Smoking Cessation Patient Information Leaflet

Smoking is very addictive- quitting is often hard, but is one of the most beneficial things you can do for your long term health and well-being. It is very common to have a few unsuccessful attempts, so it is important to keep trying. A good plan and the right support makes quitting an achievable goal.

Why quit smoking?

Apart from the obvious financial benefits, here are some positive changes that occur in the body when you quit smoking:

The first month

Within 12 hours excess carbon monoxide is out of your blood
Within 5 days most nicotine is out of your body
Within 1 month your skin appearance is likely to improve
Within 1 week your sense of taste and smell improves

The first year

Within 12 months your risk of heart disease has dropped by 50%!
Within 2 months your lungs will no longer be making extra phlegm
Within 3 months lung function and blood flow improves

Longer term health benefits

Within 5 years your risk of having a stroke has decreased very significantly
Within 10 years your risk of lung cancer is less than 50% that of a continuing smoker- and this will continue to fall over time.
Within 15 years your risk of heart attack and stroke is almost the same as that of a person who has never smoked!

Smoking and withdrawal

Quitting smoking is different for everyone- some people find it relatively easy, others find it more difficult. Withdrawal symptoms are common while quitting, as the body is no longer receiving nicotine (the addictive drug in tobacco). That is why medications containing nicotine can help with withdrawal symptoms – such as nicotine patches, gum, lozenges, mouth spray or inhalator.

What withdrawal symptoms can be expected?

Withdrawal symptoms vary from person to person. They are at their worst in the first week after quitting, and tend to ease off over the following 2-4 weeks. Common symptoms include:

Craving (the urge to smoke)
Changes in sleeping patterns
Restlessness
Increased appetite, weight gain
Feeling irritable, short-tempered, emotional or frustrated
Low mood and anxiety
Difficulty concentrating

Some other symptoms that may occur when you quit smoking:

Cough and symptoms similar to a common cold (this should settle after a few weeks)
Feeling less interest in things you’d normally enjoy
Change in bowel habit
Mouth ulcers
Dizziness
Unusual dreams
Mood swings

It is important to be aware that even after many weeks after quitting, at times it can feel very hard not to smoke, for example if challenging or stressful life events occur. You may encounter strong “triggers” to smoke in certain situations, and withdrawal symptoms may feel worse.

There can also be a sense of fatigue from the ongoing effort not to smoke- this is entirely normal. Speaking to a health professional or a Quitline counsellor may help if you are finding things tough- just call 137848.

Weight Gain

Increased appetite may last for up to 6 months, so it is important to be mindful of this before quitting. If there is weight gain, it is usually in the first 2-3 months. On a positive note, in the long term, the average weight of people who have stopped smoking is similar to people who have never smoked. There are some strategies that can help to combat this, which are discussed below.

Mental Health

If you have a mental health condition, such as anxiety or depression, or have suffered from these in the past, it is highly advisable to speak to a doctor before you quit smoking.

This is because quitting smoking can cause a variety of withdrawal symptoms, which may impact mental health.

Whilst in the first few weeks quitting smoking can negatively impact mood and stress levels, after a few months mental health tends to improve. Studies show that people who quit smoking report lower levels of anxiety, depression and stress, and feel more positive and energetic in the long run.

Anyone struggling with their mental health, whether due to quitting smoking or other life circumstances, should seek support- this could be calling the Quitline (call 137848), Beyond Blue, or making an appointment to see your GP or psychologist.

Cravings

Cravings are very common in the first few days after quitting and tend to get better over time- though the timeframe can vary from person to person.

Cravings can be due to nicotine withdrawal. However, they can also happen if you are exposed to situations which you associate with smoking- for example, in certain environments or social settings. Craving can also occur when you are in a particular mood or mental state- whether that be stressed, relaxed or happy.

One way to combat this is to prepare for situations which you know may be a “trigger” for you to smoke- you may need to find other distractions and/or to use nicotine replacement therapy in these settings.

Over time it tends to get easier to manage these scenarios.

Tips to deal with cravings, withdrawal symptoms and quitting in general:

Get support. If you are struggling with your mental health or find it difficult to deal with stress, see a GP to discuss treatment options. A psychologist may help you get better at managing your mental health, and this may make it easier to avoid smoking. A Quitline counsellor can give you support that is suited to your needs, or you can visit quit.org.au.
Nicotine Replacement Therapy – this can include nicotine patches, lozenges, mouth spray, gum and inhalators. All of these can help reduce withdrawal symptoms and improve your chances of quitting, particularly if combined with some support sessions with a counsellor/GP/practice nurse etc. Nicotine replacement therapy products are commonly available “over the counter” at pharmacies, but may be cheaper if you get a doctor’s prescription.
Prescription medication – Champix also known as Varenicline, is a prescription medication known to help some people with cravings. To get a prescription you will need to make a doctor’s appointment, either in person or via telehealth. While this medication can improve the chance of quitting, it is not suitable for everyone.
Reduce caffeine intake – it may help if you cut down on caffeine- which is present in tea, coffee and some caffeinated soft drinks.
Exercise – regular exercise can help to manage stress and irritability, act as a positive distraction, alleviate withdrawal symptoms, and avoid or reduce weight gain. If you are not used to exercising, it is important to build up gradually. An experienced personal trainer or an exercise physiologist may be able to help.
Get help from a dietitian – if you are concerned about weight gain, talk with a doctor or dietitian, who can help you with strategies and food choices.
Speak to a doctor if you are taking any other regular medications- sometimes quitting nicotine, or taking treatment(s) to ease cravings can affect how other medications work- so it is important to discuss this in advance.
Avoid smoking “just one cigarette”, as it can make withdrawal symptoms worse and increases the risk of relapsing.
Make your home and car “smoke free” and remove cigarettes, lighters, ash-trays etc.
Consider avoiding “triggers” for a while, such as situations or places that you know will increase the urge to smoke.
Keep busy with activities that you enjoy- it may help to take on a new hobby or interest.
Keep reminding yourself of the positives- each day you do not smoke, your risk of complications from smoking reduces, and you have more money in your pocket. It may help to write a list of the good things about not smoking as a reminder to read when you feel cravings.

Remember the 4Ds:

Delay acting on the craving to light up. After a few minutes, it will weaken.
Deep breathe– take a long, slow breath, and breathe out slowly. Repeat 3 times.
Do something else- distract yourself with another activity
Drink water. Sip it slowly.

Other free supports to help you quit:

Apart from consulting a doctor or psychologist, there are some very helpful, free supports available in Australia to help people quit smoking.

Quitline: If you are having a tough day or just want to improve your chances of quitting, call the Quitline 137848. This is a free telephone support service that works with you to help you stop smoking. Quitline counsellors are trained to listen carefully and can give support suited to your needs. They can help you before, during and after you stop smoking. An interpreter service is available for people who speak a language other than English. There is also an Aboriginal Quitline for people who smoke and identify as Aboriginal or Torres

QuitCoach: The QuitCoach at www.quitcoach.org.au is a free online program that asks you questions and then gives you ideas and suggestions that will be most useful to you. QuitCoach can help you before and after you stop smoking.

QuitTxt: QuitTxt sends you regular SMS messages including tips and encouragement to help you keep on track as you quit. To start, go to www.quit.org.au/quittxt

Other resources

If you need more information about quitting smoking, the following resources are very helpful:

https://www.health.gov.au/health-topics/smoking-and-tobacco/how-to-quit-smoking

https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/smoking-cessation/art-20045441

https://www.quit.org.au/resources/fact-sheets/quitting-smoking-fact-sheets/