• By Liza Torborg

Weekend Wellness: Breaking a smoking habit? Seek medical professional help

January 17, 2015

DEAR MAYO CLINIC: What is the most effective way to stopping my smoking habit of 20 years? I’ve tried the gum and it helped the cravings for a while, but not enough to get me to quit smoking. Even though I’m worried about what smoking is doing to my health, I can’t seem to stop.the word stop (smoking) spelled out with tobacco cigarettes

ANSWER: You are not alone in your experience. Many people try to quit smoking and are not successful right away. The nicotine found in cigarettes is very addictive. Breaking a smoking habit is hard, especially when you try to do it on your own. The best way to quit is to seek help from your doctor or from a counselor trained as a tobacco treatment specialist. He or she can guide you through behavioral therapy, as well as offer approved medication treatments that can help you stop smoking for good.

Behavioral therapy associated with quitting smoking can encompass a wide variety of activities in your day-to-day life. It often involves replacing old behaviors with new routines that are not associated with smoking.

For example, your counselor may suggest you try to avoid places or activities where you usually smoke. Instead, when you go out, visit places where smoking is not allowed. When you go to work if an area near an entrance is designated for smokers, use another route to and from your work area. As much as possible, strive to spend time with people who do not smoke or who also want to quit smoking.

A series of other small but meaningful changes can help, too. Make it inconvenient to smoke by getting rid of all your cigarettes. Leave your lighters in the car or another inaccessible spot when you are at home or work. Chew gum while you drive, or take new routes to your usual destinations to focus your attention on your environment and away from smoking. Get up from the table immediately after eating. If you usually have a cigarette with a cup of coffee or with alcohol, drink water, soda or tea instead.

Although they can be quite helpful, behavior changes alone usually are not enough to stop smoking. Cravings and symptoms of nicotine withdrawal can be powerful when you are trying to give up cigarettes. Fortunately, a range of safe and effective medications have been approved by the Food and Drug Administration that can help.

They include nicotine replacement therapy available without a prescription, such as the gum you tried. You can also buy nicotine patches and lozenges over-the-counter. Nicotine nasal spray and nicotine inhalers are available by prescription. Other prescription medications may be useful, too. For example, bupropion can help control nicotine cravings. Varenicline can reduce both the pleasurable effects of smoking and lessen nicotine withdrawal symptoms.

Some people have touted the benefits of using electronic cigarettes, also called e-cigarettes, as a way to stop smoking. Mayo Clinic physicians do not recommend this approach. No evidence exists that shows e-cigarettes to be effective at helping people stop smoking. In addition, very little is known about the health effects of electronic cigarettes, and there are significant questions about the safety of these products.

To give yourself the best chance to stop smoking, seek help from a medical professional who is familiar with tobacco treatment. Together, you can craft a strategy to help you get and stay tobacco-free. The effort will be well worth it, as the health benefits of not smoking are substantial, and they start accumulating almost immediately after you quit. J. Taylor Hays, M.D., Nicotine Dependence Center, Mayo Clinic, Rochester, Minn.