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Living Tobacco

T O O L K I T

Welcome

Congratulations, you are taking the first step to quitting tobacco.

The activities and information in this workbook can be used to stop cigarette smoking or other tobacco use.

This program was created to help you live life tobacco free. It is designed to help you quit by:

ϒ Helping you better understand the power of nicotine and why you smoke or chew.

ϒ Teaching you how to handle withdrawal symptoms and stress.

ϒ Teaching you tips to resist the urge to smoke or chew.

The more support you get, the more likely you will quit for good.

This toolkit is just one part of the Living Tobacco Free program.

Work with your Health Coach to learn about all of the tools available to you.

Health Coaches are here to help you quit for good!

Quitting isn’t easy. It may take several tries. But you learn something

each time you try.

As you work through this program, think of the word

NOPE: Not One Puff Ever. Remember, this is your goal!

Table of Contents

Getting Started ..................................................................................................................................................................4

Smokeless Tobacco ........................................................................................................................................................5

Weighing the Pros and Cons ....................................................................................................................................6

Getting Ready to Quit ....................................................................................................................................................7

My Tobacco Use ................................................................................................................................................................8

Triggers ................................................................................................................................................................................9

Creating Your Quit Plan..............................................................................................................................................10

My Quit Plan ........................................................................................................................................................................11

Helpful Tips..........................................................................................................................................................................12

Nicotine Replacement Therapy..............................................................................................................................13

Pack Wrap............................................................................................................................................................................15

Pack Track............................................................................................................................................................................17

After You’ve Quit ............................................................................................................................................................18

Preventing Relapse ....................................................................................................................................................20

Will I Gain Weight When I Stop Smoking?........................................................................................................21

Staying Tobacco Free..................................................................................................................................................22

Additional Resources ..................................................................................................................................................23

3

You may feel uncomfortable not smoking or chewing at times or in places where you usually do. These times and

places are called “triggers” because they turn on your nicotine cravings. Not smoking at these times is the hardest

part of quitting for some smokers. Don’t give up too soon. You will feel good again. It takes time to break free

from nicotine.

Cigarettes—not just nicotine

Your body gets more than nicotine when you smoke. There are more than 4,000 chemicals in cigarette smoke. Some

of them are also in wood varnish, the insect poison DDT, arsenic, nail polish remover, and rat poison. The ashes,

tar, gases, and other poisons in cigarettes harm your body over time. They damage your heart and lungs. They also

make it harder for you to taste and smell things, and fight infections.1

The long-term rewards of quitting

By quitting, you will add healthy, full days to each year of your life. You will greatly lower your risk of death from

cancer and diseases, including:

Smokeless Tobacco

Quitting dip, chew, snuff, and betel

You may already know of the health risks of using smokeless tobacco. In addition to the health risks, you may

already have personal reasons for quitting.

The Dangers of

Smokeless Tobacco

Smokeless tobacco can:

ϒ Lead to cancer of the mouth, throat, and pancreas.

ϒ Cause tooth decay.

ϒ Damage your gums.

ϒ Give you mouth sores that can lead to cancer.

Research shows that smokeless tobacco can cause heart disease and stroke as well.5

Smokeless tobacco addiction

Smokeless tobacco is not harmless. It contains nicotine, which makes it addictive. Not only is it bad for your health,

it stains your teeth and clothes, smells, and gives you bad breath. It’s expensive too!

It is important to have the support of friends and family to help you quit.

Quit plan

It is important to know why you want to quit and to make a quit plan and stick to it! This toolkit can help you make

a plan to quit for good. Health Coaches are also available to help. Read on to learn more.

U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Centers for Disease Control and Prevention, 2000.

U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention

and Health Promotion, Office on Smoking and Health; 2001.

Centers for Disease Control and Prevention. Annual Smoking–Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 1997–2001. Morbidity and Mortality Weekly Report [serial

online]. 2005.

Centers for Disease Control and Prevention. Health United States, 2005 With Chartbook on Trends in the Health of Americans. (PDF–119KB) Hyattsville, MD: U.S. Department of Health and Human Services, CDC, National

Center for Health Statistics; 2006.

