Struggling to Quit Smoking: Tips for Effective Cessation Strategies

I want to quit smoking?

Hello doctor, I have been smoking for nearly 10 years.
Currently, I smoke about 3 packs a day, sometimes even more.
I have tried to quit smoking about 4 or 5 times in the past.
While others feel uncomfortable after smoking a pack in 6 hours, I can smoke 3 packs in that time without feeling any discomfort.
Because of this, my body doesn't feel bad, and I end up smoking more.
However, this year I have been feeling sick often, with stomach discomfort, occasional shortness of breath, dizziness, and I spend nearly 4,000 to 5,000 NT dollars a month on cigarettes.
If I hadn't smoked for the past 10 years, I could have saved a lot of money.
Most importantly, my health has been deteriorating year by year, and I realize that I need to quit smoking as soon as possible to avoid future regrets.
Currently, I am using nicotine patches.
In the first week, I was smoking about 5 cigarettes a day, but after 10 days without the patch, I went back to smoking 2 packs.
Now I have started using the patches again, but I feel like they aren't working as well as before.
Previously, they helped me not crave cigarettes, but now they seem ineffective.
I would like to ask if I can increase the dosage by using 2 nicotine patches? I really want to quit smoking.

Xiao Bo, 20~29 year old female. Ask Date: 2002/12/21

Dr. Tao Ruiming reply Smoking Cessation

It is absolutely prohibited to use a "clean nicotine" patch while simultaneously smoking, as this may cause discomfort to the body.
For a patient who smokes 30 cigarettes a day and wishes to quit, using a single nicotine replacement therapy patch containing 10.4 mg/5 cm (size 5) may not provide sufficient nicotine tolerance.
Therefore, it is recommended to use two patches containing 31.2 mg/15 cm (size 15) of nicotine.
However, it is imperative not to smoke cigarettes during this time, as doing so could lead to nicotine toxicity, resulting in symptoms such as vomiting, nausea, increased endocrine activity, abdominal pain, diarrhea, excessive sweating, restlessness, headache, dizziness, irritability, muscle weakness, numbness, and unstable blood pressure.

Reply Date: 2002/12/21

More Info

Quitting smoking is a challenging journey, especially for someone who has been smoking for nearly a decade and consumes a significant amount daily. Your experience reflects a common struggle among smokers, and it's commendable that you recognize the need to quit for both your health and financial well-being. Here are some strategies and insights that may help you effectively quit smoking.

Understanding Nicotine Dependence
Nicotine is a highly addictive substance found in tobacco. When you smoke, nicotine quickly reaches your brain, leading to feelings of pleasure and relaxation. Over time, your body becomes dependent on nicotine, making it difficult to quit. Withdrawal symptoms can include irritability, anxiety, difficulty concentrating, and physical discomfort, which you may have experienced when trying to quit in the past.

The Role of Nicotine Replacement Therapy (NRT)
You mentioned using nicotine patches, which are a form of NRT. These patches deliver a steady dose of nicotine to help reduce withdrawal symptoms and cravings. It's important to note that the effectiveness of NRT can vary from person to person. If you feel that the patch is no longer working, it could be due to several factors, including:
1. Tolerance: Over time, your body may become accustomed to the nicotine dose from the patch, leading to reduced effectiveness.

2. Increased Cravings: As you reduce your smoking, your cravings may intensify, making it feel like the patch is less effective.

3. Psychological Factors: Smoking is often tied to habits and routines. If you find yourself in situations where you used to smoke, the psychological triggers can lead to cravings that the patch alone may not alleviate.

Adjusting Your NRT Strategy
If you feel that one patch is not sufficient, consult with a healthcare professional before increasing the dosage or using multiple patches simultaneously. They can provide guidance on the appropriate use of NRT and may suggest combining it with other forms of therapy, such as:
- Gum or Lozenges: These can provide additional nicotine and help manage cravings on-the-go.

- Inhalers or Nasal Sprays: These deliver nicotine more rapidly and can be effective for immediate cravings.

- Behavioral Therapy: Working with a counselor or joining a support group can help you develop coping strategies and address the psychological aspects of quitting.

Behavioral Strategies for Quitting
1. Identify Triggers: Keep a diary of when and why you smoke. Understanding your triggers can help you avoid situations that lead to cravings.

2. Develop New Routines: Replace smoking with healthier habits. For example, when you feel the urge to smoke, try going for a walk, chewing gum, or practicing deep breathing exercises.

3. Set Clear Goals: Establish specific, achievable goals for reducing your smoking. For instance, aim to cut down gradually before quitting completely.

4. Stay Busy: Engage in activities that keep your hands and mind occupied. Hobbies, exercise, or spending time with friends can distract you from cravings.

Managing Withdrawal Symptoms
It's common to experience withdrawal symptoms when quitting smoking. Here are some strategies to manage them:
- Stay Hydrated: Drink plenty of water to help flush nicotine out of your system.

- Eat Healthy: A balanced diet can improve your mood and energy levels.

- Exercise: Physical activity can reduce stress and improve your overall well-being.

- Practice Relaxation Techniques: Techniques such as yoga, meditation, or deep breathing can help manage stress and anxiety.

Seeking Professional Help
If you find that self-directed efforts are not yielding the desired results, consider seeking help from a healthcare provider or a smoking cessation program. They can offer personalized support, medication options, and resources tailored to your needs.

Conclusion
Quitting smoking is a process that often requires multiple attempts and a combination of strategies. Recognizing the need to quit is the first step, and with the right support and tools, you can overcome the challenges associated with nicotine dependence. Remember, it's never too late to quit, and the benefits to your health and finances are well worth the effort. Stay committed, and don't hesitate to reach out for help when needed. Good luck on your journey to becoming smoke-free!

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