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Do you know why you want to stop smoking? People who have quit say it's important to be clear about your reasons. Here are some of the best reasons we know.

Smoking kills

Every year, about 19,000 Australians die from diseases caused by smoking.' One in two lifetime smokers will die from their habit. Half of these deaths will occur in middle age.'

Cigarettes are full of poisons

Tobacco smoke contains over 4,000 chemicals.' As well as tar and nicotine, there is also the gas carbon monoxide (found in car exhaust fumes), ammonia (found in floor cleaner) and arsenic (found in rat poison).' At least 43 of the chemicals in tobacco smoke are known to cause cancers of the lung, throat, mouth, bladder and kidneys." Tobacco smoke also contributes to a number of other cancers.

• Nicotine is the addictive drug in tobacco.' The mixture of nicotine and carbon monoxide in each cigarette you smoke temporarily increases your head rate and blood pressure, straining your heart and blood vessels.' This can cause heart attacks and stroke. It slows your blood flow, cutting off oxygen to your feet and hands.' Some smokers end up having their limbs amputated.
• Tar coats your lungs like soot in a chimney and causes cancer. A 20-a-day smoker breathes in up to a full cup (210 g) of tar in a year.' Changing to low-tar cigarettes doesn't help because smokers usually take deeper puffs and hold the smoke in for longer, dragging the tar deeper into their lungs."
• Carbon monoxide robs your muscles, brain and body tissue of oxygen, making your whole body - especially your heart - work harder." Over time, your airways swell up and let less air into your lungs."

Smoking causes disease

Smoking is a slow way to die. The strain put on your body by smoking often causes years of suffering.

Emphysema is an illness that slowly rots your lungs. People with emphysema often get bronchitis again and again, and suffer lung and heart failure .12

Lung cancer is caused by the tar in tobacco smoke." Men who smoke are ten times more likely to die from lung cancer than non smokers.

A diseased lung stained by tar. (opposite)
This lung removed from a smoker, shows a lung cancer (white tissue) blocking the main air passage to the right lung. The tumour extends to the outside of the lung.
Picture courtesy of the Prince Charles Hospital Departmet of Pathology and Medical Photography

Heart disease and strokes are also more common among smokers than non-smokers-' Smoking causes fat deposits to narrow and block blood vessels which leads to heart attack.' Smoking causes around one in five deaths from heart disease.' In younger people, three out of four deaths from heart disease are due to smoking."

More good reasons to quit

• Confidence. Quitting smoking is a challenge. Once you have quit, you will know you can succeed at a difficult job and take control of your life. Quitting helps you believe in yourself and take on other challenges.
• Fitness. Smoking makes it harder to exercise and reduces the benefits to your body." Smokers have more coughs and colds than non-smokers and take longer to feel well again.'
• Money. In a way, giving up smoking is like getting a pay rise, as much as $2500* a year if you smoke 25 cigarettes a day.
• Your appearance. Skin starved of oxygen by smoking becomes dry and grey."' Wrinkles around the eyes and mouth develop much earlier,"" and the tar stains your teeth and fingers.
• Fertility and childbirth. Men who smoke may suffer impotence due to damage to the blood vessels in the penis." Sperm quality and density can also be affected by smoking. Smokers may produce less sperm and their sperm may have more abnormalities.' Women who smoke take longer to conceive and are more likely to have a miscarriage."'
• Babies born to mothers who smoked in pregnancy are more likely to be premature, stillborn or die shortly after birth."' A baby exposed to tobacco smoke has a higher risk of dying from cot death."
• Children whose parents smoke are more likely to get pneumonia and bronchitis in their first year of life, to suffer from more frequent and more severe asthma attacks 21 and to become regular smokers themselves. 22

*At the time of publication.

Smokers who plan before they quit are more successful than those who don't, and planning can be done quickly. There are four stages of getting ready:

• Understand your nicotine addiction
• Know why you smoke
• Plan ways to deal with quitting
• Set a date to quit

1. Understand your nicotine addiction

Nicotine is a drug that produces many different effects on the body at the same time'. It stimulates your system, even though it makes you feel relaxed.6 Nicotine affects the chemicals in your brain 6 and, after a puff, you usually feel good for a moment or two.

New smokers often feel dizzy and sick from tobacco smoke, but they get used to its effects.' As they continue to smoke, smokers' bodies learn to depend on nicotine and they can smoke more and more.

When smokers stop, most get cravings, they can feel anxious, hungry and irritable, and they find it hard to focus on what they are doing.' Even after giving up smoking for long periods of time, most smokers who try to just have an occasional cigarette quickly return to regular smoking.

