**Getting Started**

**How do I quit? --- The basics of just what works.**

What works is easy. It is three things:

-   Counseling

-   Medications for quitting smoking

-   Follow-up

**Counseling** means receiving advice from a doctor, nurse or other
health care provider. You may be saying, \"I don\'t need counseling. I
already know what to do.\" However, if you don\'t get counseling, you
may be cheating yourself, and here is why. First, counseling doubles
your chance of successfully quitting. And why wouldn\'t you want to
double your chance of becoming a non-smoker? You wouldn\'t turn down an
offer of double your salary, so don\'t turn down this double. The second
reason is that in spite of all you already know, you still are smoking.
Even if you only learn a few things this time, those might be the key to
your success. And sometimes hearing the same information is a good way
to reinforce your commitment. Counseling will help you quit, so let your
VA provider make sure you receive counseling.

**Medications** also double your chances of success. There are different
forms of nicotine replacement therapy (nicotine patch, gum, lozenge,
inhaler, and nasal spray). And there is also a drug called bupropion
(Zyban). All medicines for quitting smoking work equally well --- they
all double your chances of successfully quitting. The medicines you are
most likely to receive from the VA are nicotine patch or bupropion
(Zyban), and possibly nicotine gum or nicotine lozenge. VA also
carefully considers new FDA-approved medications as they become
available to see if they will be helpful to our patients. So along with
counseling, ask your doctor for a prescription to help you quit.
Remember, only turkeys try to quit cold turkey!

**Follow-up** means having another contact with your VA provider to
discuss your efforts at quitting. Simply put, more contacts to discuss
quitting means more success. And they can be in person or by telephone,
they can be with your provider, with a nurse or pharmacist, with the
smoking cessation clinic, you name it. The ways you can arrange
follow-up are limited only by your creativity.

If you have any health problems or take medications, you should consult
with your healthcare provider. Recording your personal and family
history under the My Health***[e]{.underline}***Vet Health History
section can provide valuable information and help your health care
provider get you started. It is important to look at your health history
and lifestyle as they relate to you or your family. Make sure you record
if you have diabetes, hypertension, heart disease or other health
problems --- all of which can be influenced by use of tobacco products.
My Health***[e]{.underline}***Vet has many ways to help you manage your
healthcare. Start tracking your health today.

Remember to ask your health care provider for counseling, medications,
and follow-up. You\'ll soon join the ranks of people who can call
themselves former smokers!

-   [How Can I Kick the Habit?](../SMOKE_Kick%20the%20Habit.doc) (Word
    Doc)

-   [Should I Quit Smoking?](../SMOKE_Should%20I%20Quit%20Smoking.doc)
    (Word Doc)

-   [Clearing the Air---Quit Smoking Today]{.underline} (PDF)

    **General Information - Smoking and Tobacco Use Cessation**

Check out information about stopping the use of tobacco, how tobacco
affects your health, the benefits of quitting, tips on how to get
started, and how to stay on track.

Smoking cessation or giving up tobacco products has many health
benefits. Once you quit, you will begin to have more energy and feel
better.

-   [[Benefits of
    Change]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=healthyLiving&contentPage=healthy_living/smoking_cessation_benefits_of_change.htm)

-   [[Starting Healthy
    Living]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=healthyLiving&contentPage=healthy_living/smoking_cessation_starting_healthy_living.htm)

-   [[Special
    Situations]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=healthyLiving&contentPage=healthy_living/smoking_cessation_special_situations.htm)

    **What Happens When You Stop Smoking\...**

It is never too late to quit and benefit from a smoke-free lifestyle.
Even people who have smoked for decades can notice big changes within
just a few minutes.

**Within 20 Minutes:**

-   Blood pressure drops to normal

-   Pulse rate returns to normal

-   Body temperature of hands and feet increases to normal

If you are having withdrawal symptoms, drink a glass of water, suck on a
mint, or keep your hands busy until the urge leaves. Take deep breaths
to calm yourself.

