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SO YOUWANT TOQUIT ?

THE LAT E S TQUIT GUIDE

TOS TO P P I N GS M O K I N G

QUIT is a Company Limited by Guarantee Registered in England andWa l e s Co. Reg. No. 2886660 Registered Charity No. 10 4 2 4 8 2

This guide is supported by an educational grant from –

www.nicorette.co.uk

WE ARE GOING TO HELP YOUYou’ll increase your chances of successfully stoppingsmoking by up to four times if you get the rightsupport.The QUIT© Guide to stopping smoking givesyou a step-by-step guide on how to quit for good.

QUIT is an independent charity which has helpedover two million smokers. QUIT Counsellors can offeryou friendly help and advice throughout your quittingprocess. So to discuss any concerns you have justring Quitline© 0800 00 22 00 - a trained counsellor isthere to help you or email stopsmoking@quit.org.ukfor a same day reply.

DO IT !BREAKTHEHABIT

STEP 1 NOT ALL SMOKERS ARE THE SAMEIf you’ve had enough of being a smoker and just wantto stop, then just do it! You will improve your chances of success if you get help as soon as possible.

If you don't feel ready to stop straight away, thenreplacing some of your cigarettes with NRT is a saferoption. This may well help you to think about setting a quit date in the future.

If you prefer to plan ahead, then that’s fine too. Set a date not too far ahead and stick to it.

You will improve your chances of success if you gethelp as soon as possible. Ring Quitline on 0800 00 22 00or email stopsmoking@quit.org.uk to find out whatsupport will suit you best.

STEP 2 CHOOSE THE RIGHT SUPPORT FOR YOUOnly 3% of smokers succeed by willpower alone.Both Nicotine Replacement Therapy (NRT) and Zybanhave been proven to double a smoker’s chances ofquitting successfully. If you take NRT or Zyban AND getsupport from a local stop smoking group you increaseyour chances by up to 4 times! A new treatment,Champix has been clinically proven to more than treblea smoker’s odds of successfully quitting.

C i g a rettes deliver nicotine very quickly, which contributesto their addictive nature. However the nicotine in NRT issupplied in a slower and more controlled way. This isbecause NRT is designed to help you quit smoking andso gradually reduces your need for nicotine, until youd o n ’t need it anymore .

There are a wide range of NRT products available.If youare having trouble deciding which product to use, givea QUIT Counsellor a ring on 0800 00 22 00.

DON’TDELAY

DO EXPECTMORE KISSES

All NRT products are available on prescription andcan also be bought over the counter at pharmaciesand large supermarkets. It’s important to complete thefull course of NRT as this increases your chances ofquitting successfully. Some NRT formats may alsohelp reduce weight gain associated with quittingsmoking. Here ’s a brief description of the rangeof products available, to help you decide if NRT is rightfor you. Refer to individual packs for further details.All NRT products, Zyban and Champix reduce boththe withdrawal symptoms and also the desire orcravings to smoke.

DON’T RELY ON D.I.Y.CURES

D OT RYA NEWWAYT OH E L PY O UQ U I T

NICOTINE MOUTH SPRAY(Nicorette®)

An instant release mouth spray which acts fast to help you quit.

You can use the spray before or during cravings. It is suitable for all smokers regardless of the number of cigarettes you smoke. The spray can be used if youwant to stop abruptly or to replace cigarettes for a saferoption. A fresh mint taste , you are likely to need 1-2sprays when you normally would have a cigarette orwhen you get a craving. You can have a maximum of64 sprays in a day. For best results don’t swallow for a few seconds after spraying. The discreet blackdispenser should last between 1 to 2 weeks.

COMBINATION NRTUsing more than one NRT product often increases thelikelihood of success of quitting, especially if you havepreviously tried and failed using the patch alone. Thepatch provides background nicotine replacement whilethe mouth spray, nasal spray, inhalator, chewing gum,tablets that dissolve under the tongue and lozenges, areall forms that can be used if you get a sudden craving.