U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Centers for Disease Control and Prevention, 2000.

5

Weighing the Pros and Cons

Think about why you want to quit smoking or chew. Think of more than just health reasons. For example, think of

how much money you’ll save by not buying cigarettes or how you will be setting a good example for your children.

Weigh the pros and cons to help you identify your most important goals and possible obstacles. Write your thoughts

in each section.

THE PROS OF SMOKING: THE CONS OF SMOKING:

What do you enjoy about smoking or chewing? What are some of the things about smoking or

chewing that you dislike?

THE PROS OF QUITTING: THE CONS OF QUITTING:

Why would it be good to give up smoking or chew? What would be the down side of quitting?

6

Getting Ready to Quit

It’s OK to have mixed feelings about quitting. Don’t let that stop you. There will be times every day that you don’t

feel like quitting. Try to stick with it anyway.

Find reasons to quit that are important to you. Think of more than just health reasons. For example, think of:

ϒ The extra time you’ll have for yourself by not taking cigarette breaks, rushing out to buy a pack, or searching

for a light.

ϒ Not being short of breath or coughing as much.

ϒ Your car, clothes, and breath will all smell better.

Think of the word NOPE: Not One Puff Ever. Remember, this is your goal!

Keep your lists of reasons to quit where you’ll see them often.

Good places are:

My Tobacco Use

It is important for you to understand when and why you use tobacco. The chart below describes situations where

you might use tobacco. Think about how often (rarely, sometimes, often) you find yourself in each situation. Then,

put a check mark in the column that best describes how often you are in each situation.

Keep this list where you will see it often. Talk to your Health Coach about it too. Your Health Coach can help you

find healthier ways of dealing with these situations.

Check your response: Rarely Sometimes Often

Smoking or chewing tobacco is something I do when I’m out

having a good time with friends.

I smoke or chew when I need a “lift.”

Instead of having a snack when I’m hungry, I smoke or chew.

I smoke or chew after I’ve had an argument with someone.

I socialize with other people who smoke or chew.

I smoke or chew when I feel angry or upset, or need to relax.

When I feel “down” or want to forget about my worries, I smoke

or chew.

I skip meals and smoke cigarettes or chew instead.

I use tobacco more when I’m with my friends.

I smoke or chew to perk myself up or boost my energy.

I light up a cigarette or chew when I feel uncomfortable or

nervous about something.

I smoke or chew when I start feeling sluggish during the day.

Source: © 1995-2008, Healthwise, Incorporated, P.O. Box 1989, Boise, ID 83701. ALL RIGHTS RESERVED This information is not intended to replace the advice of a doctor.

Healthwise disclaims any Liability for the decisions you make based on this information.

Triggers

Know your triggers

Certain things trigger, or turn on, your need for tobacco. They can be moods, feelings, places, or things you do. Put

a check next to things that tempt you to smoke. Then, write down what you can do to fight the urge to smoke.

Triggers: Ways I can fight the urge to smoke or chew:

θ Feeling stressed

θ Feeling down

θ Talking on the phone

θ Drinking alcohol, like wine or beer

θ Watching TV

θ Driving my car

θ Finishing a meal

θ Playing cards

θ Taking a work break

θ Being with other smokers

θ Drinking coffee

θ Seeing someone else smoke

θ Cooling off after a fight

θ Feeling lonely

θ After having sex

θ Other:

Face these triggers

Knowing your triggers is very important. Here are some tips to help you fight the urge to smoke:

Not everyone has all of these feelings of withdrawal. You may have one or many of these problems. And they may

last different amounts of time. Talk to your doctor about medicines that may help.

Get support

Quitting tobacco is easier with the support of others. Tell your family, friends, and co-workers that you plan to quit.

Tell them how they can help. Here are some ideas:

ϒ Ask everyone to understand your change in mood. Remind them that this won’t last long. The worst will be

over within two weeks.

ϒ Does someone close to you smoke? Ask them to quit with you, or at least not to smoke around you.

ϒ Do you take any medicines? Tell your doctor and pharmacist you are quitting. Nicotine changes how some

drugs work. You may need to change your prescriptions after you quit.

