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University of Pittsburgh Schools of the Health Sciences

Want to Quit Smoking? Pitt Expert Says to Plan, Use Products

PITTSBURGH, November 13, 2006 — An estimated 45 million Americans currently smoke, but a number of them will give up the habit this Thursday, if only for the day, in conjunction with the American Cancer Society’s Great American Smokeout, an annual event that encourages smokers to quit for 24 hours. Allegheny County smokers have reason to kick the habit for good this year, as 2007 promises to usher in a ban on smoking in almost all public places.

Many smokers try to quit abruptly, or “go cold turkey,” but according to Frank Vitale, M.A., national director of the Pharmacy Partnership for Tobacco Cessation, those who attempt that method most likely will fail.

“Going cold turkey almost never works,” said Mr. Vitale, who also is a senior lecturer at the University of Pittsburgh School of Pharmacy. “Instead, I tell people to follow two basic steps that may double or triple their chances for success. Create a plan. Use a product.” He offers these additional tips to smokers hoping to leave the habit behind:

Create a plan....

Choose a quit day – Some smokers who give up the habit for Thursday’s Great American Smokeout may give it another shot on Friday and maybe Saturday, too, but they would have a better chance at long-term success by selecting a quit day at least two weeks away.

“Setting a date in advance gives a smoker time to mentally prepare for the task,” Mr. Vitale said. “It also allows him to ask for support from his family and friends.”

When the quit day arrives, Mr. Vitale suggests the smoker stage a ceremony in which she emphasizes the disposal of any remaining cigarettes, ashtrays and lighters. Smokers also should start using their nicotine replacement products on their quit day, he added.

Practice, practice, practice – Nonsmokers-to-be often find that their resolve crumbles when they encounter settings in which they ordinarily would smoke. “It’s unrealistic to expect smokers to avoid triggers entirely, so it’s important that they’re prepared to handle these circumstances,” Mr. Vitale said.

He tells his clients to mentally rehearse in advance to help fight the urge to light up. Someone accustomed to smoking after dinner in a restaurant should imagine himself instead engaging in post-meal conversation without a cigarette instead. Smokers who picture themselves breaking their normal patterns are more likely to do so in a real-life situation.

Master a mantra – Cigarettes are enticing, in part, because they can be used as stress management tools. So, in the absence of the habit, smokers need to identify other methods to reduce tension. A simple phrase like “I am in control” can be repeated quietly when an urge strikes and work wonders for getting through such challenging moments.

As anyone who has inhaled deeply at a particularly nerve-racking moment can attest, controlled breathing can diffuse pressure as well. Mr. Vitale also recommends that smokers repeatedly inhale slowly through the nose for a two-count then exhale through the mouth to get through particularly trying times.

Use a product....

Pick an appropriate product – From over-the-counter patches, gums and lozenges to prescription inhalers, nasal sprays and medications, smokers have a bevy of smoking cessation options at their disposal to battle their physical withdrawal symptoms and boost their chances of quitting. According to Mr. Vitale, all products have essentially the same effectiveness, so smokers should select the option that best fits their needs, like a patch for busy people who only want to think about their product once a day.

“With so many alternatives available, most smokers should easily be able to find a product that’s a good match,” he said, noting that particularly heavy smokers may have the best luck with one of the prescription medications available in higher doses.

Follow the directions – The recommended length of use for most nicotine replacement products is 8-12 weeks, but many smokers give up on their products in frustration only days, or even hours, into the regimen when they don’t get instant results. Smokers face other roadblocks when they don’t use the product with the recommended frequency and if they turn to leftover products from a friend or relative.

“I tell pharmacists to have the patient read the instructions right there in the store,” Mr. Vitale said, adding that health care providers can review the instructions for individuals with low literacy levels or little English-speaking ability.

These tips are far from all-inclusive, Mr. Vitale noted. He recommends that, in addition to seeking out support from friends and family, smokers turn to resources available from health care organizations and community groups, and even on the Internet. Even the smoking cessation products offer a behavior modification program as well. It’s tough to quit smoking all alone, but a solid support network can help people become – and stay – smoke-free.

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