Like 36 million Americans, you may have a close relationship with cigarettes or other products and devices that deliver nicotine, a derivative of tobacco. And, like 25 million of those U.S. tobacco users, you may be trying to quit. Nicotine products physically and emotionally draw you in, and it doesn't matter whether you're smoking or vaping, dipping or using snuff.
Nicotine addiction is nothing new, but as many people try to leave it behind, they face a daunting task. The problem is compounded by fears of side effects, such as weight gain, and a wealth of misinformation.
Fortunately, you're not the first person to face such challenges. Weaning off nicotine is possible, and you can avoid weight gain and other side effects – the key is to have a plan.
Why quit? You tell me.
Quitting nicotine is a personal choice. No one can tell you why it matters, or make you do it. At the National Jewish Health QuitLogix tobacco cessation program, we answer 7,000 to 22,000 calls every month from people wanting to quit, and I advise our counselors to follow the caller's goals, not our own.
For most of our patients at National Jewish Health, mortality is the biggest motivator to abandon tobacco products. For others, the motivation is more immediate. Activities that were once simple, like walking up stairs, may have become a struggle. Or the isolation from needing to step out for a cigarette, whether at work or with family, has grown burdensome.
While cancer spawns the most fear about tobacco—and lung cancer is the leading cause of cancer death in the United States—its impact pales compared to heart disease. Some people remark how their grandparent smoked for a lifetime and never got cancer. But, that relative likely died prematurely from a heart attack or stroke, something sadly too common to be noticed as “linked to smoking.”
It may be comforting to know that when you quit, the impact is immediate. Within 20 minutes after smoking your last cigarette, your heart rate will drop. One year after quitting, your risk of coronary heart disease is half that of a current smoker. After 10 years, your risk of dying from lung cancer is half that of current smokers, and you also lower your risk of cancers in the mouth, throat, esophagus, bladder, kidney and pancreas. (A more complete list of benefits is available in this CDC poster.)
What about the weight?
Statistically, the majority of people who quit tobacco gain weight, though there are misperceptions about how much. On average, people only gain five to seven pounds. However, even that isn't necessary – there's a lot one can do to postpone or prevent weight gain, from chewing on toothpicks to taking prescription medications, and everything in between. The truth is, quitting can add an extra decade of life, but you do not have to accept weight gain or other over-hyped compromises.
While metabolism may change when you quit, the most obvious impacts on weight come from rising stress and the otherwise welcome return of taste and smell. However, medications to help you quit, like bupropion (Wellbutrin, Zyban, and their generics), can curtail hunger while nicotine gum and lozenges can help delay weight gain.
Perhaps the most complex reasons for overeating during withdrawal are the emotional triggers. You may grow irritable, and it can be a drag when a close friend tells you, "Hey, I liked you better when you were smoking," but it's not you, or your character or any lack of strength. It's withdrawal, and it will fade along with the physical health effects. People also will tell me a cigarette is their best friend. That cigarette has been with you through life's challenges, and leaving that behind, there's often a sadness and sometimes grief that goes with it. When you then add shame, from a constant drumbeat telling you to quit, it's a recipe for emotional eating. We know you want to quit, there's no need for anyone to hammer you with guilt.
So how do you keep the weight off?
A long history of research, with thousands of smokers, reveals you'll have the best chance of quitting by reaching out for help. Those providing help can guide you on how to avoid weight gain, tailored to your goals and priorities, but here are a few tips to help you get started.
1. Develop a personal plan. If weight is a barrier keeping you from quitting, tell your doctor or coach to make sure it's addressed in your personal quit plan.
2. Use over-the-counter help. Nicotine gum and lozenges can fight weight gain, so have them at the ready before you walk away from tobacco products.
3. Get moving. When you wake up, go for a walk, breaking your morning routine. Incorporate more activity into your day for distraction, and to feel better as you move around. You don't have to spend an hour at the gym, just stay active and break routine.
4. Stay away from triggers. Don't grab that cup of hot coffee when you first wake up, it can be a smoking trigger (switching to iced coffee can help). Avoid stressful situations, and temporarily avoid social outings where friends or situations may lead you astray. And while difficult for some, you'll also get a powerful boost if you can briefly step away from alcohol.
5. Recognize emotional eating. Recognize that you are going through a transition, and develop coping strategies that endure far beyond the last cigarette. Exercise forces your body to release endorphins, and it can be a powerful distraction when emotions trigger food cravings.
6. Get creative. Many smokers I've worked with found a straw or toothpick can be a remarkable distraction. It turns out some drinking straws are about the same width as a cigarette and can serve to keep your mouth busy.
7. Consider prescription medications. Studies suggest medications to help you quit (both prescription and OTC) will give you the best chance of leaving nicotine without adding weight. However, they're not for everyone, so talk to your doctor first.
For all of these, keep in mind the “Three As.” Alter your routines, develop Alternatives and Avoid triggers. None of the changes need to be forever, but all can help you reach your quitting goals. Also consider using a 10-point scale during withdrawal – if you're having cravings or stresses at a level of five or above, get out of that situation.
You can do this
So many positive things will happen, to you and your body, when you quit. Weight gain spawns such a strong fear for many people, and yet that fear is not necessary when beating addiction.
Our team at National Jewish Health in Denver is connected to 1-800-QUIT-NOW, a quitline for people in all 50 states, and the line automatically directs you to someone in your state. The key is getting started with your own plan.
Quitting is complicated and unique for everyone, but not at all beyond reach. Understanding what's involved and not complicating the process with judgment will be critical to success.
This is not about any emotional weakness you may have – your body is unique in how it responds to the complexity of nicotine. However, with a personal approach, you can leave addiction behind.