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My quit date:

_________________________________________

Who can help me?

_________________________________________

_________________________________________

_________________________________________

_________________________________________

Skills and tips I can use:

_________________________________________

_________________________________________

_________________________________________

_________________________________________

_________________________________________

_________________________________________

_________________________________________

My medicine plan:

Medicine: ______________________________

Instructions: __________________________

_________________________________________

_________________________________________

How I’ll handle tough situations:

_________________________________________

_________________________________________

_________________________________________

_________________________________________

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Helpful Tips

Remove cigarettes and other tobacco

from your home, car, and work

Getting rid of things that remind you of smoking will

also help you get ready to quit. Try these ideas:

ϒ Make things clean and fresh at work, in your car,

and at home. Clean your curtains and clothes. Wash

your car. Buy yourself flowers. You will enjoy their

scent as your sense of smell returns.

ϒ Have your dentist clean your teeth to get rid of

smoking stains. See how great they look. Try to

keep them that way.

ϒ Throw away all of your cigarettes and matches. Get

rid of your lighters and ashtrays.

Keep busy

ϒ Be active. Take long walks. Go bike riding. Start a

new hobby.

ϒ Spend as much free time as you can where smoking

isn’t allowed. Some good places are malls, libraries,

museums, theaters, and places of worship.

ϒ If you miss having a cigarette in your hand, hold

something else. Try a pen or a paper clip. If the

craving gets bad, take a shower—you don’t smoke

in the shower.

ϒ If you miss having something in your mouth, try

toothpicks, cinnamon sticks, lollipops, hard candy,

sugarfree gum, or carrot sticks.

Stay away from what tempts you

ϒ If you always smoke while driving, try something

new. Listen to a new radio station or take a

different route. Take the train or bus for a while, if

you can.

ϒ Instead of smoking after meals, get up from the

table. Brush your teeth or go for a walk.

ϒ Stay away from things that you connect with

smoking or chew. These may include:

ϒ Watching your favorite TV show.

ϒ Sitting in your favorite chair.

ϒ Having a drink before dinner.

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ϒ Be patient. Using NRT the right way can take some getting used to. Follow the instructions and give it

some time.

ϒ Don’t mix tobacco and NRT. Having one or two cigarettes while you use the gum, patch, nasal spray, inhaler,

or lozenge is not dangerous, but your goal is to quit smoking for good. Use NRT only when you are ready to

stop smoking. If you do slip up and smoke a cigarette or two, don’t give up on NRT. Keep trying.

ϒ Take enough medicine. Use the full amount of NRT in the instructions. Don’t skip or forget to use NRT

after you first stop smoking.

ϒ Slowly use less and less medicine. Don’t stop completely until you’re ready. You can set up a schedule with

your doctor, pharmacist, or other health care provider.

ϒ Wait 30 minutes after using the gum, lozenge, or inhaler before you eat or drink:

} Coffee

} Soda

} Tomatoes, tomato sauce, or tomato juice

} Oranges or orange juice

} Lemons or lemonade

} Grapefruit or grapefruit juice

ϒ These acidic foods and drinks can keep nicotine gums and inhalers from working.

ϒ Keep some of the medicine with you after you stop using it. This way you’ll be ready if you have a craving.

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Many large drug stores or pharmacies also sell their own brands of nicotine gum and nicotine patches.

Using these medicines can double your chances of quitting. Talk to your doctor or pharmacist for more

information. But remember: medicine can help with cravings and withdrawal, but quitting will still be hard at times.

Other medicines

Zyban®, Wellbutrin®, and Chantix™ are medicines that have no nicotine. You need a prescription to get these pills.

They help with withdrawal and the urge to smoke so that you’re more likely to quit. Some people have side effects

when using bupropion SR or Varenicline Tartrate pills. Side effects may include dry mouth and trouble sleeping.

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Pack Wrap

Wrap your pack with reminders of why

you want to quit.

Try placing a wallet size photo of a loved one on the pack, so you

remember why you want to quit. You could even write your reasons

for wanting to quit on the back of the photo. Or, put a picture of

your reward for quitting on the package to help you stick to your

quit plan.