NICOTINE PATCH (NicAssist® – only available at Boots, Nicorette®, Nicotinell®, NiQuitin CQ®)

Patches are most helpful to people who like to feelprotected from cravings throughout the day. They areeasy to use and should be applied to dry non-hairy skinsuch as the upper arm, thigh or chest. The patches offer a continuous supply of nicotine throughout the day to help relieve the withdrawal symptoms and physicalcravings you’ll experience. You may still get urges to smoke but these will not be as strong.

A patch lasts either 16 or 24 hours, each of which come in three strengths delivering diff e rent amounts of nicotine, which is absorbed slowly through the skin.You are recommended to use them for up to thre emonths d e p e n d i n g on the brand you choose, starting o ff with the most appro p r i a t e s t rength for you. Alwaysfollow manufacturers’ instructions. Some peopleexperience a slight itching or redness of the skin and this can be lessened by varying the position of the patch when you apply a new one.

DO TRYSOM ENRT

DON’T PANIC !

NICOTINE GUM (NicAssist®, Nicorette®, Nicotinell®, NiQuitin CQ®)

Nicotine gum helps you to control your cravingswhenever you feel the urge to smoke. It is diff e re n tf rom ordinary chewing gum and can havea slightly peppery taste, especially to begin with, soyou may have to persevere in using it. It is importantto use it properly to get the full benefit. The gumcomes in two strengths, regular (2mg) and maximum(4mg) and in a choice of flavours. The brand youselect will determine which strength you use. The gum should be chewed slowly and then re s t e dbetween your gum and the side of your mouth,re p e a t e d l y, for about 30 minutes. You shouldgradually reduce the number of gums you chew over about 3 months.

Maximum strength NRT gum can also help re d u c eweight gain associated with quitting smoking. Thenicotine is slowly absorbed through the lining of themouth. The main side effect is a slight irritation of the mouth and throat, but this lessens with use. The gum is difficult to use if you wear dentures and can aggravate stomach ulcers.

NICOTINE LOZENGES (Nicorette®, Nicotinell®, NiQuitin CQ®)

The lozenge is an effective alternative to the gum andis available in a variety of strengths. The brand youselect will determine which strength you use. You takeone lozenge every hour or two for the first few weeksand then gradually reduce the number you take eachday over the next few weeks until you don’t need thelozenges anymore. Like the gum, the nicotine isabsorbed through the lining of the mouth. Researc hhas shown that the 4mg NRT lozenge can also helpreduce weight gain associated with quitting smoking.

NICOTINE MICROTAB (Nicorette®)

The Microtab is a small white tablet containing nicotinethat dissolves under your tongue. Don’t suck, chew orswallow it, as this will reduce the amount of nicotinethat is absorbed through the lining of the mouth.

DOFOLLO WTHEINSTRUCTIONS

NICOTINE NASAL SPRAY(Nicorette®)

The nicotine nasal spray is good for people who getsevere withdrawal symptoms or who smoke heavily.The nicotine nasal spray comes in a bottle with anozzle that delivers a dose of nicotine via a fine spraysquirted into each nostril. It can be used up to 32times a day. The nicotine is quickly absorbed throughthe lining of the nose. It mimics cigarettes moreclosely by giving a relatively fast effect. The spraymay irritate your nose and throat, especially at first.However if you persevere this lessens. NRT nasalspray can help reduce weight gain associated withquitting smoking.

DON’TGOEMPTYHANDED

NICOTINE INHALATOR (NicAssist®, Nicorette®)

The inhalator is helpful when your body cravesthe nicotine and your hands miss a cigarette. The inhalator looks like a cigarette holder, inside whichyou place a cartridge containing nicotine. You simplysuck on the inhalator when you get a craving.Nicotine is taken into the mouth and the back of thethroat but not into the lungs.