**Within 8 Hours:**

-   Carbon monoxide level in blood drops to normal

-   Oxygen level in blood increases to normal

-   Smoker\'s breath disappears

It is common to feel restless at this time, so keep your hands and mind
busy. Good choices are jigsaw puzzles, coins, twine or bead strands,
marbles, and rubber bands.

**Within 24 Hours:**

-   Your chance of a heart attack decreases

If you are out-of-sorts or snapping at family and friends, your sleeping
habits may need help. You will sleep better and feel calmer if you
exercise daily or go for long walks.

**Within 48 Hours:**

-   Nerve endings start to re-grow

-   Your ability to smell and taste is enhanced

Use your support network to help with cravings. Keep drinking plenty of
water to flush toxins. Review your lists of reasons to quit. Reward
yourself for quitting!

**Within 72 Hours:**

-   Bronchial tubes relax making it easier to breathe

-   Lung capacity increases making it easier to do physical activities

If you are tense and nervous, practice your deep breathing exercises. Be
sure to set aside time for rest and relaxation.

**Within Two Weeks - Three Months:**

-   Circulation improves

-   Walking becomes easier

-   Lung function increases up to 30%

If you are worried about weight gain, pick foods that are low in fat,
sugar and salt. Go for a 10-minute walk 3 or more days a week.

**Within One to Nine Months:**

-   Coughing, sinus congestion, fatigue, shortness of breath decrease

-   Your body\'s overall energy level increases

-   Cilia re-grow in lungs, increasing the ability to handle mucus,
    clean lungs, reduce infection

You may still have cravings during this time. Keep up your exercise
program. Continue to review your reasons for quitting. Plan ahead for
future smoking triggers.

**Within One Year:**

-   Risk of coronary heart disease is half that of a smoker

This is a milestone and should be celebrated. You will have fewer urges
at this stage, but keep using your coping skills to help with triggers.

**Within Two Years:**

-   Heart attack risk drops to near normal

Urges may be gone, but remember that many people relapse because they
forget that just one puff leads back to a pack a day.

**Within 5 Years:**

-   Lung cancer death rate decreases by almost half

-   Stroke risk is reduced

-   Risk of mouth, throat and esophageal cancer is cut in half

    **Within 10 Years:**

```{=html}
<!-- -->
```
-   Lung cancer death rate is similar to that of a lifetime non-smoker

-   Pre-cancerous cells are replaced

    **Starting Healthy Living - Smoking and Tobacco Use Cessation**

Healthy living is an important part of a good smoking cessation program.
Good eating habits and a movement and exercise program will not only
help take your mind off tobacco products, it will provide a foundation
for a healthier life style. After quitting, you\'ll notice that you have
more energy, have increased stamina, and are able to breathe easier.
These changes will help you get used to your new healthy look. The key
is to begin the journey by asking yourself, [[should I quit
smoking?]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/Should I Quit Smoking.doc)
(Word Doc).

It is a concern of many smokers that when they quit smoking they may
gain weight. Learn [how to avoid gaining
weight](../EDUCATION_Avoid%20Gaining%20Weight.doc) (Word Doc). There are
three things you can do to manage your weight:

-   [increase physical activity]{.underline}

#### Physical Activity - Smoking and Tobacco Use Cessation

When you quit using tobacco products you will begin to breathe better
and have more physical energy. This is the time to think about physical
exercise. Different types of physical activities include planned and
routine workouts. An activity as simple as walking can provide great
benefit. Visit [[Physical Activity
Center]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=healthyLiving&contentPage=healthy_living/movement_exercise_intro.htm)
to learn more. *(Note: This will take you out of this center to another
healthy living center)*

-   [[make healthy food
    choices]{.underline}](http://www.move.va.gov/download/NewHandouts/Standard/S06_MakingHealthyFoodChoices.pdf)
    (PDF)

-   [[change your
    behavior]{.underline}](http://www.move.va.gov/download/NewHandouts/Standard/S09_ChangeYourBehavior.pdf)
    (PDF)