Cut out the Pack Wrap below.

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Pack Track

Keep track of when and why you smoke

Pack tracks help you to become more aware of your smoking patterns. You can tape your “pack track” to your

package of cigarettes, or carry it in your purse or wallet. When you feel the urge to smoke, but before you actually

put the cigarette in your mouth and light up, fill in the following information on your pack track.

Filling out your pack track

1) Enter the time of day.

2) Check the activity you are doing.

3) Check the word(s) that best describe your feeling at the time.

4) Mark how important that particular cigarette is to you in the “Level of Need Rating” column.

1 – VERY IMPORTANT 2 – IMPORTANT 3 – LEAST IMPORTANT

Fill out pack tracks on different days of the week (such as 2 workdays and 2 non-working days). When you smoke and

where you smoke may be different on days you work compared to days off. You’ll learn about your smoking triggers.

And you’ll learn which cigarettes are your favorites. These facts will help you prepare to fight your urge to smoke.

Photocopy and cut out the Pack Track below. Fold it to fit in your pack, wallet or purse.

After You’ve Quit

Did you know your body begins to recover from the damage done by smoking within 20 minutes after your last

cigarette? The poisonous gas and nicotine start to leave your body. Your pulse rate goes back to normal.

Within a few days you may notice other things:

ϒ Your senses of taste and smell are better.

ϒ You can breathe easier.

ϒ Your “smoker’s hack” starts to go away. You may keep coughing for a while, though.

The nicotine leaves your body within three days. At first, you may feel worse instead of better. Withdrawal feelings

can be hard. But they are a sign that your body is healing. And don’t forget about the long-term benefits of quitting

smoking. Quitting lowers your chances of heart disease, stroke, chronic bronchitis, emphysema, and several types

of cancer.

Find new things to do

Starting today you may want to create some new habits. Here are some things you might try:

ϒ Swimming, jogging, playing tennis, bike riding, or basketball. It’s hard to smoke and do these things at

the same time.

ϒ Keep your hands busy. Do crossword puzzles or needlework. Paint a room in your home. Do woodworking,

gardening, or household chores. You can also write a letter or paint your nails.

ϒ Enjoy having a clean-tasting mouth. Brush your teeth often and use mouthwash.

ϒ Take a stretch when you’re tempted to reach for a cigarette. Set aside time for the activities that satisfy you and

mean the most to you. There are natural breaks even during a busy day. After dinner, first thing in the morning,

or just before bed are good examples. You’ll also need plenty of rest while you get used to your tobacco-free

lifestyle.

Remember once you quit smoking, you will have more energy and money to try new and interesting hobbies!

Reward yourself

You are saving money by not buying cigarettes! Plan to buy yourself a gift

after your quit date.

ϒ Buy a new CD.

ϒ Buy a piece of jewelry.

ϒ Go to a sports event, movie, or play.

ϒ Get a manicure.

ϒ Buy a new couch or armchair—it won’t smell like cigarettes.

ϒ Buy new curtains for your home.

Stick with it

Beating an addiction to nicotine takes a lot of determination. If you’ve quit, you’ve made it very far. Now’s the time

to focus on sticking with it!

Keep your guard up

Preventing Relapse

Stay upbeat!

As you go through the first days and weeks without smoking, keep a positive outlook. Don’t blame or punish

yourself if you do have a cigarette. Instead, take it one day at a time. Remember that quitting is a learning process,

and remember to look at what you are gaining and not what you are giving up.

If you do slip, you have not failed!

If you have a slip or relapse, don’t be too hard on yourself.

ϒ A slip is defined as smoking for an isolated period of time that is not longer than six consecutive days,

following at least 24 hours of not smoking.

ϒ Relapse is defined as continuous smoking, at least one puff a day, beyond six consecutive days.

A slip or relapse doesn’t mean that you can’t be a non-smoker, but it’s important to get yourself back on the

non-smoking track RIGHT AWAY.

Relapse is not failure—it can take an average of 10 tries before quitting for good.

Find the trigger. What was it that led you to smoke? Be aware of the trigger and decide NOW about how you’ll

cope with it when it comes up again.

