For Smokers Who Want to Quit

For Smokers Who
Want to Quit
One Step at a Time
One Step at a Time
print materials
Booklet 1
(this booklet)
For Smokers Who Want to Quit
This booklet is for smokers who have
decided that they want to quit smoking.
Booklet 2
For Smokers Who Don’t Want to Quit
This booklet is for smokers who don’t want
to quit smoking. It won’t tell them to quit
but instead it will help them to better
understand their relationship with smoking.
Booklet 3
Help a Smoker Quit
This booklet is for friends and family
who want to help a smoker quit.
One Step at a Time booklets can be ordered by phone or
downloaded from the Canadian Cancer Society’s website at
cancer.ca/OneStepAtATime.
For more information, contact the Canadian Cancer Society.
1-888-939-3333 | info@cis.cancer.ca | cancer.ca
Facebook.com/CanadianCancerSociety
Twitter.com/CancerSociety
Acknowledgments
Based on a booklet written by Paul McDonald, PhD,
Thelma Maxwell, RN, BN, and Kelli-an Lawrance, PhD.
Photographs: © iStock images
Licensed material is for illustrative purposes only; persons depicted are models.
Introduction Scientific
and medical
research
indicates
that people
who use
and follow
a booklet
like this
smoking
than those
who try to
quit on
their own.
Worksheets
in quitting
Chapter 4 – Staying smoke-free
successful
Your
booklet
includes
Chapter 3 – Ready to quit
to be
Chapter 2 – Preparing to quit
more likely
This booklet has information, activities and tools
to help guide you through the process of quitting
and support you in reaching your goal of
becoming smoke-free. Take it at your own pace
and remember that you’re doing this for you.
Chapter 1 – Thinking about quitting
one are
Welcome! If you are a smoker who is thinking
about quitting or if you are ready to quit smoking,
this booklet is for you. Quitting smoking is the
single best thing you can do for your health. By
picking up this booklet, you are taking the first
step to making a healthy change in your life.
© Canadian Cancer Society 2013
i
Table of contents
Reconsider the costs of smoking
Consider the benefits of quitting
Decide if you are ready
Quit aids
Common questions about quit aids
Tips for quitting
Tip 1: List your triggers
Tip 2: Practise positive self-talk
Tip 3: Build your support system
Tip 4: Write down your reasons for quitting
Tip 5: Set a quit date
Prepare for your quit date
Write out a quit plan
What to expect from withdrawal symptoms
Cope with withdrawal symptoms
Manage cravings with the 4 Ds
Make some changes
Stay fit and healthy
Milestones and rewards
29
30
32
34
36
37
38
40
Deal with a slip
Deal with a relapse
Get ready to quit again
Live a smoke-free life
For more information
43
44
46
47
48
50
51
Worksheets:Write down your reasons for quitting
Set a quit date
Quit plan diary
Write out a quit plan
Milestones
54
54
55
59
60
© Canadian Cancer Society 2013
Chapter 4
Chapter 4: Staying smoke-free
Manage stress – Using the 3 A’s
21
22
23
24
25
26
27
Chapter 3
Chapter 3: Ready to quit
On your quit day
9
10
12
18
Chapter 2
Chapter 2: Preparing to quit
Understand your options
1
2
3
5
7
Chapter 1
Chapter 1: Thinking about quitting
Weigh your pros and cons
iii
Chapter 1 – Thinking about quitting
Thinking about quitting
In this chapter:
Remember,
• a look at your pros and cons of smoking
you deserve
• the costs of smoking
a healthy and
smoke-free
life.
• the benefits of quitting
• decide if you are ready
© Canadian Cancer Society 2013
1
Chapter 1 – Thinking about quitting
Weigh your
pros and cons Think about what benefits you get from smoking
and about some of the not-so-good things. What
does smoking mean to you? Since you’re reading
this booklet, you probably have a love/hate
relationship with smoking. This is an opportunity
for you to see which side of that relationship
is stronger.
Pros of smoking
Cons of smoking
Do you have more cons? You can see that
smoking is doing more harm than good in your
life. It’s time to move forward and take that next
step. Keep reading and remember your cons!
Do you have more pros? There are still some
aspects of smoking that are important to you.
You see some benefits to quitting, but right now,
they may not outweigh your reasons to keep
smoking. Keep reading but come back to this
list before you make a final decision.
Were your lists equal? You see some good and
some bad things that come with smoking but
you’re still on the fence about which side is right
for you. Keep an open mind as you continue
through the booklet and complete the activities.
2
For Smokers Who Want to Quit – One Step at a Time
Chapter
1 – Thinking
about quitting
Chapter
1
Reconsider the costs
of smoking You probably already know that smoking isn’t
good for your health, but you may not be aware of
all of the damaging effects. Here are some costs
to think about:
• In Canada, it’s estimated that smoking causes 30% of all cancer deaths. It’s the main cause
of lung cancer, related to more than 85%
of cases.
• Unless they quit, up to half of all smokers will
die from smoking-related illnesses, most of them losing 8 to 10 years of life compared to
someone who has never smoked.
• Women who smoke have a higher risk of
developing breast cancer.
• Men who smoke are twice as likely to suffer from erectile dysfunction.
• Exposure to second-hand smoke increases
children’s risk of sudden infant death syndrome
(SIDS), acute respiratory infections and severe
asthma.
• Cats, dogs and birds living in homes of smokers are at risk of developing cancer and other
respiratory illnesses.
• At least 4.5 trillion non-biodegradable filter-
tipped cigarettes are deposited annually around the world. Cigarette butts rank at the very top of litter problems.
© Canadian Cancer Society 2013
3
Chapter 1 – Thinking about quitting
And those aren’t the only costs. Have you
ever thought about how much smoking has
cost you financially?