CUT DOWN THEN STOPIf you feel you can’t stop abruptly then you can usesome forms of NRT to help you cut down the numberof cigarettes then stop. You need to cut out at leasthalf of your cigarettes with the help of NRT then aftera while you can stop completely. Call the Quitline on0800 00 22 00 or ask your GP or pharmacist foradvice on this method.

DO ASKYOURDOC TOR

ZYBAN Your GP will be able to advise if Zyban is suitablefor you depending on your medical history. It is onlyavailable on prescription. Zyban is an eff e c t i v et reatment, which has helped many smokers to quit.It is a non-nicotine tablet. A course of Zyban tabletslasts two months. You start taking Zyban while youa re still smoking and set a date for quitting during thesecond week of treatment. It is not suitable forpeople who have a history of blackouts, fits, headinjury or brain tumour but your GP will advise youf u r t h e r. The most common side effects are diffic u l t ysleeping, dry mouth and headache.

Every patient who is prescribed Zyban is off e re dmotivational support from the Right Ti m eP rogramme, which is a personalised pro g r a m m edesigned to encourage and support patientst h roughout their quit attempt.

G L U C O S ET h e re is now some preliminary evidence thatglucose tablets reduce cravings and may helppeople to stop smoking.

DON’T NARROWYOUR OPTIONS

C H A M P I XThis is a non-nicotine therapy developed specifically to help people stop smoking. It works in two ways - it reduces cravings and withdrawal symptoms and italso diminishes the sense of satisfaction associatedwith smoking; potentially preventing a lapse fromturning into a full relapse.Champix is only available onprescription from your GP and NHS Stop SmokingServices. You start taking the tablet while you are stillsmoking and set a quit date 8-14 days ahead. The dosage is gradually increased until you are taking 2 tablets a day. The treatment lasts for 12 weeks. The most common side effects are nausea and sleep disturbance.

Every patient who is prescribed Champix is off e re dmotivational support from the Life Reward sP rogramme, which is a personalised pro g r a m m edesigned to support and encourage patientst h roughout their quit attempt.

DO IT, BE THE CHAMP

DON’T FORGETGROUP SUPPORT

SPECIALIST CLINICS AND SUPPORT GROUPSSpecialist smokers’ clinics recommend using eitherNRT, Zyban or Champix.

Groups can help you to feel less alone in your attemptto quit. Being with other people who are also stoppingcan provide that all-important mutual support and asense of being understood. They are usually run overa period of weeks and guide you through the differentstages of quitting.

There are a growing number of both specialist clinicsand support groups. Ring Quitline 0800 00 22 00 oremail stopsmoking@quit.org.uk and a QUITCounsellor will be able to tell you the location of yournearest group or clinic.

ALTERNATIVE THERAPIESSome people claim to be helped by altern a t i v etherapies. However, the results of re s e a rch are notc l e a r, so overall their effectiveness remains unpro v e n .The two most popular forms are hypnotherapy anda c u p u n c t u re. If you decide to try alternative therapy,it is important to find a re g i s t e red practitioner. TheInstitute of Complementary Medicine, PO Box 194,London SE16 7QZ or The British ComplementaryMedicine Association, UK Training College,St Charles Hospital, Exmoor St, London W10 6DZcan both supply further information on the servicesavailable and details of local practitioners.

DO CHECK

STEP 3WATCH YOUR WEIGHTMake sure you don’t replace cigarettes with fatteningfoods! If you feel you need to lose weight it’s best tocope with stopping smoking first. If you t ry to do bothat once you are more likely to fail. Quitting smoking isthe most important thing a person can do to impro v etheir health. If you put on weight while trying to quitresolve to do something about it as soon as you feelyou are able to cope without cigarettes. In themeantime increase your exercise routine and eath e a l t h i l y. For QUIT’s free "So You Want A HealthyBody?" booklet about how to control your weight whilequitting, ring Quitline 0800 00 22 00 or emailstopsmoking@quit. org. uk

DON’T OVER EAT

STEP 4 EXERCISEResearch shows that undertaking exercise whilestopping smoking can increase your chance of beingsuccessful. QUIT in conjunction with fitness expertshave designed an exercise programme specificallyfor smokers to help you with your quit attempt. Thestep-by-step programme focuses on the areas mostlikely to be affected by smoking; lung capacity andcardiovascular health. ‘Keep QUIT’ has 4 levels ofintensity designed to cater for a wide range of fitnessand ability. It can be downloaded by visitingwww.quit.org.uk. Alternatively choose any physicalactivity you enjoy and fit it into your quitting plan atleast 3-4 times a week. Exercise will help your bodycope with withdrawal symptoms and boost yourselfconfidence and well-being.