[[Basics of Weight
Control]{.underline}](http://www.move.va.gov/download/NewHandouts/Standard/S01_TheBasicsOfWeightControl.pdf)
(MOVE! Weight Management Program) (PDF)

[[Making Healthy Food
Choices]{.underline}](http://www.move.va.gov/download/NewHandouts/Standard/S06_MakingHealthyFoodChoices.pdf)
(MOVE! Weight Management Program) (PDF)

[[Change your
Behavior]{.underline}](http://www.move.va.gov/download/NewHandouts/Standard/S09_ChangeYourBehavior.pdf)
(MOVE! Weight Management Program) (PDF)

#### Special Situations - Smoking and Tobacco Use Cessation

Work with your health care provider to develop a successful plan to stop
using tobacco products. You may already know what to do, but support
from your health care provider can improve your chance of successfully
quitting. Talk with your health care provider about medications that may
double or triple your chance of success in quiting. Also, ask your
health care provider about clinical resources available locally.

#### Self-Management - Smoking and Tobacco Use Cessation

Developing new skills and making behavior changes is necessary to help
you soon join the ranks of people who can call themselves former
smokers! These new skills and behaviors include advice on how to quit
tobacco use, cope with how to change old bad habits and to stay on
track.

#### Self-Assessment - Smoking and Tobacco Use Cessation

The first step to self-assessment is asking the question: [[Should I
Quit
Smoking?]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/Should I Quit Smoking.doc)
(Word Doc)

Learn about helpful tips to quit smoking and live a healthier life
style. Consider advice on how to avoid the temptation to smoke again.

Change old habits for healthier new ones by becoming aware of your
actions. However, changing too many things at once is difficult and
stressful. It is better to change one or two things at a time. Here are
[[strategies to help you change your
behavior]{.underline}](http://www.move.va.gov/download/NewHandouts/BehavioralHealth/B01_OldHabitsDieHard.pdf)
(PDF) long-term.

If you have any health problems or take medications, you should consult
with your health care provider. Recording your personal and family
history under the My Health***[e]{.underline}***Vet [[Health
History]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=medicalHistory)
section can provide valuable information and help your health care
provider get you started. It is important to look at health history and
lifestyle as they relate to you or your family. Many chronic illnesses,
including but not limited to HIV and Hepatitis C, are affected by the
use of tobacco products. Make sure you record if you have diabetes,
hypertension, heart disease or other health problems which can be
influenced by use of tobacco products. My Health***[e]{.underline}***Vet
has many ways to help you manage your healthcare. Start tracking your
health today.

[[Old Habits Die
Hard]{.underline}](http://www.move.va.gov/download/NewHandouts/BehavioralHealth/B01_OldHabitsDieHard.pdf)
(MOVE! Weight Management Program) (PDF)

**Tips to Quit Smoking**

-   Stop carrying cigarettes with you. Put them away in a place that in
    inconvenient, so you have to make a real effort to go get each one.
    That way, the habit of automatically reaching for a cigarette is
    interrupted.

-   Smoke outdoors *only*. Stop smoking in your house or your vehicle.

-   When you smoke, do absolutely nothing else at the same time. Break
    the connections between smoking and other activities.

-   After eating, and also after getting up in the morning, wait a while
    before lighting a cigarette. Break those connections!

-   Only buy one pack at a time. No cartons.

-   Once you are in treatment and have quit, get rid of ashtrays,
    lighters, and other reminders to smoke.

-   Put something else in your mouth instead of a cigarette -
    toothpicks, mints, gum, straws, carrot sticks, etc.

-   Do something to distract yourself to make the urge to smoke
    disappear.

-   Make some personal reminder cards. Write something on each one that
    will motivate you. Carry them with you where you used to carry
    cigarettes.

-   Ask others to give you support and encouragement. And accept it!

-   Ask your health care provider about taking bupropion SR and using
    nicotine replacement products. Although they won\'t quit smoking for
    you, they can really help and will double or triple your chances of
    quitting! Use them as directed.

-   On the day you quit, get rid of *all tobacco*.