=
x $
packs per week
price per
pack
$
weekly cost
52
x
WEEKS
=$
cost per year
This is how much you spend on cigarettes in one
year. Think about what else you could do with
that money. The good news is that you can quit
smoking. Want to know how it will benefit you?
Keep reading.
Try the online quit calculator at
cancer.ca/QuitCalculator to see the financial
and health benefits you can experience.
4
For Smokers Who Want to Quit – One Step at a Time
Much of the
damage
smoking
does to your
No matter how long you’ve been smoking, your
health will improve when you quit and your body
will start to reverse some of the damage done by
smoking. You’ll see some changes right away and
others as time goes on.
After your last cigarette:
body is
reversible –
it’s never too
late to quit.
Chapter
1 – Thinking
about quitting
Chapter
1
Consider the benefits
of quitting Your blood
pressure and
pulse rate
will return
to normal.
20
minutes
Your lungs will
start to clear
out the mucus.
All that coughing
will be a
good sign.
24
HOURS
You’ll be nicotinefree. Your senses
of taste and
HOURS
smell will improve
so you’ll probably
start to enjoy food more.
48
1
year
Your risk of having
a heart attack will
drop by 50%.
10
Your risk of dying
from lung cancer will
be cut in half.
yearS
10-15
yearS
8
HOURS
You’ll notice that
you can breathe
easier. Your
oxygen levels
will be back to
normal and your
chance of having
a heart attack
will go down.
72
HOURS
You’ll have
more energy.
Your lung
capacity will
increase and
your bronchial
tubes will relax,
so breathing
and exercising
will get easier.
Your risk of coronary heart
disease will be the same as
the risk for someone who
has never smoked.
© Canadian Cancer Society 2013
5
Chapter 1 – Thinking about quitting
What other benefits of quitting do you see in
your future?
6
For Smokers Who Want to Quit – One Step at a Time
A quit coach
is a tobacco
cessation
specialist at
a quitline.
Sometimes
they have
different
job titles
but they
all have a
similar
role – to
Chapter
1 – Thinking
about quitting
Chapter
1
Decide if you are ready Is the thought of you as a non-smoker becoming
a little clearer now? Close your eyes and imagine
yourself as a non-smoker. Can you picture it?
What does it look like? Write down what you see.
help you
on your
journey
to be
tobaccofree.
Are you ready to take this next step to becoming
smoke-free? Are you going to make a commitment
to quit smoking?
If the answer is yes – congratulations! The next
chapter will help you put a solid plan in place.
If the answer is no – that’s okay. Maybe you need
more time to think about why you might want
to quit. You need to try to quit when the time is
right for you. When you’re ready, come back to
the activities in this chapter.
At any point, you can discuss your options with a
quit coach by calling your local quitline number
listed on the back of this booklet.
© Canadian Cancer Society 2013
7
Chapter 1
14
For Smokers Who Want to Quit – One Step at a Time
Chapter 2 – Preparing to quit
Preparing to quit
In this chapter:
Even though
• understand your options
you might
• quit aids and common concerns
be eager
to quit
• tips for quitting
smoking, it’s
• prepare for your quit date
important
• write a quit plan
to prepare
yourself by
following
the steps
in this
section –
these steps
will give
you a
better
chance of
quitting
smoking
for good.
© Canadian Cancer Society 2013
9
Chapter 2 – Preparing to quit
Understand your options People have successfully quit using many
methods. There is no single way that works
for everyone. You need to find the option that
works best for you.
Quitlines
Every province and territory has a quitline,
where you can get free information on tobacco
use and support to quit smoking. You’ll find your
local quitline number listed on the back of this
booklet. Studies have shown that using a quitline
can double your chances of successfully quitting.
Quit aids
You can also try quit-smoking medicines. When
used properly, many of these quit aids have been
shown to increase your chances of successfully
quitting.
Self-help guides
Self-help booklets (just like this one) are good
tools to help you quit because they help you
create a plan to follow. There are other great
forms of self-help, such as online forums,
interactive websites and smartphone apps.
Check out the app called Break It Off
developed by the Canadian Cancer Society at
cancer.ca/BreakItOffApp.
10
For Smokers Who Want to Quit – One Step at a Time
a quit aid,
be sure
to speak
with your
pharmacist
or other
healthcare
professional
about
medicines
you are
currently
taking and
Chapter
2 – Preparing
to quit
Chapter
1
Before using
Cold turkey
Quitting smoking all at once, without looking
back and without any help, may be the right
route for you. But if at any point you think you
need some support, consider the other options
listed below.
Buddy system
If you know another smoker who also wants to
quit, you could “buddy up” and quit together.
Or if you have a friend or family member who
wants to help, enlist them as a buddy (a support
person) and bring them along with you on your
quitting journey. Make sure you get your support
person to read the booklet Help a Smoker Quit
– One Step at a Time so they can learn how to
best support you.
what option
might be
best for you.
© Canadian Cancer Society 2013
11
Chapter 2 – Preparing to quit
Quit aids Nicotine replacement therapy (NRT)
Nicotine replacement therapy works by reducing
the cravings caused by quitting smoking. It
delivers a controlled dose of nicotine to your
body over time. Each product is available in
different doses so talk with your pharmacist or
other healthcare professional about the correct
dose for you.
NRT comes in 5 forms: patch, inhaler, oral spray,
gum and lozenge. Each is available without
a prescription at your drugstore, and the cost
varies from approximately $4 to $8 a day.
Although they all contain nicotine, they are much
safer than tobacco and they don’t cause cancer.
Patch
12
What is it?How does it work?Tips for use
The patch is
applied to your
skin and delivers
a continuous
controlled dose
of nicotine.
Applying the
patch to your skin
allows nicotine to
enter your body
slowly, helping to
reduce cravings
and withdrawal
symptoms.
