The Case for Quitting

Quitting smoking can be extremely challenging, but the benefits are immediate and profound; lung capacity increases, blood pressure drops and the odds of having a heart attack or stroke plunge within the first year. The American Cancer Society provides a timeline of health milestones individuals can look forward to once they’ve quit:

Time Smoke-free: 1 hour

Benefits: Heart rate and blood pressure drop

Time Smoke-free: 12 hours

Benefits: The carbon monoxide level in your blood drops to normal

Time Smoke-free: 2 weeks to 3 months

Benefits: Circulation improves and lung function increases

Time Smoke-free: 1 to 9 months

Benefits: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function, reducing the risk of infection

Time Smoke-free: 1 year

Benefits: Excess risk of coronary heart disease is half that of a habitual smoker

Time Smoke-free: 2 years

Benefits: Stroke risk can fall to that of a non-smoker

Time Smoke-free: 5 years

Benefits: Risk of cancer of the mouth, throat, esophagus, and bladder are cut in half; cervical cancer risk falls to that of a non-smoker

Time Smoke-free: 10 years

Benefits: The risk of dying from lung cancer is about half that of a person who is still smoking; the risk of cancer of the larynx and pancreas decrease

Time Smoke-free: 15 years

Benefits: The risk of coronary heart disease is that of a non-smoker’s

Socially, a reformed smoker can expect better breath and body odor, a greater ability to exercise, and meaningful savings. According to Lung.org, the U.S. average for a pack of cigarettes is $5.51, meaning a pack-a-day smoker’s average annual expense sits at $2,011; but that’s just the surface costs. The total economic cost of a pack is $18.05, a cost which factors in government and consumer spending dedicated to combating smoking. Put another way, money that could be used elsewhere if smoking were not a drag on public health. Total yearly economic cost for a pack-a-day smoker: $6,588.

Adding another financial perspective, in 2013, The New York Times reported that smokers cost private employers an additional $5,816 compared to nonsmokers. These costs are the sum of healthcare expenses, smoking breaks and absenteeism from work; on average, smokers miss two-and-a-half more workdays in a year than nonsmokers do.

Over the long term, benefits of quitting continue to accumulate as the body mends itself from the damage caused by smoking. Damaged nerves regrow, bronchial passages relax, and circulation improves. After ten years or more, ex-smokers enjoy the same odds of good health as people who have never smoked.

Cigarettes contain not only nicotine, an addictive substance, but other chemicals that increase the likelihood that smokers become dependent. While conventional wisdom is clear that smoking is bad for one’s health, quitting an established habit is generally not easy. In fact, a multibillion-dollar industry has evolved to meet this need. Almost 70% of current U.S. smokers want to quit, and these smokers are willing to put hard-earned cash on the table for smoking cessation aids that work.

When it comes to quitting smoking, success rates are subjective. They are determined on different levels depending on who is asked. Some measure success in terms of lowering usage, while others determine success based on how long someone goes without smoking. According to Cancer.org, four to seven percent of smokers quit completely without the use of cessation aids or other treatments.

The website also reports that nearly 25% of smokers who used medication to kick their habit were able to remain “smoke-free for over six months.” Cancer.org asserts that those who participate in counseling, or who receive another form of emotional support while trying to stop, better their chances of quitting.

The U.S. Food and Drug Administration (FDA) has already approved several products that assist in smoking cessation. As with any medication, these aids take time to be effective. Most require 12 weeks of use, though the nicotine nasal sprays can be used for up to six months.

The most common of these cessation aids are nicotine replacement therapies (NRT). They are designed to help wean you off cigarettes by allowing you to control or slowly reduce the amount of nicotine entering your system. While it is possible to use more than one NRT at a time, it is important to understand the dosage and potential side effects of each product before combining them. We have compiled and provided the dosage and side effects information for popular cessation aids. Before pursuing any listed below, be sure to contact your doctor to discuss your options.