List the reason(s) for your relapse (i.e. stress, social event, driving): ______________________________________

Think about the slip or relapse, and ask yourself:

Where was I? ______________________________________________________________________________

What was I doing? ________________________________________________________________________

Who was I with? __________________________________________________________________________

What was I thinking? ________________________________________________________________________

What could I do besides smoke? ______________________________________________________________

What can I do differently next time? ____________________________________________________________

If you slip up and smoke one or two cigarettes, you can still quit for good! When people slip up, it’s usually within

the first three months after quitting. Here’s what you can do if this happens:

ϒ Understand that you’ve had a slip. You’ve had a small setback. This doesn’t mean you are a smoker again.

ϒ Don’t be too hard on yourself! One slip up doesn’t make you a failure. It doesn’t mean you can’t quit for good.

ϒ Don’t be too easy on yourself either! If you slip up, don’t say, “Well, I’ve blown it. I might as well smoke the

rest of this pack.” It’s important to get back on the non-smoking track right away! Remember, your goal is no

cigarettes—not one puff ever!

ϒ Feel good about all the time you went without smoking! Try to learn how to make your coping skills better.

ϒ Find the trigger! Exactly what was it that made you smoke? Be aware of that trigger. Decide now how you will

face it when it comes up again. Learn from your experience. What has helped the most to keep you from

smoking? Make sure to do that on your next try.

ϒ Are you using a medicine to help you quit? Don’t stop using your medicine after only one or two cigarettes. Stay

with it! It will help you get back on track!

People with just one coping skill are more likely to stay non-smokers than those who don’t know any.

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Will I Gain Weight When I Stop Smoking?

Many people who stop smoking worry about gaining weight. Your body uses food more slowly when you

first stop smoking. You may eat more when you quit, too. There is a good chance you will gain weight. But not

everyone does.

Are you worried about gaining weight? Think about this: you’d have to gain a lot of weight to offset the health

rewards of quitting. Here are some tips to keep off those extra pounds.

How to avoid gaining weight after quitting

ϒ Make time to exercise everyday. Even walking will improve your health. And all exercise burns calories, which

helps you gain less weight.

ϒ Exercising can distract you from smoking. It lowers the stress that makes you crave a cigarette. Exercise with a

friend to help you stick to it!

ϒ Are you starting a new exercise program? Begin with as little as 10 minutes. Slowly build up to longer periods

of time. It’s a good idea to talk to your doctor before you start. Your doctor can suggest what will keep you safe

and get you healthy.

ϒ As you get in shape, you will build muscle. Muscle weighs more than fat. So you may find that clothes become

looser even if you don’t lose weight.

ϒ Get plenty of rest. Staying up late can lead to unhealthy late night snacks.

Eating tips for the new non-smoker

Because you may eat more when you quit, it

eat healthy foods. It is important to have sm

portions to avoid eating too much.

ϒ Stay away from sweets and high-calorie foods. But d

cut back on eating to lose weight. Craving both foo

and cigarettes is tough to handle.

ϒ Have healthy, low-calorie foods on hand if you

like to snack. Try fresh fruits and vegetables,

yogurt, or air-popped popcorn without butter.

ϒ Bring a healthy lunch and snacks to work. This

can help you eat well and save money.

ϒ Chew sugarfree gum or suck on sugarfree

candy if you crave sweets.

ϒ Drink water before your meals and between

meals. Drinking plenty of water is healthy for

everyone. It can also keep you from over-eating

and give you something to do instead of smoking a

cigarette. NOTE: If you are on fluid restrictions,

please check with your doctor.

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Staying Tobacco Free

It doesn’t matter how old you are or how long you’ve smoked. You become healthier

and stronger each day you are tobacco-free.

Take time to praise the GOOD things you did this week…remember positive thinking!

Do not let slips keep you from quitting. Learn from slips and move on.

You may find that quitting smoking has helped you to:

ϒ Eat healthier.

ϒ Exercise more.

ϒ Save money.

ϒ Feel better about yourself and your health.

ϒ Set a good example for your family and friends.

Enjoy these healthy changes! You worked hard to get here!