For Smokers Who Want to Quit – One Step at a Time
Start using the
patch as soon
as you stop
smoking. It
is usually not
recommended
to smoke while
on the patch. It
probably won’t
harm you, but
by doing both,
you could get too
much nicotine.
The patch should
be applied to a
clean, dry area
above your waist.
Inhaler
Oral spray
Chapter
2 – Preparing
to quit
Chapter
1
What is it?How does it work?Tips for use
The inhaler
looks similar to
a cigarette.
It’s a plastic
cylinder that
holds a
cartridge
containing
nicotine.
By puffing on
the inhaler,
nicotine vapour
is released and
absorbed through
the lining of your
mouth.
The vapour is
not designed to
be inhaled into
your lungs like
a cigarette, but
rather should
be puffed on
lightly so that the
vapour stays in
your mouth. The
inhaler should
be cleaned
regularly with
soap and water.
Avoid drinking
acidic beverages
such as coffee,
tea, soft drinks,
alcohol and citrus
juices when
using the inhaler
because they can
prevent it from
working properly.
The oral spray is
an instant spray
into the mouth.
When sprayed,
the vapour
releases nicotine
that is absorbed
through the
lining of the
mouth.
Avoid spraying
the vapour on
your lips or down
your throat. To
avoid spraying
down your throat,
do not inhale
while spraying.
© Canadian Cancer Society 2013
13
Chapter 2 – Preparing to quit
Gum
14
What is it?How does it work?Tips for use
The gum contains
nicotine that is
absorbed through
your cheek. It
can be used to
cut down on the
number of
cigarettes you
smoke per day.
Nicotine gum is
available in
several flavours.
It enters your
body slowly
and provides
nicotine over
20–30 minutes.
For Smokers Who Want to Quit – One Step at a Time
It’s important
to follow the
instructions on
the package
about how to
chew the gum;
otherwise, you
might not get the
right effect from
it. Chomp on the
gum a few times
and then park
it against your
cheek for 20–30
minutes. Chew it
occasionally but
don’t chew it
rapidly like
regular gum.
Chew only one
piece of gum
at a time.
Lozenge
Chapter
2 – Preparing
to quit
Chapter
1
What is it?How does it work?Tips for use
The lozenge
comes in the
form of a hard
candy.
The lozenge
slowly releases
nicotine as it
dissolves in your
mouth.
It’s important
to follow the
instructions on
the package;
otherwise, you
might not get
the right effect
from it. Place one
lozenge in your
mouth and slowly
suck it until you
notice a strong
taste. Then park
it between your
cheek and gum.
Wait a minute,
or until the taste
fades, and repeat
by sucking it
until you again
notice a strong
taste. Then park
it again. It should
take 20–30
minutes to
dissolve. Do not
chew or swallow
the lozenge.
© Canadian Cancer Society 2013
15
Chapter 2 – Preparing to quit
Prescription medicines There are 2 quit-smoking medicines you
can get that need a prescription from your
doctor: Champix and Zyban. Both are
available in pill form and actively target
your brain and how it processes nicotine.
They cost about $3 to $5 a day.
People who
have the
best chance
of quitting
are those
who use
both a
program
that offers
some
counselling
or support,
like a
quitline, and
a quit aid.
16
For Smokers Who Want to Quit – One Step at a Time
Chapter
2 – Preparing
to quit
Chapter
1
What is it?How does it work?Tips for use
Champix
(generic
name
varenicline)
Champix
(Chantix in the
US) is available in
pill form, and it
does not contain
nicotine.
It stimulates the
same areas of the
brain that nicotine
does. It prevents
the pleasurable
effects of
smoking. It helps
to reduce cravings
and withdrawal
symptoms.
There are 2 ways
to set your quit
date when using
Champix. Follow
the instructions
on the package
or talk to your
doctor about
which way is
best for you.
Zyban
(generic
name
bupropion)
Zyban is available
in pill form and
has also been
used for treating
depression.
When used for
depression it’s
sold as
Wellbutrin. It
does not contain
nicotine and it is
non-addictive.
It stimulates the
same areas of
the brain that
nicotine does.
It helps to reduce
cravings and
withdrawal
symptoms.
It’s important to
set a quit date
before you start
taking Zyban.
Start taking Zyban
7–10 days before
your quit date.
© Canadian Cancer Society 2013
17
Chapter 2 – Preparing to quit
Common questions about
quit aids There are questions and concerns that come up
when talking about quit-smoking medicines.
Here are some questions and answers.
Can I get addicted to these medicines? Will I
just be trading in one addiction for another?
NRT gives your body nicotine but at a much
lower level than smoking. It enters your body less
quickly and by a much safer route. You avoid
inhaling more than 70 cancer-causing chemicals
and the poisonous carbon monoxide found in
tobacco smoke. As your cravings become more
manageable, you can reduce the amount of NRT
that you use. Talk to your pharmacist or other
healthcare professional if you have any concerns
about the products you are taking.
I’ve heard that using NRT can cause cancer.
Is this true?
This is false. Nicotine is not one of the cancercausing agents in cigarettes – it’s the tar, carbon
monoxide and some of the other 4,000 chemicals
in cigarettes that can cause cancer. NRTs help
get the nicotine into your body but without the
added dangers.
Can I use these medicines if I’m pregnant?
If you’re pregnant, it’s a great time to quit! Most
prescription medicines are not recommended
during pregnancy, but talk to your doctor or
midwife about NRT or other options that may be
available to you. For more information on tobacco
and pregnancy, visit www.pregnets.org.
18
For Smokers Who Want to Quit – One Step at a Time
It’s okay
to try one
approach
and then
switch to
another,
if needed.
Ultimately,
people who
persist
will be
successful.
Chapter
Chapter12 – Preparing to quit
My friend told me that if I take Champix it
will make me depressed or even suicidal.
Is this true?
Discuss possible risks of taking Champix with
your doctor. Many people have had success
with it. When you quit smoking, it’s normal
to have feelings of depression, insomnia,
irritability, frustration, anger or anxiety.