Surprising as it sounds, research shows that for many smokers their addiction to nicotine is similar to addiction to heroin or cocaine.' For example, research shows that some smokers cannot bring themselves to quit even though they think smoking is harmful they don't believe that they will be affected .21

2. Know why you smoke

All smokers have their own smoking habit, and these habits are often tied to certain moods, events or places.
Some of the most common reasons why people smoke are:

• emotions: feeling stressed, upset, angry or frustrated
• pleasure: to enjoy something even more or to reward yourself
• social pressure: feeling part of the crowd
• habit: feeling used to doing things while smoking
• addiction: to satisfy the craving for nicotine

3. Plan ways to deal with quitting

Telephone the Quit office: 131 848 (Melbourne, Australia)

You can get some help in planning how to quit.

Visit your doctor

If you have asthma, are overweight or have other health problems or would like more advice, visit your doctor and talk about your plan to quit smoking. Your doctor might recommend using nicotine gum or patches or want to see you tor regular checks.

Example of Smoking Record. >>

Nicotine gum and patches

If you are a heavy smoker, using nicotine gum or patches in the first few weeks or months of quitting may improve your chance of success. However, most people who succeed go cold turkey. Your doctor or pharmacist can explain to you how to use gum or patches safely.

Plan for your most risky times

After you've done the Smoking Record exercise, you'll know when you are most likely to light up. Work out how you will deal with these situations (see Step Three: Quitting and Step Four: Staying a Non-Smoker for ideas).

Find a quitting partner

Set a quit date with a friend or workmate and plan to quit together. Consider doing a Quit course.

Get help from friends and family

Tell your family and friends you plan to quit, and explain how they can help and encourage you. Look at your Smoking Record and check whether any of your family and friends actually make you want to smoke. It may be best to simply avoid the subject with them.

TRY THIS

Clean up the day before your Quit Day. Check your house, car, workplace (and anywhere else that has anything to do with smoking) and throw out cigarettes, lighters and ashtrays.

4. Set a date to quit

Unless there is a very good reason, make the date within two or three weeks from now. Choose an easy date to stop, one when you will not be under much pressure, but will have plenty to occupy yourself.

Some words about weight gain

When you quit smoking, you may gain weight, although not all ex-smokers do. Of those people who do gain weight, half put on less than two kilos.'

Many smokers are underweight because smoking suppresses the appetite and nicotine speeds up the body's processes."' When you stop smoking, your body needs less energy; however, you may feel hungrier.

For some smokers, worrying about putting on weight stops them from trying to quit. If you are one of those people, remember:

• Not everyone gains weight when they stop smoking.
• Be informed. Find out whether you will still be in the normal weight range for your height and age if you put on up to two kilos.
• Act on your concerns. Talk to a doctor or dietitian, and make a sensible eating plan.
• Exercise. It's the best way to keep your weight down, and it keeps you fit.
• Eat healthy snacks. But be realistic, allow yourself some treats.

Deciding to quit checklist

• I'll reduce my risk of heart attack.
• I'll reduce my risk of getting cancer.
• I'll feet fitter and my skin will look younger.
• Within two hours, my body will be free of nicotine.
• I'll set a great example for the children around me.
• My lungs will start to repair themselves, getting rid of the build-up of tar.
• I'll have more money to spend any way I choose.
• My teeth will be whiter.
• I'll give myself a confidence boost by quitting cigarettes.

Are you thinking about how hard quitting could be, or are you looking forward to the challenge? Acknowledge your feelings, but stick to your decision. You're doing the right thing.

How to quit

Choose an approach that willwork for you

• Going cold turkey means stopping suddenly and completely. For most people, this is the most successful method.
• Cut down by reducing to five cigarettes a day, going on half rations or delaying your first cigarette by an hour each day. If you choose to cut down, make sure your quit date is set for two weeks after you start.

Understand withdrawal symptoms

Withdrawal symptoms are the way your body reacts when it stops getting nicotine and all the other chemicals in tobacco smoke. Think of them as recovery symptoms.

Some recovery symptoms will come and go over a period of a few days, and most are gone within two to three weeks. The emotional symptoms such as anxiety and irritability - are closely tied to the physical reaction of your body as the nicotine leaves your system.

Common recovery symptoms include:

• Cravings - Each one lasts a short time, but may be strong. Over time, cravings will happen less often.
• Occasional headaches.
• Upset digestion, constipation, nausea, diarrhoea or a sore throat - rarely last more than four days.
• Changed sleeping patterns; unusual or strong dreams. Many people find they sleep better.
• Coughing - means the cilia that line your lungs are working again and are sweeping out the tar and mucus.
• Feelings of irritability, depression or anxiety - will lessen over one to three weeks.
• Temporary increase in appetite and possible weight gain.

