Just slap on a nicotine patch and stop smoking. Right? Well, not exactly. See the video that goes with this piece called Smoke-Free in 30 Days: The Program
Based on my twenty years of experience helping smokers, here are some often overlooked solutions to the problems many smokers face in using patches and other nicotine replacement therapies (NRT). These five key points can help make quitting as easy, successful and permanent as possible.
(1) When using Nicotine Replacement Therapy, be careful not to use too little. How do you
know how much is best to start off with? How do you measure nicotine so you know you are getting enough? Here is the secret: each cigarette delivers about 1 mg of nicotine regardless of brand or kind (menthol, low tar etc). Each smoker will extract about 1mg even if they have to puff harder to do it with some brands.
So when you consider your starting point with NRT you can figure out how many mgs of nicotine are needed based on how many cigarettes are smoked on average each day. This brings us to our next point in need of clarification.
(2) Know the difference between how NRT is labeled, what it delivers and how much nicotine you will absorb. There are differences among nicotine replacement products. For example, the patch is the only form of NRT that delivers and absorbs the amount that is labeled. A 21 mg patch delivers 21 mgs of nicotine, usually over a 24-hour period. 4mg nicotine gum, on the other hand, delivers 4mg and you absorb 2mgs (which as you now know equals two cigarettes worth of nicotine). 2 mg nicotine gum delivers 2mg and only 1mg is absorbed (or one cigarette worth of nicotine). The nicotine oral inhaler is labeled 10mg, but delivers 4mg per cartridge and only 2mgs are absorbed. Once you are clear about how much nicotine is needed and will be absorbed from the different kinds of NRT, this is a good time to consider the next key point.
(3) Consider doubling up with two forms of NRT. Combining the patch and the gum or the patch and the nicotine inhaler, for example, has been shown in the most recent government clinical practice guidelines to be the most successful medication strategy available! By putting on a patch you are getting a steady state of nicotine to lessen withdrawal symptoms. By using the gum or the inhaler as needed, you will be developing a ritual which can serve as an alternative behavior when you feel like smoking. It also helps to use the second form of NRT when struggling or having tough times, especially in the first few smoke-free weeks.
(4) Be careful not to stop using NRT too soon. Many people delay quitting for years, but are in a tearing hurry to get off the NRT. Sometimes the problem can be overconfidence. In fact, overconfidence and under confidence are classic mistakes in using NRT. If you stop NRT before achieving a secure adjustment to being smoke-free, the next time you face stress, or drink alcohol, or visit with a smoker, or all three, may become a set up for a relapse. Under confidence usually shows up as avoiding the smoking problem altogether out of fear you won't be successful anyway.
(5) Don't rely only on NRT to do the job. Decide in advance of your quit date your own preferred behavioral strategies. Here are a few good tips that many people find helpful as alternatives to reaching for a cigarette:
Drink water and carry around a water bottle or suck on ice cubes when at home.
Learn to breathe slowly and deeply to relax, especially when you need a work break, or after a task you have completed, or when you experience stress.
Avoid smoke and smokers, or work out an arrangement with them so you don't have to breathe their smoke. Smoking is contagious!
Limit or avoid alcohol, especially when you are first smoke-free, and especially if smoking and drinking often go together for you.
Remember to use your NRT at risky times when you might be tempted to smoke! It is always safer to use NRT than to smoke. Remember, if you aren't smoking, you are healing both mentally and physically. Knowing how to get the most out of NRT can make your smoke-free journey as pain-free as possible!
Dr. Seidman is author of the new book Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit with a foreword by Dr. Mehmet Oz (Fireside Trade Paperback Original, January 2010). An audio book is available from Random House. After 20 years of helping smokers quit at Columbia University, Dr. Seidman first introduced his own program to stop smoking as a featured expert on The Oprah Winfrey Show with Dr. Oz early in 2008. For more details about the book go to www.danielfseidman.com