Some people on Champix have reported serious
psychiatric symptoms, including depressed
mood and suicide-related thoughts or events.
It isn’t known if these symptoms were
directly related to Champix. But if you are
taking Champix and you experience any of
these symptoms, stop taking it and contact your
doctor right away. You and your family members
should watch for changes in your behaviour
while you are taking Champix. You should be
closely monitored by your doctor, especially
if you have a history of mental illness or
depression.
© Canadian Cancer Society 2013
19
Chapter 2 – Preparing to quit
What about using alternative treatments such
as hypnosis or acupuncture to quit smoking?
Some people have found these to be useful;
however, there is no evidence to support that either
of these treatments is effective. The same is true
for other alternative quit methods like herbal
supplements, herbal patches, laser therapy or
electronic cigarettes (e-cigarettes). In fact, Health
Canada advises that e-cigarettes should not be used
because they may pose health risks and have not
been fully evaluated for safety and quality.
Visit Health Canada’s website at www.hc-sc.gc.ca.
Wouldn’t it be cheaper for me to keep
smoking?
The ongoing costs of smoking are more than the
costs of medicines. Also, for some, quit-smoking
medicines may be free as part of their private
health insurance plan or through their provincial
health plan. If you have personal health coverage
or participate in a health plan through your
employer, contact your health insurance company
to see what they cover.
20
For Smokers Who Want to Quit – One Step at a Time
Chapter
2 – Preparing
to quit
Chapter
1
Tips for quitting Here are 5 things you can do to help you prepare
to quit smoking and build a quit plan made just
for you.
Tip 1: List your triggers
There are probably a few people, places and
things that can cause you to want a cigarette.
Think of all the situations where you might have
a hard time resisting the urge.
It would be great if you could avoid them, but
chances are you won’t be able to hide from them
all. It is important for you to plan for those
situations and think about ways that you can
cope with these triggers.
Here is an example to help get you started:
Trigger: Drinking my morning coffee.
How I’ll cope: Have juice instead and
only drink coffee after lunch.
© Canadian Cancer Society 2013
21
Chapter 2 – Preparing to quit
Tip 2: Practise positive self-talk
If you feel confident about your own ability to
quit smoking, it will be easier to quit. Without
that confidence, just one instant or one situation
might be enough for you to give in to temptation.
Negative self-talk can hurt your chances of
staying smoke-free. For example, when faced with
a tempting situation, you might think, “One little
cigarette won’t hurt” or “I know I shouldn’t
smoke, but I don’t think I have what it takes
to quit.” It’s important to be aware of negative
thoughts and plan for how to replace them with
positive ones.
A great way to build your confidence and increase
your chances of becoming smoke-free is through
positive self-talk.
often be our
own worst
enemy.
Practise
positive
self-talk
every day.
Do it in front
of a mirror
if you need
to. Don’t
Here are some examples of positive thoughts:
worry – no
I don’t need this cigarette right now.
you!
I will not let anyone stop me from quitting. I can’t
change what others think or say. I can only change
what I think and do.
I really don’t need a cigarette to have a good time
at a party.
22
We can
For Smokers Who Want to Quit – One Step at a Time
one will see
involved in
It’s time to build your support network. Who
are the people you can count on to support
you? We’re talking about the person you can
call at 2 a.m. when you’re out with friends and
have a huge craving for a cigarette, or the friend
you can text first thing every day to distract you
from having that morning cigarette. Let these
people know about your quit plan and explain
to them how they fit in and what you need
from them. Also consider joining an online
community, which has the added benefit of
being available 24/7.
your journey
My support network to quit if you
Name
How they can best
support me
you with
something
Don’t be
afraid to
tell your
supports
what you
need.
They may
feel more
ask them
to help
specific.
Chapter
2 – Preparing
to quit
Chapter
1
Tip 3: Build your support system
Don’t forget that your nurse, pharmacist or other
healthcare provider or your quit coach can also
be great allies.
© Canadian Cancer Society 2013
23
Chapter 2 – Preparing to quit
Tip 4: Write down your reasons for quitting
You likely have great reasons for wanting to quit
smoking. Perhaps you’ve decided you want to
be healthier, maybe you want to save money, or
maybe you’re motivated to quit for your children
or your partner.
In the worksheets section at the back of this
booklet, list your top 4 reasons for quitting, then
tear off the sheet and put it up somewhere where
you can see it every day. Or put it in your purse or
wallet, or add the reasons in your smartphone, so
that no matter where you are, you can pull it out
to help you get through a craving or just act as a
reminder during those tough days.
Reason 1
Reason 3
24
Reason 2
Refer to worksheet
at the Reason
back of 4the
booklet
For Smokers Who Want to Quit – One Step at a Time
Chapter
2 – Preparing
to quit
Chapter
1
Tip 5: Set a quit date
Think about what’s coming up over the next 30
days and pick a day to quit smoking. There may
never be a perfect day to quit, but here are some
things that might help you choose your date:
• Pick a day when your schedule is routine and nothing new is happening.
• Avoid dates where you have a deadline or something else that might distract you or give you additional stress.
• Make this your day for this task, so avoid
other important dates like birthdays or
anniversaries.
• If you’re a woman, avoid dates that are just
before the beginning of your menstrual cycle.
Share your date with your friends and family!
Post it on Facebook or Twitter or send an
email to let everyone know that you have
taken this great step toward being smoke-free.
Day
Month
Year
Refer to worksheet
at the back of the
booklet
© Canadian Cancer Society 2013
25
Chapter 2 – Preparing to quit
Prepare for your
quit date
Now you know a bit about your triggers, why
you want to quit and some of the things you’ll
face when you quit. Use the days leading up to
your quit date to learn more about your smoking
behaviours, like when, why and where you smoke
and who you smoke with. At the back of this
booklet, you’ll find tracking cards for you to start
using at least 5 days before your quit date.