DO SOM EEXERCI S E

FREQUENTLY ASKED QUESTIONS

Q .Does smoking reduce stre s s ?A. No, it’s a temporary feeling, the effects of

n i c o t i n e soon wear off and this withdrawal makes you feel tense.

Q. Can I use NRT when I'm pregnant andbreastfeeding?

A. Pregnant smokers ideally should try to quit without NRT but if you can't manage this, you canuse NRT. The risks to your unborn baby are far less than continuing to smoke. If you have sickness or nausea and so prefer using a patchavoid using it over night.

If you are breastfeeding it is better if you use gums,lozenges or inhalers rather than patches and avoidtheir use just before breastfeeding. If you have apartner who also smokes try to quit together.

Q. I'm under 18 can I use NRT?A. For 12 - 17 year old smokers NRT may be

helpful. You can use NRT for up to 12 weeks buttalk to a healthcare professional before using N RT for any longer.

DO N’T BECONFUSED

FEEL THE BENEFITSYOUR HEALTH – STOP SMOKING, AND AFTER . . .

20 minutes: Your blood pressure and pulse rate shouldreturn to normal.

8 hours: Oxygen levels in your blood should returnto normal.

24 hours: Carbon monoxide has been eliminatedf rom your body. Your lungs start to clearout mucus and other smoking debris.

48 hours: Your ability to taste and smell may beg reatly impro v e d.

72 hours: B reathing becomes easier. Your bro n c h i a ltubes begin to relax and your energylevels incre a s e .

2-12 weeks: C i rculation improves throughout the body.3-9 months:Coughs, wheezing and bre a t h i n g

p roblems get better as your lung functionis increased by up to 10 % .

1 year: Risk of a heart attack drops to half that of a smoker.

10 years: Risk of lung cancer falls to half that of a smoker.

15 years: Risk of heart attack falls to same assomeone who has never smoked.

FINANCIAL

Work out how much money you spend on cigarettes in a day, a week and a year then start planning all thet reats you can have with the money.

DO N ’ TF O R G E TTHE MATHS

Q .What are withdrawal symptoms?A. Symptoms include irritability, restlessness,depression, difficulty concentrating, sleep disruption,increased appetite and craving for tobacco. Thegood news is that it means your body is recoveringand all the symptoms are temporary. Any moodchanges usually go back to normal after about 3 or 4weeks. None of the symptoms are life threatening,unlike smoking!

Q. I have diabetes , can I use NRT ?A. Nicotine from smoking and from NRT affects your

blood sugar levels, so when you stop smokingthese can vary more than usual. So monitor yoursugar more regularly than usual as you may need to make changes to your diet, your insulin or theamount of medication you take.

Q. I've just come out of hospital, can I use NRT?A. If you have had a heart attack, stroke or serious

problem with irregular heartbeats you need to tellyour doctor you are going to use NRT and followhis/her advice.

DO H AV EAG O

HELPFUL WEBSITE RESOURCESwww.quit.org.ukwww.asianquitline.orgwww.Click2Quit.comwww.bhf.org.ukwww.givingupsmoking.co.ukwww.nosmokingday.org.ukwww.ash.org.ukwww.cancerresearchuk.org

THANKSThanks to Robert West, Professor of HealthPsychology and Director of Tobacco Studies at the Cancer Research UK Health Behaviour Unit,University College London for his help and advice in producing this guide.

QUIT has editorial control over all copy.

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