First get psyched up to make an adequate effort.  The U. S. Army was concerned about returning Vietnam Veterans who were addicted to heroin.  These were "normal" people who didn't want to be part of that scene over here and the vast majority of them quit heroin entirely on their own.  I have spoken to several of them as patients.  A couple of them had also tried to quit smoking. They stated that it was just as hard to quit smoking as to stop using heroin.  I mention this not to discourage, but to help with the "adequate effort".


Consider not talking about quitting.  Really it is more like a private itch than the usual New Year's resolution.  When somebody asks "have you quit smoking," answer "perhaps I have cut down some."  This is not fibbing, just humility.  Now if you relapse a few times, you have not lost face, making it more likely that you will make a prompt new attempt.  Keep setting new quit dates, perhaps a few days before a vacation, to get over the worst nicotine fits on company time. Above all, learn from mistakes.  Maybe you must wash the dishes promptly after meals.  This might have the beneficial side effect of amassing free floating brownie points with your associates (remember you are not talking about quitting). I have had a few older ladies decide they had to stay away from bingo for several weeks. The association between coffee or alcohol and smoking can stir up the craving. Drinking decaffeinated coffee doesn't help and alcohol saps will power as does Valium and similar drugs. They have the same receptor in the brain as alcohol. There is at least one drug that enhances the quit rate. The most widely used one is called Zyban. It requires a prescription, is expensive and moderately effective (like 30% success in one year against 15%).


Nicotine patches provide some nicotine through the skin, blunting withdrawal symptoms. Of course they do not supply instant relief the way inhaled nicotine does. Smoking with a patch in place increases the nicotine dose to the sum from both sources. Nicorette gum is also available without prescription and provides more instant relief of a severe nicotine fit than patches. For maximum relief, do not chew the gum furiously because that will produce more saliva containing nicotine. Swallowed nicotine, when it is absorbed, passes through the liver where it's destroyed, and therefore, does not contribute to a fix.   Chewing tobacco is much cheaper than Nicorette gum. If you are quite disgusted by the idea of chewing it, you are unlikely to get hooked on it. So carry chewing tobacco like a stunt pilot's parachute. He does not consider it a bad day when he does not need the parachute.


Finally, get into some strenuous physical activity that is enjoyable, for instance, dancing. When your ability to dance the fast numbers obviously improves, this will be a whole new dimension of motivation, much more effective than the preaching which this article represents. I have scarcely mentioned the well known health benefits of not smoking because they have become common knowledge and they are hard to deal with without preaching.


In summary, set a quit date, get psyched up to succeed, reduce time spent in situations where the craving is severe, learn from failures and pray for no letter from the IRS until you are firmly established in the rest of your life.                                 See also: 1) Why All of Us Don’t Get Tuberculosis under Medical     

                                                                 Basic Science & 2)An Innovative Treatment for Emphysema                                           

John A. Frantz, MD                                            under Other Science & Technology

Chairman, Monroe Board of Health     

March 14, 2001                                                                                          


“….you don’t reason a man out of something he wasn’t reasoned into.”

                                                                                                                Jonathan Swift, 1667 t0 1745