If your plan
includes
quitsmoking
medicine,
make sure
Take the cards with you as you go through your
day, and every time you have a cigarette, write it
down on the card.
you speak to
This is also an opportunity for you to try cutting
back on the amount you smoke before your quit
date. As you go through your day, look to see if
there is a cigarette you can cut out – one that
you can go without. If you do this every day, you
might find yourself already halfway quit before
you even start.
or other
At the end of every day, take a moment to review
your tracking card and see if you can pinpoint
your triggers. The next day, try to use some of the
coping strategies that you wrote in the triggers
section to see if you can avoid a cigarette and get
past the craving. Consider this a practice run.
This is an opportunity for you to test out your
plan before the big day.
what you
your doctor,
pharmacist
healthcare
provider
about your
options and
purchase
need to be
ready. Some
of the
medicines
need to
be started
before your
quit date.
26
Refer to worksheet
at the back of the
booklet
For Smokers Who Want to Quit – One Step at a Time
Chapter
2 – Preparing
to quit
Chapter
1
Write out a quit plan With only a few days remaining before your
quit date, it’s time to put your personalized quit
plan down on paper. Write it down in the quit
plan section of the worksheets, then tear off the
page and put it somewhere where you can see it
when you need to remind yourself of your plan.
Stick it on the fridge, in the washroom on the
mirror, or anywhere else where you’re likely to
see it often!
MY QUIT PLAN
My quit date is:
My support system includes:
The quit aid I will use is:
Refer to worksheet
at the back of the
booklet
© Canadian Cancer Society 2013
27
Chapter 1
34
For Smokers Who Want to Quit – One Step at a Time
Chapter 3 – Ready to quit
Ready to quit
In this chapter:
Your smokefree journey
is unique.
Use the tools
• on your quit day
• what to expect from withdrawal
• cope with withdrawal symptoms
in this
• manage cravings with the 4 Ds
booklet to
• make new connections
learn what
works best
for you.
• learn how to stay fit and eat healthy
• milestones and rewards
© Canadian Cancer Society 2013
29
Chapter 3 – Ready to quit
On your quit day You have worked hard to get here and you
should be proud of yourself. Take a few
moments to celebrate your positive decision to
quit. It’s not every day that you make a decision
that will have such a big impact on the rest of
your life.
Remember, though, that cravings can start at
any time. When you feel yourself wanting a
cigarette, do everything you can to get out of
that situation and go somewhere else or do
something else. Take control of your cravings.
Avoid people who are smoking
Do you usually have a cigarette with some of
your co-workers during your break? Not today
– head outside for a walk or take a break in the
lunchroom with others.
Keep help within arm’s reach
If you’re taking NRT in the form of an inhaler,
gum, a lozenge or a spray, keep it on hand and
use it when you need to get through cravings.
Have your supports ready
Let the people around you know that you may
reach out to them with a phone call or text.
Keep your local quitline number handy.
Take it easy
Quitting smoking is stressful enough on its own,
so do what you can to remove yourself from
other potentially stressful situations.
30
For Smokers Who Want to Quit – One Step at a Time
Chapter
3 – Ready
to quit
Chapter
1
And above all, keep your hands, mouth and mind
busy. Here are some tips:
HANDSMOUTH MIND
draw or paint
something
text a friend
knit, crochet
or sew
master the
Rubik’s cube
tidy up
clean the house
or the car
garden or mow
the lawn
play cards or a
board game
lift weights or
try yoga
paint your nails
play video
games
throw a football
around
work on
your car
call an old
friend
sing your
favourite songs
chew sugar-free
gum and blow
bubbles
brush your
teeth
kiss someone
whistle a tune
suck on a
lollipop
rock out to
some great
music
dance like
no one is
watchingng
find a new
healthy recipe
to make
rearrange your
furniture
go for a walk,
run or bike ride
do a crossword
puzzle or
Sudoku
walk the dog
take photos
read a good
book
© Canadian Cancer Society 2013
31
Chapter 3 – Ready to quit
What to expect from
withdrawal symptoms Withdrawal symptoms are your body’s way of
responding to being without nicotine. It’s normal
to experience withdrawal symptoms when quitting
smoking. Everyone is different and everyone’s body
adjusts to not smoking in different ways.
Cravings: Urges, or cravings, to smoke are often
worse at the beginning but usually become less
strong after a few weeks of being smoke-free.
Cravings usually last for a few minutes. Try out
some of the tips in the previous section to keep
your hands, mouth and mind busy.
Changes in mood: Your body is craving nicotine
and, for a while, it may feel like there is nothing else
that will satisfy that need. Of course you’re a little
cranky – who wouldn’t be? You might become
irritable, sad or angry. Although these symptoms are
not pleasant, they are normal and will eventually go
away as your body adjusts.
Stress: For many smokers, smoking is what they
do to deal with their daily stress. Without that as an
option, it can feel as though your stress levels are
out of control. Look for other ways to keep calm
when you get stressed, like deep breathing, thinking
about something else or going for a walk.
Coughing/phlegm: When you first quit, you might
have a cough and notice an increase in mucus. This
might sound odd but that’s a good thing! It’s your
body’s way of cleaning out all of the tar and toxins
that have been building up over the years. Your
body is healing itself so give it time to do that.
32
For Smokers Who Want to Quit – One Step at a Time
Chapter
3 – Ready
to quit
Chapter
1
Weight gain: Not everyone who quits gains
weight but in the first few months some people
gain between 5 and 10 pounds. This can be
managed with healthy eating and exercise.
Concentration: Your body has become
accustomed to getting a buzz from cigarettes.
It now has to learn how to stay awake and alert
without it. Be patient with your body – take
breaks and don’t put too much pressure
on yourself.