Nicotine Gum (Nicorette)

Over-the-Counter
Dosage: 2 mg (<25 cig/day); 4 mg (>25 cig/day)
Potential Side Effects: Sore throat, hiccups, pruritus, jaw soreness
Pros: Curbs sudden cravings and withdrawal symptoms
Cons: Lasts for a short period of time; Does not kill cravings completely; Have to chew gum a certain way for it to work; May stick to dental work; Can’t eat or drink while chewing or the gum won’t be effective; Must wait at least 15 minutes after eating or drinking anything other than water before using

Nictoine Patch (Nicoderm CQ)

Over-the-Counter
Dosage: 7mg/day; 14 mg/day; 21 mg/day
Potential Side Effects: Shoulder and arm pain, pruritus, erythema, vivid dreams, skin irritation
Pros: Lasts up to 24 hours
Cons: No way to regulate sudden urges or cravings; Replace patch every day; Putting patch on same spot of skin two days in a row may cause irritation

Nasal Spray (Nicotrol NS)

Prescription
Dosage: 10mg/mL (1 spray = 0.5 mg); 1 dose = 2 sprays (1 spray per nostril)
Potential Side Effects: Nasal irritation, sneezing, cough, tearing, headache
Pros: Control sudden urges or cravings; Faster absorption into the bloodstream; User controls dosage
Cons: Used repeatedly throughout the day to control urges; Higher risk of forming a dependency on the spray

Nicotine Inhaler (Nicotrol)

Prescription
Dosage: 4 mg
Potential Side Effects: Mouth and throat irritation, cough
Pros: Control sudden urges or cravings; User controls how much nicotine they put into their bodies via inhaler puffs; Benefit from the sensation of hand-to-mouth movement that is often part of cigarette addiction
Cons: Used repeatedly throughout the day to control urges; Can’t eat or drink while using or it won’t be as effective; Must wait at least 15 minutes after eating or drinking anything other than water before using

Nicotine Lozenge (Commit)

Over-the-Counter
Dosage: 2 mg (if person smokes 1st cigarette more than 30 minutes after waking); 4 mg (if person smokes 1st cigarette less than 30 minutes after waking)
Potential Side Effects: Mouth irritation, nausea, hiccups, heartburn
Pros: Control sudden urges or cravings
Cons: Curbs but doesn’t eliminate cravings; Can’t eat or drink while using or it won’t be as effective; Must wait at least 15 minutes after eating or drinking anything other than water before using

Zyban

Prescription
Dosage: 1 150 mg tablet/day for 3 days; Increase to 300 mg/day; 1 150 mg tablet twice a day at 8 hour interval; Treatment lasts for 7-12 weeks
Potential Side Effects: Anxiety, dry mouth, irregular heartbeats, restlessness, shortness of breath, trouble sleeping
Pros: Easy to use pill
Cons: Start prescription one week before wanting to quit; Must take pills at the same time every day

Chantix

Prescription
Dosage:
Week One: Days 1-3: 1 white pill every day, in the morning; Days 4-7: 2 white pills every day, in the morning and evening
Weeks 2-12: 2 blue pills every day, in the morning and evening
Potential Side Effects: Nausea, changes in behavior, hostility, agitation, depressed mood, suicidal thoughts or actions
Pros: Easy to use pill
Cons: Serious mental health problems known to stem from this cessation aid

Sources:Mayo Clinic, U.S. Pharmacists, Drugs.com and Chantix

Prescription cessation aids, like Zyban and Chantix, are designed to inhibit the pleasure receptors in the brain that have been affected by nicotine. In other words, they make smoking less desirable. Neither of these prescriptions contain nicotine, and people often use the faster-acting NRTs at the same time to curb withdrawal symptoms.

Though both Zyban and Chantix have been approved by the FDA, it is important to be cautious when taking these medications. Both can affect moods and cause extreme changes in behavior and thoughts of suicide. If you choose the prescription route to quitting smoking, keep your doctor informed of all changes you experience.