More people may have started smoking thanks to the social isolation and heightened anxiety of the COVID-19 era. It's certainly harder now for those who want to kick the habit.
But there is strength in numbers. The Great American Smokeout hosted by the American Cancer Society encourages smokers to quit for just one day — and then try to stay smoke-free, one day at a time, with others pursuing the same goals.
As a thoracic medical oncologist at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, I’ve seen many patients who suffer serious consequences from smoking. It’s the leading cause of cancer death in the United States. There are 1.4 billion people who smoke around the world, and almost half of them will die early of cancer and other smoking-related diseases.
Nicotine addiction is not only one of the deadliest but one of the strongest that a person can have, making it extremely hard to quit for the estimated 34 million adults who smoke.
But as hard as it is to stop smoking, the immediate and long-term health benefits of becoming smoke-free cannot be overstated. Within 20 minutes without a cigarette, elevated heart rates and blood pressures drop. After 12 hours, the carbon monoxide level in the bloodstream drops to normal. In two to 12 weeks, circulation improves, and lung function increases. Most astoundingly, the risk of coronary heart disease is cut in half just one year after quitting, and after 15 years, it becomes the same as that of a nonsmoker. Five to 15 years after quitting, the risk of stroke drops to a nonsmoker’s level, and the risk of dying of lung cancer halves within 10 years of living smoke-free.
Most people who smoke have tried to quit at some point. A history of trying but not succeeding can make it harder to imagine quitting for good. For many, it may take 30 or more quit attempts to succeed. If you relapse on a try, it’s OK. With every effort, what worked and what didn’t work can be assessed and then used to tailor a better smoking-cessation program for next time.
So, how can those who want to quit give it their best try?
First, people who smoke should remember that they don’t have to quit alone. When you want to smoke, text or call a friend instead. Help can also be found in programs such as Freedom From Smoking, support groups, telehealth counseling, quit-smoking apps, in-person counseling, or the ACS’s Guide To Quitting.
Second, cravings are real, but they don’t have to be in control. According to the American Lung Association, the urge to smoke will pass within three to five minutes, regardless of a cigarette. Thus, when a craving comes on, it’s best to do something that distracts from the urge. And this is one instance in which nicotine-replacement therapy (lozenges or gum) could help. Track your triggers and use these aids just before the triggers come. Some people like to go for a short walk around the block or drink a glass of water.
Some consider e-cigarettes, or "vapes," to be a safe alternative, but we do not fully understand the effects of inhaling aerosolized e-cig liquids. And it remains unclear how well they actually work. Instead, consider first nicotine gum or nicotine lozenges, which satisfy the need for oral fixation while weaning off nicotine dependence. Using sugar-free gum when a cigarette craving comes may help, too. Gum chewing also allows a person to stimulate the oral muscles habituated to smoking and is proven to reduce anxiety and stress.
Some people are successful with nicotine patches or medications their doctor can prescribe, along with counseling. People who smoke need to try one or all to figure out what works for them, sometimes in combination.
The good news is that smoking is in decline, and there are millions of success stories. If you’re thinking of quitting, the Great American Smokeout could inspire you to take that first step — and remind you that you are not alone.
Dr. Peter Shields is a thoracic medical oncologist who focuses on the treatment of lung cancer at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. He also is the deputy director of the OSUCCC.