Sleep: Nicotine affects how your brain works,
so when you quit, you might find that you have
trouble sleeping at night. Eliminate or reduce
caffeine (coffee, tea, cola, chocolate), especially
in the evenings. Also, slow down as bedtime
gets near. Avoid the computer. Read or do a
crossword puzzle to help you relax.
The important thing to remember is that from
the moment you stop smoking, your body will
begin to repair itself. As your body works hard,
be patient with it and remember that the
withdrawal symptoms won’t last forever.
In some cases, they can lessen in just a few
days or weeks.
© Canadian Cancer Society 2013
33
Chapter 3 – Ready to quit
Cope with withdrawal
symptoms Quitting smoking is good for you, but you may
feel worse before you feel better. The good news
is that these symptoms won’t last forever and
there are some general things you can do to
minimize them.
•Breathe deeply and do some relaxation
exercises or listen to your favourite music.
Get out and do some exercise or yoga.
• Avoid caffeine, especially in the evenings
(coffee, tea, cola, chocolate) and try to slow down toward bedtime. Try reading,
meditating, taking a bath or drinking a
cup of herbal tea.
•Keep your throat lubricated with plenty of water or juice. Chew sugarless candies or gum.
•Cut up fresh fruit and veggies so they are ready to go when you’re hungry. Avoid foods and drinks that offer little nutrition, such as chips and soft drinks. Check out the website at
www.fruitsandveggies.ca for ideas and
resources to help you maintain a good diet.
•Talk to friends about how you’re feeling.
Do things that make you happy, and focus on
the positive outcomes you are experiencing.
Make an appointment to speak with your
pharmacist or other healthcare professional to
see what they can suggest to help you cope.
This would also be a great time to connect with
a quit coach by calling your local quitline
number on the back of this booklet.
34
For Smokers Who Want to Quit – One Step at a Time
are more
affected by
caffeine so
reduce the
amount you
take in to
help you
avoid some
of the
unpleasant
effects like
nervousness,
irritability,
headaches
and trouble
sleeping.
Chapter
3 – Ready
to quit
Chapter
1
Non-smokers
What other withdrawal symptoms are you
experiencing? What solutions have you come
up with to cope with them?
© Canadian Cancer Society 2013
35
•
Deep bre
a
on
cti
r
ate
w
• Delay
D
• Drink
Another great tool to
help you get through
cravings or other
withdrawal
symptoms is the
4 Ds. Use any
combination of the
following when you
experience symptoms.
e
th
Chapter 3 – Ready to quit
Manage cravings with
the 4 Ds • Distra
Deep breathing: Breathe in and out
slowly. When you do this, inhale deeply, hold
your breath for a few seconds and then slowly
let it out. Deep breathing will help you to relax
and focus on something else.
Drink water: Keep a bottle of water on
hand. Drink the water slowly and keep it in your
mouth a while before swallowing. This will help
to wash the bad stuff out of your system and will
help keep your hands and mouth busy. Drinking
water can also help with coughing or phlegm
buildup.
Distraction: Distract yourself by getting
up and going somewhere or doing something.
Go for a walk, call a friend, head to the gym
or walk the dog.
Delay: Cravings don’t last as long as most
people think they do. It might feel like forever,
but it’s really about 5 to 10 minutes. Convince
yourself that you can wait 10 minutes, and try
one of the other Ds above.
36
For Smokers Who Want to Quit – One Step at a Time
Chapter
3 – Ready
to quit
Chapter
1
Make some changes To quit smoking you have to be able to make
some changes in your life. You need to break
the behaviours that connect you to cigarettes
throughout your day. You need to figure out how
to live without smoking.
Love a smoke with that coffee?
Drink herbal tea. Have a healthy snack with your
coffee instead.
Can’t talk on the phone without lighting up?
Chat with your friends in person. Use Skype or
another form of video chat.
Is a cigarette the first thing on your mind
when you wake up?
Jump in the shower right away. Hit the gym or go
out for a walk to start your day.
Are alcohol and tobacco your favourite mix?
Order a mocktail or soda water. Ask the
bartender for a straw or a stir stick to bite on.
Hard to drive without a cigarette in
your hand?
Take cigarettes and lighters out of your car.
Walk or take the bus.
Does stress equal “Where is my lighter?”
Take a deep breath and get away from what is
causing you stress. Squeeze a stress ball.
© Canadian Cancer Society 2013
37
Chapter 3 – Ready to quit
Stay fit and healthy One of the main concerns people have when
quitting smoking is a fear of gaining weight.
About 1 in 5 people who quit smoking do not
gain weight. For those who do gain weight,
the average gain is about 5 to 10 pounds. Don’t
worry – there are ways to help ensure that
any weight you gain is minimal.
Here are some helpful tips:
Stay active
Physical activity is a great way to help manage
your weight and can also help with cravings and
withdrawal symptoms. It’s an investment in your
health, and if you make it something enjoyable,
you’ll have a better chance of sticking to it.
Eat regularly
Don’t skip meals. This can result in over-eating
later in the day. It can also make you irritable,
which may make it harder to resist cravings.
Eat breakfast, lunch, dinner and 1 or 2 snacks
every day.
Eat healthy snacks
Keep nutritious snacks prepared and ready for
when you need them. Try raw veggies, fruit and
yogurt, and drink lots of water.
38
For Smokers Who Want to Quit – One Step at a Time
The good
news is that
any weight
gain is
manageable
so try not to
worry too
much about
your weight
for now.
Your primary
goal is to
quit and
stay
smoke-free.
Chapter
3 – Ready
to quit
Chapter
1
Listen to your body
If you are hungry, eat something. If you’re not
sure if you’re hungry, try drinking a glass of
water and then distract yourself by doing
something else. If you are still hungry afterwards,
have a healthy snack.
Limit alcohol
Avoid alcohol. It is filled with empty calories
and can be a trigger for smoking.