Reflect on the benefits of quitting smoking

List at least four things that have improved personally, at work, or at home, since you have stopped smoking.

1. ________________________________________________________________________________________

2. ________________________________________________________________________________________

3. ________________________________________________________________________________________

4. ________________________________________________________________________________________

What is your reward for quitting smoking?

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

Reflect on your new coping skills

What skills have you learned that you feel will help YOU prevent relapse? What is working for you?

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

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Additional Resources

American Cancer Society

American Lung Association

Use the space below to note other resources you discuss with your Health Coach.

_________________________________________________________________________________________

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_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

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This program will give you the tools that you need to succeed.

Member’s Name: ____________________________________________________________________________

Health Coach’s Name:________________________________________________________________________

Health Coach’s Telephone Number: __________________________________________________________

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ϒ Drinking coffee, wine, or beer.

ϒ Talking on the phone.

Getting Started

Why is quitting so hard?

Nicotine is in all tobacco products. It can make you feel calm and satisfied. It can also make you feel more alert and

focused. The more you smoke or chew tobacco, the more nicotine you need to feel good. Soon, you don’t feel

“normal” without nicotine. This is called nicotine addiction.

Quitting is also hard because smoking or chewing is a big part of your life. You might smoke when you are stressed,

bored, or angry. You may light up or chew when you feel a certain way or do certain things, such as:

ϒ Driving.

ϒ Being with other smokers.

ϒ Lung cancer.

ϒ Heart disease.

ϒ Stroke.

ϒ Chronic bronchitis.

ϒ Emphysema.

ϒ At least 13 other kinds of cancer.

By quitting you’ll also keep dangerous second-hand smoke away from your loved ones. And you’ll be saving money

by not buying cigarettes. Beating an addiction to nicotine takes a lot of determination.

Tobacco use

is the leading cause of preventable death in

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the United States. Smoking-related diseases claim an estimated

438,000 American lives each year, or about 1 out of every 5

deaths each year.

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ϒ Where you keep your cigarettes or chew.

ϒ In your wallet or purse.

ϒ In the kitchen.

ϒ In your car.

ϒ On your bathroom mirror.

Before you reach for a cigarette, review your list. It will remind you

of all the reasons you have for why you want to stop smoking.

Reasons why I want to quit.

NE

VER

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ϒ

ϒ

ϒ

ϒ

ϒ

ϒ

Stay away from places where smoking is allowed. Sit in the non-smoking section at restaurants.

Keep your hands busy. Hold a pencil or paper clip. Carry a water bottle. Draw or write a letter.

Stay away from people who smoke when you are going through the quitting process.

Spend time with non-smoking friends.

Keep a rubber band around your wrist.

Chew sugarfree gum. Snack on a carrot or celery stick. Keep your mouth

and hands busy with a toothpick, sugarfree lollipop, or straw.

Drink less or stay away from alcohol. Drinking alcohol often makes people

want to smoke. Drink juice, soda, or ice water instead.

Remember:

The urge to smoke

usually lasts for

about four to six

minutes. Try to

wait it out.

9

Creating Your Quit Plan

Quitting smoking and chew is hard, especially during the first few weeks.

Prepare for challenges

You may be more tempted to smoke or chew when you are stressed or sad. To prepare yourself for these times

before they happen, try to:

ϒ Look over your pack track (page 17). See when you may be tempted to smoke.

ϒ Plan for how to deal with the urge before it hits.

Dealing with withdrawal

Nicotine leaves your body within three days. Your body then starts to repair itself. At first, you may feel worse

instead of better. Withdrawal feelings can be hard. But they are a sign that your body is healing. Remember, these

feelings will go away in time.

Common feelings of smoking withdrawal include:

Stress and the Withdrawal Cycle

You should also expect feelings of withdrawal.

Withdrawal is the feeling of discomfort when

you give up nicotine. It is your body’s way of

telling you it’s learning to be smoke-free.

ϒ Feeling depressed.

ϒ Not being able to sleep.

ϒ Getting cranky, frustrated, or mad.

ϒ Feeling worried, nervous, or restless.

