November 18, 2015

Quitting smoking: cutting down smoking vs cold turkey


Learn how to wean off smoking cigarettes to live a healthier life


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. Is it better to quit smoking cold turkey or gradually?

There’s some dramatic appeal to quitting cold turkey — going from your usual cigarette consumption to no nicotine at all. 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 weaning off 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 tapering off cigarettes. 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



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.

21 thoughts on “Quitting smoking: cutting down smoking vs cold turkey”

  1. Judy Akers says:

    I quit cold Turkey, been almost 2 years, I would never do do that again, I went thru the worst 2 years stayed sick , blood pressure went out of whack, finally getting straightened out a little, If I ever decided to start smoking again, which I never think I would, Id never quit it the next time, cause I wouldnt go thru that again for nothing.

    1. Cynthia Manley says:

      Good for you quitting and staying quit. I am sorry you had such a rough time of it. Nicotine addiction is strong and seeking help if they need it. Best wishes for a continued smoke-free life!

    2. Judy Akers says:

      Im still Smoke free , will be three years in August, Quitting cold turkey was very hard , Don’t Plan on ever picking up one again!! I dont think no more, lol!

    3. Tammy Mathews Burkett says:

      I’m going on my 6th day and my blood pressure is going crazy! You’d think it’d get better by putting the ciggeretes down! So proud y’all for quitting!! I keep telling myself I’m a non smoker..

  2. BRENDA says:

    I smoked from age 12, yes I said 12, stopped when I got pregnant, start right back. When the price started rising my son quit. I was proud of him but continued to smoke. I had quit working and was depending on him to buy them. So he announces one day. Momma I quit cause they were getting too high to buy, so i won’t be buying you anymore. Needless to say I was a little upset but couldn’t argue with him. I was ill going through withdrawals. Probably was the best way for me to quit. I had been a smoker for 30 plus years. My point is it can be achieved regardless if the method you choose. It takes a LOT, I mean a LOT of willpower and praying. Good luck to all!!!!!!

    1. Linda Zettler says:

      Thank you for sharing your story, Brenda, and congrats to you — and your son – for kicking the habit!

  3. Kimmie Williams says:

    I quit cold turkey and did just fine I wasn’t a nice person to be around and gained 25 I lbs but I’ll take that over smoking any day it is possible to quit cold turkey with no side effects..Dec 4 will be 3 years for me

    1. Linda Zettler says:

      Congratulations on your upcoming third anniversary of being smoke-free, Kimmie!

  4. Brenda says:

    I also quit cold turkey, I think it’s the way to go. I tried “weening” many times…but it seems it always ends up circling back around…my vote is cold turkey – 7 years clean!

    1. Maura Ammenheuser says:

      Congratulations on being tobacco-free for so long! That’s fantastic.

  5. gingersharp says:

    I quit smoking cold turkey 28 days ago. Some days are better than others. This is my second time to quit. I really want this time be the last time I go through this. I tell myself when I have a strong urge to smoke to give it a few minutes and it will go away. Also, I tell myself, “I do not smoke. I am a non-smoker”. I have smoked for many years and know I have to quit for my health. I also try to focus on how bad cigarettes are for me, when I feel the strongest urges to smoke.

  6. Melissa says:

    Where do you find counseling? My fiancé is a heavy smoker. I’d like to see him quit. I know that’s a decision he has to make. But I’d love to help him when/if he quits.

    1. Maura Ammenheuser says:

      Hi, Melissa. Great question. Your best bet is calling the Tennessee Tobacco Quitline, at 1-800-QUIT-NOW. Here’s their info online: They’ve got details on that website about the services they offer, but yes, counseling is a big part of it. We wish your fiancé well.

  7. Barbara Hackett says:

    I smoked for many years. I quit cold turkey and have been smoke free for 14 years. I tried many different smoke aides
    and nothing worked until I made a decision that I would never buy a pack of cigarettes again. It took making that decision and a pact with my self that did it. Best thing I ever did for myself. I’m not even tempted to have a cigarette.
    Most people I know quit successfully by going cold turkey.

    1. Maura Ammenheuser says:

      Congratulations on remaining smoke-free for so long. Quitting smoking is a big accomplishment. Thank you for proving to others that even though it’s challenging, it can be done.

  8. Thomas says:

    Congratulations on remaining smoke-free for so long everybody !
    it looks like almost every body went cold turkey and with success ,

  9. Sohana Jesy says:

    this is a really awesome post. i have more benefited from your website. thank you so much for this necessary information

  10. Drew says:

    My wife started quitting two days ago. She is doing the cutting back method. 1/4 cigarette in the morning and 1/4 cigarette in the evening. I clip the cigarettes my self. She also takes Wellbutrin to help with anxiety. She has said her cravings are less of a problem to deal with on Wellbutrin.

    1. Maura Ammenheuser says:

      That’s great that she is making progress. We wish her well!

  11. Alichael says:

    I keep hearing how difficult it is when quitting cold turkey, that people can feel pretty rough physically for up to an entire month after their last smoke, and still fight cravings for another several months after that. That’s why I’m going to taper off gradually. In spite of the difficulty it still may be, I’m totally freaked out about lung cancer, dealing with a disease where you have trouble breathing and that the only way out of that is horrible chemotherapy, and even then the chances of being cured are less than 50℅, not the way I want to go (since I’m much more afraid of the suffering part than the dying part. I’m not as scared of dying if it’ll be quick and painless, but lung cancer is definitely not quick or painless).

    Anyway, this is how I plan on tapering off: instead of measuring by cigarettes, I’m going to measure by puffs. Right now, I take more than 3 puffs everytime I smoke. So this is how I’ll do it: (week 1) 3 puffs per smoke every 2 hours for a week, (week 2) 3 puffs every 3 hours for half a week, 3 puffs every 4 hours for half a week, (week 3) 2 puffs every 4 hours for half a week, 2 puffs every 5 hours for half a week, (week 4) 2 puffs every 6 hours for half a week, 2 puffs when I wake up in morning and 2 puffs before bed for half a week plus 2 more days. Then, it will officially be 30 days since I started my taper off program. Then for the next 30 days, I will chew nicotine gum and gradually lessen the amount of that over the next 30 days. So, 60 days later, I will be free of all nicotine permanently. I feel that I will cut down on a lot of discomfort and irritability by doing this 2 month quitting program. And then, hopefully, I’ll have saved myself from lung cancer, fingers crossed

  12. Alichael says:

    When I mentioned that my first week of my quitting program, I would take 3 puffs every 2 hours for that week, I forgot to mention how much I smoke now. I smoke somewhere between 4 and 6 puffs every 1 to 2 hours now, so switching to 3 puffs every 2 hours will be my first step forward.

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