Shop smart
Go to the grocery store with a list and don’t go
when you’re hungry.
By making small changes to your diet and activity
levels you can manage your appetite and any
possible weight gain. For more information on
eating well and being active visit Health Canada’s
website at http://www.hc-sc.gc.ca/fn-an/
index-eng.php.
© Canadian Cancer Society 2013
39
Chapter 3 – Ready to quit
Milestones and rewards Setting milestones or goals can be a great
motivation and a way to stay on track. What are
the key moments you’re looking forward to?
Maybe it’s reaching the end of your first
smoke-free day or maybe it’s making it through
your first night out with friends without
lighting up.
List your personal quit-smoking milestones:
In the worksheets section at the back of this
booklet, list your personal quit-smoking
milestones and fill in the dates when you aim
to accomplish them.
Date
Date
40
Date
Refer to worksheet
at the back of the
booklet Date
For Smokers Who Want to Quit – One Step at a Time
don’t forget
about all of
that cash
you are now
Here are just a few ideas:
saving by
• Go see a movie.
not buying
• Cook a special dinner.
cigarettes. If
• Hire a cleaning person for the day.
you can, use
• Update your Facebook status.
that money
to reward
yourself!
Chapter
3 – Ready
to quit
Chapter
1
Oh, and
Each one of your milestones should come with
a reward. You are working hard and need to
reward yourself for the amazing job you’re
doing. Rewards can be anything that make you
feel good without compromising your progress.
• Take the night off from studying.
• Get a manicure and pedicure.
• Buy a new gadget.
• Test drive a car you’ve always wanted.
Do you have any other ideas? List some of the
ways you can reward yourself.
© Canadian Cancer Society 2013
41
Chapter 4 – Staying smoke-free
Staying smoke-free
In this chapter:
Staying
• stay in control
smoke-free
• deal with a slip
is your
next goal.
• deal with a relapse
Remember
• get ready to quit again
what you’ve
• live a smoke-free life
learned and
keep at it.
© Canadian Cancer Society 2013
43
Chapter 4 – Staying smoke-free
Manage stress – Using
the 3 A’s No matter how good your reasons are for
quitting, you may still want to smoke. Success
relies on your ability to stay in control – of
yourself and of the situations you’re placed in.
Use the 3 A’s to help you stay in control in a
tempting situation: avoid, alter, accept.
Avoid: Avoid what you cannot handle. You may
have to do this more often during the first few
weeks of your quit period and gradually move to
other methods as you feel more in control.
Example: Avoid people who smoke. Talk honestly
with your friends who smoke and let them know
that you still want to be friends, but that it’s
important to you to be a non-smoker. Tell them
that you may not be spending time with them for
a little while. You don’t expect them to quit, but
you do want their support.
Alter: Make a new response to the situation.
Example: If a friend always offers you a cigarette,
politely tell them, in advance of seeing them,
that you have quit and that you would like them
to not offer you a cigarette under any
circumstances.
Accept: If the situation can’t be changed in any
way, try to accept it.
Example: Use some positive self-talk. “I’m really
stressed. This is a challenge. It won’t last forever.
I will get through it.” Or “I will be a stronger
person for handling this without a cigarette.”
44
For Smokers Who Want to Quit – One Step at a Time
part of
staying
smoke-free
is controlling
your
surroundings
and learning
to deal with
temptations
to smoke.
Chapter
4 – Staying
smoke-free
Chapter
1
An important
To find out if you’re in control, take a moment to
respond to the following statements:
I’ve thrown away all my cigarettes, lighters
and ashtrays.
Yes
No
I am avoiding places where people smoke a lot
(parties, outdoor patios at restaurants and bars).
Yes
No
Sometimes
I can handle stress without smoking.
Yes
No
Somewhat
I have asked my family and friends not to smoke
around me.
Yes
No
Sometimes
I have replaced smoking with other activities like
chewing gum or taking walks.
Yes
No
Sometimes
I’ve changed my morning routine to reduce the
temptations to smoke.
Yes
No
Somewhat
If you answered No, Somewhat, or Sometimes
to any of these questions, you may be at risk of a
relapse. You need to keep working hard to stay
in control and change your old smoking routines.
This is your future; take control of it.
© Canadian Cancer Society 2013
45
Chapter 4 – Staying smoke-free
Deal with a slip It’s common to have a slip – take a puff or smoke
a cigarette – after you quit smoking. If this
happens, remember that a slip does not mean
the end of your new smoke-free life. Think about
how smoking makes you feel and focus on your
reasons for quitting. Don’t lose sight of your goal.
One of these days, you will be smoke-free for
good. Get back on track as soon as possible.
to have a
slip or two
after you quit
smoking.
Remember
Here are some questions you can ask yourself to
help you get back on track. See this slip as an
opportunity to learn how to avoid it next time.
that a setback
What triggered you to have a cigarette or
take a puff?
give up.
Where were you?
Who were you with?
What can you do to avoid a slip the next
time you are in this situation?
You can also contact a quitline to help you
troubleshoot strategies to get you back on track.
46
It’s common
For Smokers Who Want to Quit – One Step at a Time
doesn’t mean
you have to
Chapter
4 – Staying
smoke-free
Chapter
1
Deal with a relapse A relapse is when you start smoking again on a
regular basis. You may have quit smoking for a
while. You resisted many temptations to smoke,
but then for some reason – stress, frustration,
desire or pressure – you went back to smoking.
Instead of feeling bad about it, put it behind you
and move on.
As you move forward, congratulate yourself for
the success you’ve had so far. Staying smoke-free
for any length of time is a big accomplishment.
You’ve proven to yourself that you can quit.
Are you ready to try again?
If your answer is no, that’s okay. Maybe now
is not the right time for you to quit smoking.
Remember what you learned from this time.
And when you’re ready, set another quit date
and build your plan.
