The Stages of Quitting Smoking

Strategies to help smokers quit.

The most popular methods of quitting.

More than 1 million people each year decide to quit smoking. When they do, they often quit and quit and quit. As the saying goes, "Quitting smoking is easy. I've done it hundreds of times."

The Centers for Disease Control and Prevention reported that Americans are trying to kick the habit four times more often than before the advent of nicotine gum, nicotine patches and other products became available to help people quit.

• 48% - Nicotine Gum
• 28% - Nicotine Patch
• 21% - Zyban
• Less than 3% - Inhalers and Sprays

Surveys also show that 70 percent to 80 percent of the 48 million adults who smoke want to quit, but 80 percent are not prepared to quit. Even when they are, studies show it often takes them several attempts to quit. Like breaking up, quitting is hard to do.

Getting ready to quit smoking.

"It used to be, you had to hit bottom or have a crisis to be motivated to quit," says James Prochaska, Ph.D., director of the Cancer Prevention Research Center at the University of Rhode Island and co-author of Changing for Good.

Now smokers don't have to wait to have a heart attack to motivate them to kick their habit. Warnings about tobacco's hazards are everywhere, including on the side of a cigarette pack. Still, many smokers need help moving from thinking about quitting to breaking their addiction to that very powerful drug - nicotine.

Quitting smoking is a gradual process, according to Prochaska, who spent 15 years studying thousands of people before he and two other psychologists, John C. Norcross and Carlo C. DiClemente, the other co-authors of Changing for Good, came up with a now-famous behavior model, The Stages of Change. The stage model, which is detailed in the book, is widely recognized by smoking cessation experts.

The Six Stages of Change are used to help people change unhealthy behaviors by moving step-by-step from zero - before they are even thinking about losing weight or quitting drinking or smoking - to thinking about it, acting on it, reaching their goal and avoiding the temptation to slide back to their unhealthy habit.

The journey toward quitting.

The 6 stages of change are:

1. Pre-contemplation:

Smokers "in denial" may not see health advice even applying to them. For a physician or a smoking cessation program, the goal at this point is to get smokers to think about changing and personalizing their risk factors.

2. Contemplation:

Smokers are thinking about the barriers to quitting, such as fear and not wanting to give up something they enjoy. But they also are thinking about the benefits of quitting.

3. Preparation:

This is when smokers prepare to quit. They may switch to a different brand of cigarettes or try to cut back. Now is the time to develop a personalized quit plan, which involves setting a date to quit. The smoker's mindset is crucial. A sense of commitment is essential to his or her success.

4. Action:

This is the point where people work the hardest, Prochaska says. There is no one right way to quit. Most smokers prefer to quit "cold turkey" - that is, abruptly and totally, according to the American Cancer Society. However, that's not always possible for many. You can try tapering and fading, gradually reducing the number or cigarettes smoked each day and, thus, gradually reducing the amount of nicotine in your body. Some smokers need a nicotine substitute, such as the nicotine patch, gum, spray or inhaler, or the nicotine-free pill, such as Zyban®, a prescription antidepressant designed to reduce symptoms of nicotine withdrawal. Varenicline (Chantix®), recently approved by the FDA, reduces the severity of nicotine cravings and the intensity of withdrawal symptoms. Varenicline is normally taken for 12 weeks. Patients who quit during that time can continue therapy for an additional 12 weeks to increase their chances of remaining tobacco-free.

Prochaska says he believes it's much better to give people three good choices or options in quitting. "If they have only one choice, such as going cold turkey, then that can be a problem. They won't be as committed," he says.

5. Maintenance:

At this point, people work to prevent relapse, which is extremely common. The maintenance phase can last months or years. Smokers need to keep reminding themselves why they quit.

6. Termination:

People who quit for good usually still have to fight the temptation to smoke again. Prochaska says only about 20 percent of smokers who have quit in the past five years report no temptations.

The good news, though, is that as long as people move through the process, they are changing, Prochaska says. What should come as further encouragement to smokers is a finding by the U.S. Department of Health and Human Services that 90 percent of successful quitters have done it themselves through a self-help strategy, rather than a formal smoking cessation program.

External Sources

• The Centers for Disease Control and Prevention
• The Agency for Health Care Research and Quality
• The American Cancer Society

Article source:HealthAtoZ