Expert: Ways to quit smoking that are proven to work

Neil L. Bartlett

ways to quit smokingMark Twain said, "Giving up smoking is the easiest thing in the world. I know because I've done it hundreds of times."

Over 18 percent of adult Americans smoke cigarettes - and often with deadly consequences. According to the Centers for Disease Control and Prevention (CDC), smoking causes one in every five deaths in the U.S.

But there's hope for smokers who want to quit. Thanks to Obamacare, there are more medications and other aids available than ever.

Dr. Scott McIntosh is the associate director of the Smoking Research Program at the University of Rochester Medical Center in New York. For two decades, he has worked with individuals who want to quit smoking. asked him about smoking addiction, new treatments to help smokers quit, how provisions in the Affordable Care Act can help and the effectiveness of e-cigarettes.

Q. Why is it so difficult for a smoker to quit?

A. Smoking isn't just a habit like the tobacco industry would like you to believe. It's a powerful addiction. Nicotine is one of the most addictive substances that humans can consume. Pound for pound, it's more addictive than cocaine. If there was no nicotine in cigarettes, the cigarette industry would die practically overnight.

The addiction is psychological and physical. So when you stop, you experience withdrawal symptoms. Then you're likely to feel more agitated and distressed. Then when you go back to smoking to relieve those symptoms, you tell yourself it's the nicotine that helps (with your) stress.

Nicotine also helps individuals experiencing severe depression. There are at least two monoamine oxidase inhibitors in tobacco. These are also found in many antidepressant medications.

But if smokers can stop successfully, they'll be rewarded with calm. The ups and downs they experienced while smoking will be gone. They'll handle stress much more easily.

The good news is that there are many types of tools and treatment options such as medications, patches and gum, talking therapy, Web help, and phone quit lines.

Q. Are there any 'success factors' that mark a successful switch from smoker to nonsmoker?

A. There's an old joke: How many psychologists does it take to change a light bulb? Answer: only one -- but the light bulb has to want to change.

Being motivated to quit is a key success factor in quitting, along with having a plan and resources to access. It may be your doctor telling you you're going to develop chronic obstructive pulmonary disease (COPD), or the cost of cigarettes is going through the roof, or smoking was just banned where you work. Maybe you see a scary TV ad showing an ex-smoker talking through a hole in their throat.

You won't be able to beat your nicotine addiction unless you've committed to stopping. But beyond motivation, you also need a plan and a strategy.

In the past, most smokers quit cold turkey. But that isn't necessary. It's also very difficult for most smokers to quit that way.

Q. How can your family physician help?

A. A good physician will ask you about your exposure to tobacco each time you visit. Some of them can also perform counseling. They should advocate for having your electronic health records updated so if you stop smoking, it's well-documented.

Your doctor can also act as an advocate. They might suggest the right medication for you or refer you to local support groups, or help you navigate your health plan's copays and help you access smoking cessation tools. Everybody's different when it comes to what will work for them, and a good physician will help you find what's right for you.

The most common treatment is nicotine replacement therapy - patches, gums, inhalers, nasal sprays and lozenges. There are many medications available if those don't work. And there are new products in development, including a vaccine.

The Affordable Care Act requires most health insurance companies to provide "quit smoking" services at no cost.

Q. What objections are most common from a smoker trying to stop smoking?

A. Often there's denial -- a smoker tells himself, "it's not as harmful as my doctor's making it out be." Or they've tried and were unsuccessful. They don't want to try again and look weak in front of their partner or kids.

There's a big fear of gaining weight. But studies show that most individuals don't gain weight when they stop smoking. Of those who do, one-third to one-half only gain five to eight pounds -- but that's enough to keep some people from trying to quit.

Q. What's about smokeless tobacco and e-cigarettes? Is it helpful for a smoker to be able to 'wean off' smoking using these tools?

A. The evidence so far is that these products aren't successful in helping you quit smoking. Seventy to 90 percent of people who use e-cigarettes also smoke regular cigarettes. And often with e-cigarettes, there's no plan or strategy.

Just as there's no such animal as a harm-free tobacco product, there's no such thing as a harm-free e-cigarette yet. There are toxins in e-cigarettes -- not just carcinogens but oxidants that can cause oxidative stress which can increase the likelihood of lung cancer, COPD and atherosclerosis.

Just as there's secondhand smoke, there's also secondhand vapor that lands on your counters and clothing and gets into your skin. Vapor isn't just steam -- it contains toxins and carcinogens.

Q. Any other advice?

A. Don't give up! There are plenty of resources to help you. Visit for strategies and tips. Or you can call 1-800-QUITNOW and they'll connect you to resources in your state.