Tobacco use is the most common preventable cause of death. About half of the people who don’t quit smoking will die of smoking-related problems. Quitting smoking is important for your health. Soon after you quit, your circulation begins to improve, and your blood pressure starts to return to normal. Your sense of smell and taste return, and it’s easier for you to breathe. In the long term, giving up tobacco can help you live longer. Your risk of getting cancer decreases with each year you stay smoke-free. Quitting is not easy. You may have short-term affects such as weight gain, irritability, and anxiety. Some people try several times before they succeed. There are many ways to quit smoking. Some people stop “cold turkey.” Others benefit from step-by-step manuals, counseling, or medicines or products that help reduce nicotine addiction.

Quitting smoking improves health in smokers of all ages.

The risk of most health problems from smoking, including cancer and heart and lung disease, can be lowered by stopping smoking. People of all ages can improve their health if they quit smoking. Quitting at a younger age will improve a person’s health even more. People who quit smoking cut their risk of lung cancer by 30% to 50% after 10 years compared to people who keep smoking, and they cut their risk of cancer of the mouth or esophagus in half within 5 years after quitting.

The damage caused by smoking is even worse for people who have had cancer. They have an increased risk of cancer recurrence, new cancers, and long-term side effects from cancer treatment. Quitting smoking and stopping other unhealthy behaviors can improve long-term health and quality of life. See the PDQ summary Smoking in Cancer Care for more information.

The Public Health Service has a set of guidelines called Treating Tobacco Use and Dependence. It asks health care professionals to talk to their patients about the health problems caused by smoking and the importance of quitting smoking.

Different ways to quit smoking have been studied. The following are the most common methods used to help smokers quit:

Counseling

People who have even a short counseling session with a health care professional are more likely to quit smoking. Your doctor or other health care professional may take the following steps to help you quit:

  • Ask about your smoking habits at every visit.
  • Advise you to stop smoking.
  • Ask you how willing you are to quit.
  • Help you plan to quit smoking by:
    • setting a date to quit smoking;
    • giving you self-help materials;
    • recommending drug treatment.
  • Plan follow-up visits with you.

Childhood cancer survivors who smoke may be more likely to quit when they take part in programs that use peer-counseling. In these programs, childhood cancer survivors are trained in ways to give support to other childhood cancer survivors who smoke and want to quit. More people quit smoking with peer-counseling than with self-help programs. If you are a childhood cancer survivor and you smoke, talk to your doctor about peer-counseling programs.

Drug treatment

Treatment with drugs is also used to help people quit smoking. These include nicotine replacement products and non-nicotine medicines. People who use any type of drug treatment are more likely to quit smoking after 6 months than those who use a placebo or no drug treatment at all.

Nicotine replacement products have nicotine in them. You slowly reduce the use of the nicotine product in order to reduce the amount of nicotine you take in. Using a nicotine replacement product can help break the addiction to nicotine. It lessens the side effects of nicotine withdrawal, such as feeling depressed or nervous, having trouble thinking clearly, or having trouble sleeping. Nicotine replacement products that have been shown to help people quit smoking include:

  • Nicotine gum. – A chewing gum that contains a small dose of nicotine, which enters the blood by being absorbed through the lining of the mouth. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine gum.
  • Nicotine patches. – A patch that sticks on the skin and contains a small dose of nicotine, which enters the blood by being absorbed through the skin. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. Nicotine patches are available with and without a prescription.
  • Nicotine nasal spray. – A nose spray that contains a small dose of nicotine, which enters the blood by being absorbed through the lining of the nose. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is needed for nicotine nasal spray.
  • Nicotine inhalers. – A device used to inhale (breathe in) small doses of nicotine through the mouth. The nicotine is absorbed through the lining of the mouth and lungs and goes into the blood. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is needed for nicotine inhalers.
  • Nicotine lozenges. – A hard candy-like tablet that contains a small dose of nicotine. The nicotine is absorbed through the lining of the mouth and goes into the blood. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine lozenges.

Nicotine replacement products can cause problems in some people, especially:

  • Women who are pregnant or breast feeding.
  • Teenagers.
  • People with any of the following medical problems:
    • Heart rhythm problems.
    • High blood pressure that is not controlled.
    • Esophagitis.
    • Ulcers.
    • Insulin -dependent diabetes.
    • Asthma.

Other medicines that do not have nicotine in them are used to help people quit smoking. These include:

  • Bupropion (also called Zyban).
  • Varenicline (also called Chantix).

These medicines lessen nicotine craving and nicotine withdrawal symptoms.

It is important to know that bupropion and varenicline may cause serious psychiatric problems. Symptoms include:

  • Changes in behavior.
  • Aggressive behavior.
  • Anxiety.
  • Nervousness.
  • Depression.
  • Suicidal thoughts and attempted suicide.

Before starting to take bupropion or varenicline, talk to your doctor about the important health benefits of quitting smoking and the small but serious risk of problems with the use of these drugs.

Varenicline may also cause serious heart problems.

Smoking reduction

When smokers do not quit smoking completely but smoke fewer cigarettes (smoking reduction). they may still benefit. The more you smoke, the higher your risk of lung cancer and other cancers related to smoking. Studies show that smokers who cut back are more likely to stop smoking in the future.

Smoking less is not as helpful as quitting smoking altogether and is harmful if you inhale more deeply or smoke more of each cigarette to try to control nicotine cravings. In smokers who do not plan to quit smoking completely, nicotine replacement products have been shown to help them cut down the number of cigarettes they smoke, but this effect does not appear to last over time .

The following resources can help you quit smoking:

  • Consumer information about quitting smoking is available at the www.smokefree.gov Web site.
  • The online Quit Guide may help you understand reasons for smoking and the best ways to quit.
  • The booklet Clearing the Air: Quit Smoking Today can downloaded here.

Cancer prevention clinical trials are used to study ways to prevent cancer.

Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.

The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

New ways to help smokers quit are being studied in clinical trials.

Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check for clinical trials in NCI’s PDQ Cancer Clinical Trials Registry that are accepting patients for trials to quit smoking.