No Smoking Day: How to give up cigarettes (for the last time)

There are one billion smokers in the world and about 10 million in the UK. Once smokers pass the age of around 30, smoking will take an average of 5-6 hours off their life for every day they carry on. And that is healthy life, not life in old age – smokers spend at least as long as non-smokers with diseases of old age – they just do it when they are younger.

Half of smokers report that they don’t even enjoy it. And in the UK it costs the average smoker about £25 per week. So it’s not surprising that most smokers want to stop and four out of five have tried, usually many times. But they are still smoking.

Some people think stopping smoking should be as easy as clenching your fist, so if smokers don’t stop it’s because they don’t ‘really’ want to. But the brain does not work like that – there is no ‘I’ that controls everything we do.

There is our ‘human brain’ which decides what we should do and our ‘animal brain’ which experiences wants, needs and impulses. Our human and animal brains are both very much ‘us’. The human brain does not get to control what we do – it has somehow to get the animal brain to want or need to it more than whatever else might be on offer.

The reason that intentions to stop smoking so often come unstuck is that nicotine from cigarettes trains our ‘animal brain’ to want or need to smoke to such an extent that it overwhelms and subverts the instruction from the ‘human brain’ which is saying ‘don’t’.

Stopping smoking is like grabbing a tiger by the tail and then trying to hold on for dear life – until it settles down and starts to purr! Almost from the moment you implement the decision to stop smoking, and the nicotine concentrations in your brain start to take a nose dive – which they will do within an hour or two – you will start to experience urges to smoke; these will spike in situations or at times when you would normally smoke. You have to find a way to hold on no matter what.

Here’s my interpretation of what decades of scientific research has discovered about how to get that tiger under control:

It’s best not to try to cut down before stopping – just get yourself ready then grab that tail as tightly as you can when the moment comes.

Once the quit attempt has started, do everything possible to avoid any slips but if you have a slip, don’t be hard on yourself or let go completely – grab on even tighter.

Be prepared to feel angry, restless, hungry, unable to concentrate, and depressed. These are common nicotine withdrawal symptoms. They will pass in a few weeks and you can control them by using one of the nicotine products available. You will probably gain weight and find it hard to shift. Don’t worry about it for the time being, but it will help to do more physical activity (which also reduces cigarette cravings).

Start thinking like a non-smoker. You don’t feel like smoking in the supermarket because smoking is not an option – make your life that supermarket.

Stay away from temptation – don’t get the tiger riled or excited! If you can keep away from situations that trigger cravings for a while it can make all the difference. Actively plan things to do instead of smoking during breaks or after meals. Probably the highest risk comes from other smokers. Just seeing other people smoke kindles all those suppressed desires. I strongly suggest you minimise contact with people who are smoking and have your script ready for when they offer you a cigarette.

We know that the smoke from roll-ups is at least as dangerous as the smoke from manufactured cigarettes. Smoking any form of tobacco is deadly. In a way, roll-ups are more dangerous than manufactured cigarettes – simply because they are so much cheaper.

Reduce the cravings by taking Champix, or using ‘dual form’ nicotine replacement therapy (NRT). Dual form means a transdermal patch plus one of the other products such as gum, lozenge, nasal spray, mouth spray or inhalator. I recommend dual form NRT because there is very strong evidence that this gives better results than using one form of NRT by itself. You can get both Champix and NRT on prescription, or with the NRT you can buy it from a shop.

If you want to try an electronic cigarette that is fine – we know less about them than other nicotine products but they clearly do help some people to stop smoking and they are the most popular method of stopping these days. Whatever you do, make sure you follow the instructions and use enough – that is the classic mistake that most smokers make. With NRT, if you are still experiencing cravings, you are not using enough – do not be afraid to increase the dose to whatever you need.

If it doesn’t work out this time – don’t worry – there’s a huge amount of luck involved. Take a break and then then have another go when you next feel ready.

Robert West is Professor of Health Psychology and Director of the Tobacco and Alcohol Research Group at University College London and author of ‘How to Stop Smoking: The Ultimate SmokeFree Formula’ Twitter: @robertjwest