Quitting smoking: Cold turkey vs. cutting back
Which is the better strategy to quit cigarettes?
If you’ve decided to quit smoking, congratulations! This is the single best thing you can do to safeguard your health.
Now the question is how to go about breaking your nicotine addiction. Some people quit “cold turkey” – going from their usual cigarette consumption to no nicotine at all.
There’s some dramatic appeal to that strategy, and it may seem like a faster way to becoming smoke-free than gradually weaning yourself off cigarettes.
But going cold turkey is harder, and you may be less likely to achieve your goal, says Hilary Tindle, M.D., a physician scientist and founding director of the Vanderbilt Center for Tobacco, Addictions and Lifestyle.
Yes, some people quit smoking this way, so it’s not impossible. But “our first recommendation is not cold turkey,” Tindle said. Studies have found that people are two to three times more likely to be smoke-free a year after their quit date with a combination of counseling and medications, compared with those who don’t use those tools.
Many people find that the easiest (or perhaps the least difficult) way to quit is to gradually cut back on their daily cigarettes while using nicotine replacement medications and some kind of counseling or support group.
The most common of these medications are nicotine replacement products, including over-the-counter ones such as the patch, gum and lozenges. There are prescription medications designed to help people quit, too; ask your doctor about these.
Inhaled through a cigarette, nicotine is addictive. Not so with the nicotine replacement products, which deliver nicotine safely. When smokers stop smoking, they typically feel the symptoms of nicotine withdrawal: irritability, anxiety, depression, increased appetite and more. The patch, gum or lozenges contain smaller amounts of nicotine than cigarettes. They take the edge off withdrawal symptoms and make it easier to deal with cravings.
The traditional way to quit is to choose a quit date and stick to it. Your quit date can be the start of your efforts to quit, the day you stop smoking cigarettes completely or start cutting back on the number of them you smoke each day. Either way, you’ll probably do better using nicotine replacement starting on your quit date rather than trying this without the patch, gum or lozenges. They’ll soften your withdrawal symptoms. Nicotine replacement is typically used for two to three months, with the nicotine dose gradually decreasing over that time.
Another tactic is to gradually cut back, called the “cut down to quit” method. Using this strategy, you cut down on the number of cigarettes smoked each day for a certain period of time before your quit date, and use only nicotine replacement – no cigarettes – from the quit date on.
More and more research shows that the patch, gum and lozenges can be used safely while you are still smoking (but are cutting back). However, going this route should be done with the help of your doctor or health care provider.
Nicotine replacement, plus counseling or a support group, together give you your best chances of quitting. But perseverance is important, too! The average smoker tries to quit five times before finally breaking a nicotine addiction. So if you give in to the urge to smoke a cigarette a few days or weeks into your quit attempt, forgive yourself, and keep trying.
And if going cold turkey, especially without meds, is not going well, “give yourself a break,” Tindle advises. “Use the tools available.”
To work with a counselor to help you create a plan for quitting, call the Tennessee Tobacco Quitline, 1-800-784-8669, or use it online at tnquitline.org
Those at highest risk for lung cancer are ages 55 to 74; and current or former smokers with 30 or more pack years. See if lung cancer screenings are right for you.