn New Skills & Behaviors
• Distract yourself from urges to smoke
– Talk to someone
– Go for a walk
– Get busy with a task
– Go somewhere you’re not allowed to
smoke

17. Steps to quitting
Step 3: Learn New Skills
& Behaviors
• Change your routine
– Take a different route to work
– Drink tea instead of coffee
– Eat breakfast in a different place

18. Steps to quitting
Step 3: Learn New Skills
& Behaviors
• Reduce stress – take a hot bath, exercise,
or read a book
• Plan something enjoyable to do every day
• Drink a lot of water and other fluids

19. Steps to quitting
Step 4: Get Medication
• Your family physician may recommend one of
these to help you quit:
– Bupropion SR
– Nicotine gum
– Nicotine inhaler
– Nicotine nasal spray
– Nicotine patch
– Varenicline

20. Steps to quitting
Step 5: Avoid Relapse
• Most relapses occur within the first three
months
• Avoid drinking alcohol – drinking lowers
your chances of success
• Avoid being around other smokers – can
make you want to smoke

21. Steps to quitting
Step 5: Avoid Relapse
• Expect a small weight gain
(usually less than 10 pounds)
• Eat a healthy diet
• Stay active
• Look for ways to improve your mood other
than smoking

22. Will it work?
Successful quitters are
• Ready to change
• Motivated to quit

23. Managing withdrawal
Symptoms
• Most intense during the first three to seven
days
• May continue for several weeks but will
get less severe
• Triggers or cues associated with smoking
can cause cravings

24. Managing withdrawal
• Exercise
• Reduce or avoid caffeine or other stimulants
• Relax before going to bed
• Make your bedroom quiet
• Keep a bedtime routine
• Drink plenty of water
• Use cough drops to relieve
throat irritation

25. Managing withdrawal
If you’re having trouble concentrating
• Adjust your schedule to a lighter workload
• Lower your expectations on the amount of
work you can do
• Understand the amount of energy and
time it takes to stop smoking

26. Managing withdrawal
If your appetite has increased
• Eat healthy snacks
• Don’t delay regular meals
• Drink more water
• Exercise regularly

27. Managing withdrawal
If you crave a cigarette
• Wait out the craving (usually less than five
minutes)
• Try deep breathing
• Use distractions
• Call someone in your support network
• Chew gum
• Brush your teeth

28. Renew your dedication
• Reward yourself for resisting urges to
smoke
• Review your reasons for stopping
• Remind yourself often how well you’re
doing

29. You can do it!
• Tobacco addiction is a chronic disease – seek
advice, support, and care from your family
physician to increase your chance of success
• Quitting smoking can reduce illness, prevent
death, and increase your quality
of life
• Quitting can be difficult – remember to ask for
help
• You can do it!

30. Resources
Free Quitlines:
• 1-800-QUIT-NOW (1-800-784-8669)
– You’ll be automatically routed to a
state-run or National Cancer
Institute quitline
– You’ll get immediate advice on
quitting and an offer to have
materials mailed to you

31. Resources
Web Sites with helpful information:
• familydoctor.org
• www.smokefree.gov
• www.surgeongeneral.gov/tobacco
• http://www.cdc.gov/tobacco/quit_smoking
• http://www.cancer.org/Healthy/StayAway
fromTobacco