If your answer is maybe, try reading chapter 1
again to remind yourself why you wanted to quit
in the first place. Then, if you’re ready, set
another quit date and read the following
page for tips.
If your answer is yes, read the following page
for tips on getting ready to quit again. Take what
you learned from this experience and apply it to
your new quit plan. You can also call a quitline
for help to get you back on track.
© Canadian Cancer Society 2013
47
Chapter 4 – Staying smoke-free
Get ready to quit again As you prepare to quit smoking again, think
about your last quit and what happened to make
you start smoking again.
• What were you feeling before you lit up?
• How did your family and friends react?
• Why did you decide to continue smoking
after that first cigarette?
You have a better chance of quitting smoking
this time if you can learn from your last quit.
You learned that quitting takes self-confidence,
preparation and dedication. What else did you
learn, either about quitting or about yourself?
Write it down here.
Example:
I learned
that writing down my
reasons for quitting really helped me.
48
For Smokers Who Want to Quit – One Step at a Time
Chapter
4 – Staying
smoke-free
Chapter
1
You may find that you will get more out of this
booklet the second time you use it. Go back to
chapters 2 and 3 and work through the activities
and tools again. Remember to read the
information and do each activity as completely
and honestly as you can.
If you didn’t use medicine last time to help
with your nicotine cravings, perhaps you should
consider speaking with your doctor, pharmacist
or other healthcare provider about that option
this time around. Combining treatments such as
nicotine replacement therapy or other medicine
with this booklet can be an effective method
of quitting.
If you need support, contact a quitline. A quit
coach can assist you or refer you to other
programs in your community.
© Canadian Cancer Society 2013
49
Chapter 4 – Staying smoke-free
Live a smoke-free life Quitting is a challenge and you’ve succeeded
so far. Your goal now is to make this change
permanent and to continue living a smoke-free life.
Remember everything that you have learned and
try not to become over-confident. Every day will
bring new challenges and when you least expect
it, a craving or trigger might throw you off.
Follow these tips to stay on track:
Reward yourself
Remember to celebrate the amazing job you’re
doing. Be grateful for your new smoke-free life.
Count on friends and family
Remind them that you still need their support!
They’ve supported you all along and only want
what is best for you.
Be prepared
Cravings and temptations can turn up at any time
and you need to be ready to deal with them.
Remember what has worked best for you so far.
Rely on tools
Keep this booklet nearby and use the tools
and activities to help you stay on track.
Call a quitline or speak to your doctor,
pharmacist or other healthcare provider if you
need any additional support.
Once again, congratulations! You have joined the
millions of Canadians who enjoy life without
tobacco. Best wishes for your continued success
and your new healthy lifestyle.
50
For Smokers Who Want to Quit – One Step at a Time
Chapter
4 – Staying
smoke-free
Chapter
1
For more information If you want to understand more about how
people quit smoking, or you would like more
information about the resources and programs
in your community, call one of our information
specialists toll-free at 1-888-939-3333,
email us at info@cis.cancer.ca or visit our
website at cancer.ca.
Smokers’ helplines are available across Canada
where trained quit coaches are available for free,
confidential help over the telephone. Please call
your local toll-free number printed on the back
of this booklet.
© Canadian Cancer Society 2013
51
Worksheets
Worksheets
In this section:
• write down your reasons for quitting
• set a quit date
• quit plan diary
• write out a quit plan
© Canadian Cancer Society 2013
53
Worksheets
Write down your
reasons for quitting
Reason 1
Reason 2
Reason 3
Reason 4
Set a quit date
Day
54
Month
For Smokers Who Want to Quit – One Step at a Time
Year
#
Time OfReason for
Where
DAy
this Cigarette I was
Worksheets
Chapter 1
Quit plan diary
Who I was With
#
Time OfReason for
Where
DAy
this Cigarette I was
Who I was With
© Canadian Cancer Society 2013
55
Worksheets
Quit plan diary
#
Time OfReason for
Where
DAy
this Cigarette I was
Who I was With
#
Time OfReason for
Where
DAy
this Cigarette I was
56
For Smokers Who Want to Quit – One Step at a Time
Who I was With
#
Time OfReason for
Where
DAy
this Cigarette I was
Worksheets
Chapter 1
Quit plan diary
Who I was With
#
Time OfReason for
Where
DAy
this Cigarette I was
Who I was With
© Canadian Cancer Society 2013
57
Worksheets
Quit plan diary
#
Time OfReason for
Where
DAy
this Cigarette I was
Who I was With
#
Time OfReason for
Where
DAy
this Cigarette I was
58
For Smokers Who Want to Quit – One Step at a Time
Who I was With
Worksheets
Chapter 1
Write out a quit plan MY QUIT PLAN
My quit date is:
My support system includes:
The quit aid I will use is:
My main reasons for quitting are:
My main triggers are:
I will cope with these triggers by:
© Canadian Cancer Society 2013
59
Worksheets
Milestones
60
Date
Date
Date
Date
Date
Date
For Smokers Who Want to Quit – One Step at a Time
Call a smokers’ helpline at one of these toll-free numbers.
British Columbia
1-877-455-2233
Alberta
1-866-710-7848
Saskatchewan, Manitoba, Ontario,
New Brunswick, Prince Edward Island, Yukon
1-877-513-5333
Quebec
1-866-527-7383
Nova Scotia
811
Newfoundland and Labrador
1-800-363-5864
Northwest Territories
1-866-286-5099
Nunavut
1-866-368-7848
This is general information developed by the Canadian Cancer Society.
It is not intended to replace the advice of a qualified healthcare provider.
The material in this publication may be copied or reproduced without permission; however, the following
citation must be used: For Smokers Who Want to Quit – One Step at a Time. Canadian Cancer Society 2013.
© Canadian Cancer Society 2013 | Printed November 2016 | 32081-1-NO
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