Coping with recovery symptoms

The first few days after you quit can be the hardest.

Confront cravings
Few smokers can quit without feeling cravings. They are hard to avoid altogether. To quit, you must learn to live through them until they no longer happen. Here is one way to confront your cravings and overcome the urge to smoke:

Remember THE 4Ds:

• Delay acting on the urge to smoke. Don't open a pack or light a cigarette. After five minutes, the urge to smoke weakens and your resolve to quit will come back.
• Deep breathe. Take a long slow breath in, and slowly out again. Repeat three times.
• Drink water. Sip it slowly, holding it in your mouth a little longer to savour the taste.
• Do something else. Take your mind off smoking by taking action put on some music, go for a walk or ring a friend.

Just one WILL hurt
Having 'just one' is the way that most people go back to regular smoking. Quitting means resisting the urge to smoke even one cigarette, despite the cravings, the habit, the pressure and your own emotional reasons.

Take one day at a time
Focus on getting through each day without smoking. Remember your first cigarette? It probably made you feel sick and dizzy. He kind to your body as it adjusts to living without the nicotine it has got used to.

Tea, coffee and cola drinks
These drinks contain caffeine and, without nicotine, your body absorbs much more of this stimulant, making you restless, irritable and sleepless for a while.' Try drinking fewer or weaker cups of tea and coffee, coffee substitutes, water, fruit juice or low joule, caffeine-free cola drinks.

Reward yourself
Congratulate yourself every time you beat the urge to smoke.

Remind yourself
Take out your list of reasons for quitting and the things you want to do as a non-smoker

Refuse offers of cigarettes
You have the right to refuse a cigarette and can do so without upsetting others.

The problem of empty hands
It you need to keep your hands busy, try keys or beads, or keep active.

Smoking and other drugs
Research shows that many ex-smokers cannot resist smoking when drinking alcohol." Alcohol and other drugs may weaken your resolve about giving up smoking, so it might be best to avoid these for a few weeks.

FIND NEW WAYS TO RELAX

• Lie down or sit in a comfortable position.
• Close your eyes and take a few deep breaths.
• Tighten your feet and toes, hold them tight for three seconds, then relax them. Repeat this exercise with your leg muscles, your stomach and your arms and shoulders.
• Think about something relaxing, perhaps lying in the shade of a tree on a hot day ... a gentle breeze brushes your skin ... the leaves rustle quietly ... nothing to do just now but close your eyes and let your mind drift ...
• When you are relaxed and ready, open your eyes and bring the good feelings with you.

3. ASK A FRIEND for a neck and shoulder massage.

• Get up earlier, and go for a morning walk, or sit in a different place for breakfast.
• Choose a different chair to watch TV, and eat some sugarfree popcorn or chewing gum.
• Have a pen and paper by the phone so you can doodle, or move around while you are talking.
• Take a soft rubber ball in the car, and do hand exercises if you are stuck in traffic.
• Go off alcohol for a while and try a soft drink instead.

5. EXERCISE. This can be as simple as getting off the bus one stop early and walking the extra distance or using stairs instead of lifts.

Quitting can be hard. You might be going along OK, and suddenly you feel like smoking again. Sometimes, as you gain confidence, you actually start to think quitting is easy, so why not smoke again? Your resolve starts to weaken.

TRY THIS

• Remember, every craving only lasts a few minutes. You can fight it off: delay, deep breathe, drink water, or do something else.
• Remind Yourself of the times when you found the going really tough, and how much work you put into preparing and achieving your goal. Think of how far you have come. Do you really want to have to start all over again?
• List Your Reasons for quitting on a card that you can carry with you. Read the reasons whenever you feel the urge to smoke.

IF YOU HAVE A CIGARETTE
Think of how long you have gone without a cigarette and say to yourself: " I'm determined to give up. After all, 1 have only slipped up once. In the past, 1 would have smoked 20 a day. 1 am determined to quit."

IF YOU GO BACK TO REGULAR SMOKING

Don't despair, and don't give up on your plan to quit.
Most people who have successfully quit smoking for good have made several serious attempts. Every day that you have spent smokefree, makes your body healthier and helps to break your habit and weaken your addiction. Remember, you took a long time to learn the habit of smoking, so it may take you a while to learn to be a non-smoker.

TRY THIS
Use what you have learned from your quit attempt, and plan another date to give up as soon as possible. If you have lost the urge to give up, go back to the first section of this book. Go through all the steps in this book again if that helps you.

REMEMBER, THE QUITLINE IS THERE FOR YOU. CALL 131 848.

Extacted from "Quit because you can" booklet - Victorian Smoking and Health Program
PO Box 888 Carlton South, Victoria, 3053, Australia. © 1997