ϒ Having trouble thinking clearly.

ϒ Feeling hungry or gaining weight.

My Quit Plan

5 STEPS ACTION TO TAKE MY PLAN

1

2

3

4

5

Get ready

Get support

Learn

new skills

and tips

Get medicine

and use it

correctly

Be prepared

Set a quit date and stick to it

—not even a single puff!

Think about past quit

attempts. What worked and

what did not?

Tell your family, friends, and

co-workers you are quitting.

Talk to your doctor or other

health care provider.

Get group, personal, or

telephone coaching.

When you first try to quit,

change your routine.

Find ways to reduce stress.

Keep busy to fight the urge

to smoke.

Drink a lot of water and

other fluids.

Talk with your doctor about

which medicine may work

best for you.

Make a plan for doing things

that will distract you

from smoking.

Stay away from alcohol and

caffeine or sugar if they are

triggers.

⎫

⎫

⎫

⎫

⎫

⎫

⎫

⎫

⎫

⎫

⎫

⎫

ϒ If you must be somewhere you’ll be tempted to

smoke, for example at a party or in a bar, try to be

near non-smokers.

Plan to reward yourself

ϒ You will save money by becoming tobacco-free. Is

there something you’d like to buy for yourself or

someone else? Figure out what these things cost.

Then start putting aside “cigarette money” to buy

some of them.

ϒ Buy yourself something special today to celebrate.

Or go to a movie. Be careful with food treats. You

need less food when you don’t smoke. This is true

no matter how much you want to put something in

your mouth.

When you really crave tobacco

Remember: the urge to smoke usually lasts only four to

six minutes. Try to wait it out. Or look at the plan you

made. You wrote down steps to take at a time like this.

Try them! Try these ideas:

ϒ Learn to relax. Take 10 slow, deep breaths and hold

the last one. Then breathe out slowly. Relax all your

muscles. Picture a soothing, pleasant scene. Think

only about that peaceful image and nothing else.

ϒ Light a candle or incense instead of a cigarette.

ϒ Where you are and what is going on can make you

crave a cigarette. A change of scene can really help.

Go outside, or go to a different room. You can also

try changing what you are doing.

ϒ No matter what, don’t think, “just one won’t hurt.”

ϒ Remember: trying something to beat the urge is

always better than trying nothing.

N

P

Remember

NOPE: Not One

Puff Ever.

OT

O

UFF

E

NE

VER

Ask your doctor, pharmacist, or Health Coach if nicotine

gum, the patch, or some other kind of NRT is right for you.

These medicines can cause side effects in some people.

These medicines are not right for:

ϒ People who have had a heart attack in the last four weeks.

ϒ People who have high blood pressure not controlled by medication.

Other health conditions also need to be considered before beginning

NRT, so be sure to talk to someone first.

Read the instructions that come with the NRT. Talk to your doctor

or pharmacist if you have any questions.

It is important that you

talk to your doctor,

pharmacist, or Health

Coach before using nicotine

replacement therapy or

taking any medicines to

help you quit tobacco.

Nicotine Replacement Therapy

Thinking about using the patch or nicotine gum to help you quit?

Using nicotine patches, gum, inhalers, lozenges, or nasal sprays to help you quit tobacco is called nicotine

replacement therapy (NRT).

What you should know about Nicotine and NRT (nicotine patches, gum, inhalers, lozenges, and nasal sprays)

Nicotine gum, patches, inhalers, sprays, and lozenges are called nicotine replacement therapy (NRT). That’s because

they take the place of nicotine from cigarettes. NRT can help with withdrawal and lessen your urge to smoke. You

need a prescription to buy the inhaler and nasal spray. But you can buy nicotine gum, nicotine patches, and nicotine

lozenges over-the-counter (OTC) without a prescription.

The nicotine in cigarettes and NRT is the same, but the speed that nicotine enters your body

is different.

ϒ A cigarette sends nicotine to the brain quickly and in high

doses. Nicotine gum, patches, and lozenges send nicotine

more slowly and in smaller amounts. This helps to reduce

withdrawal and cravings while quitting. This helps train

the brain to live with less and less nicotine, and then

eventually with none.

ϒ Nicotine gum, patches, and lozenges are proven to reduce

withdrawal symptoms and cravings while quitting.

ϒ The patch and nicotine gum are not more addictive than

cigarettes.

One nicotine patch can contain 21 mg

of nicotine or less. A pack of cigarettes

can contain up to 45 mg of nicotine.*

*Based on a pack of 20 regular cigarettes.

Source: The Massachusetts Tobacco Control Program, Massachusetts

Department of Public Health Change in Nicotine Yields 1998 – 2004 Report.

Nicotine replacement products do not increase the risk of cancer and heart disease.

ϒ More than 20 years of research shows that NRT does not increase the risk of cancer or heart disease.

ϒ More than 110 studies have shown NRT to be safe, even in people with ongoing health conditions, such as

diabetes, high blood pressure, lung disease, and heart disease.

Medicines that help with withdrawal

When you quit smoking, you may feel strange at first. It is

normal to feel dull or tense, and not yourself. These are

signs that your body is getting used to life without nicotine.

It usually only lasts for a few weeks.

Most people slip up in the first week after quitting. This is

when feelings of withdrawal are strongest. There are

medicines that can help with feelings of withdrawal;

examples are shown in the table to the right. This is not a

complete list of products nor does it endorse any

brand or product.

MEDICINE EXAMPLE

Bupropion SR pills Zyban®, Wellbutrin®

Varenicline Tartrate pills Chantix™

Nicotine gum Nicorette®, Nicotrol®

Nicotine inhaler Nicotrol®

Nicotine lozenge Commit™

Nicotine nasal spray Nicotrol®

Nicotine patch Nicoderm®

Cigarette

#

Time of Day Activity Feeling

Eating, Drinking, Relaxing, Working, Socializing, Angry, Anxious, Bored, Depressed, Frustrated,

Driving, or other (specify) Happy, Relaxed, Tired, or other (specify)

Level of Need Rating

1=VERY IMPORTANT

2=IMPORTANT

3=LEAST IMPORTANT

17

The instant rewards of quitting

(source: American Lung Association)

At 20 minutes after quitting:

List your own rewards and successes since quitting. Remember your reasons for quitting.

________________________________________________________________________________________

________________________________________________________________________________________

Support to help you stay tobacco-free

Getting support can help you make the lifestyle changes you need to make to stay tobacco-free. Here are a few

resources that can help.

Telephone Resources:

National Cancer Institute Smoking Quitline:

1-877-44U-QUIT (1-877-448-7848)

:

1-800-QUITNOW (1-800-784-8669)

18

Online Resources:

Freedom From Smoking® Online Program and additional resources

from the American Lung Association:

American Cancer Society: find a Quitline and local support

resources:

:

At 48 hours:

Nerve endings start re-growing.

Senses of smell and taste improve.

⎫

⎫

Blood pressure decreases.

Pulse rate slows down.

Body temperature of hands and feet increases.

⎫

⎫

⎫

At 2 weeks to 3 months:

Blood circulation improves.

Walking becomes easier.

Lung function increases.

⎫

⎫

⎫

At 8 hours:

Carbon monoxide level in blood drops to normal.

Oxygen level in blood increases to normal.

⎫

⎫

At 1 year:

Risk of heart disease is decreased to half that

of a smoker.

⎫

At 24 hours:

Chance of heart attack decreases.

⎫

At 5 to 15 years:

Stroke risk is reduced to that of people who

have never smoked.

⎫

N

P

Your body has changed since you began to smoke. Certain places, people, or events can

trigger a strong urge to smoke, even years after quitting. Think of the word NOPE: Not

One Puff Ever.

At first, you may not be able to do things as well as when you were smoking. Don’t worry.

This won’t last long. Your mind and body just need to get used to being without nicotine.

After you have quit, the urge to smoke often hits at the same times. For many people, the

hardest place to resist the urge is at home. And many urges hit when someone else is

smoking nearby.

OT

O

UFF

E

NE

VER

Look at your pack track (page 17) to see when you might be tempted. Then use the skills you’ve learned to get

through your urges without smoking.

19

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