-   **Always remember that you have been addicted to a very powerful
    drug!** This means that smoking even a few puffs will start your
    addiction over again, and quickly! Don\'t do it!

    **Risk Reduction - Smoking and Tobacco Use Cessation**

Why should I quit? No matter how old you are, quitting smoking or
tobacco use is the single most effective thing you can do to improve
your health. It is never too late to quit. In fact, older smokers are
more likely to be successful than younger smokers.

Tobacco use kills more than 440,000 Americans each year --- more than
alcohol, cocaine, heroin, homicide, suicide, car accidents, and HIV/AIDS
combined.

Smokers are also at higher risk for the following:

-   a shorter life (smokers die 13 -15 years earlier),

-   lung disease, such as bronchitis or emphysema

-   cancers of the lung, mouth, esophagus, stomach, pancreas, cervix,
    kidney, and bladder,

-   heart disease and stroke,

-   sexual impotence and infertility,

-   increased depression & anxiety,

-   cataracts, skin wrinkling, and skin discoloration,

-   increased use of other drugs and alcohol, and

-   complicated pregnancies.

Smoking doesn\'t kill *just* smokers. Approximately 50,000 Americans die
each year as a result of breathing other people\'s smoke. The recent
U.S. Surgeon General Report on the health effects of secondhand smokers
concluded that secondhand smoke causes early death and disease in
children and adults who do not smoke. The non-smoking spouse of a smoker
is more likely to have heart disease or lung cancer than if they were
not exposed to smoke in the home. Infants and children who are exposed
to smoke are at higher risk for dangerous diseases such as sudden infant
death syndrome (SIDS), severe respiratory illnesses, ear infections, and
asthma. And, the most effective way to make sure that your children
never smoke is to not smoke. You can help save the health of those you
love by quitting smoking.

Cigarette smoke contains many very dangerous chemicals, such as arsenic,
and others found in DDT and insecticides.

Smoking is expensive. In addition to the costs associated with increased
illnesses, at over \$3.00 a pack, a smoker can expect to save well over
\$1,000 a year.

**How to Avoid Gaining Weight**

Some smokers gain a little weight after they quit. However, the average
weight gain is less than 10 pounds, and many ex-smokers are able to
avoid weight gain altogether by eating healthy and increasing their
activity level. After quitting, you\'ll notice that you have more
energy, have increased stamina, and are able to breathe easier. These
changes will help you get used to your new healthy look.

***In preparation for quitting, try the following suggestions:***

1.  Stock up on *healthy snacks*.

2.  Replace potato chips with crunchy *baby carrots and celery*.

3.  Replace candy with almonds, sunflower seeds and other *nuts*.

4.  Replace soft drinks with *lots of water* to flush toxins out of your
    body.

5.  Take *fresh fruit* and other healthy snacks with you.

6.  Limit yourself to *low-calorie choices* when eating outside your
    home.

7.  *Take your lunch with you to work*\... you\'ll be less likely to buy
    fattening foods and you\'ll save money.

8.  *Avoid fast-food restaurants* or other \'tempting\' places.

9.  *Avoid foods and drinks that remind you of smoking*.

10. *Eat slowly and mindfully*. When you eat, *only eat*. Turn off TV
    and unplug the phone (we are much more likely to overeat when we are
    multi-tasking). Never eat \"on the run\" or while driving!

11. Try not to deny yourself an *occasional* food treat\... we are much
    more likely to \"binge\" when we feel denied that occasional
    favorite food.

12. Take a *daily walk, and work your way up to 30 minutes of brisk
    exercise every day*.

**The key is *not* to \"diet\" or cut down on how much you eat, but
rather to *make healthier eating and lifestyle choices*.**

***Extra Tips For Weight Management***

1.  Treat: Frozen pops in a paper cup - use applesauce, or combination
    fruit juice and chopped fruit, or just fruit juices. Put wooden
    stick in center after 1/2 frozen. Enjoy when frozen hard.

2.  Treat: Instead of a candy bar or chips, try toasted whole wheat
    lightly spread with honey.

3.  Treat: Chocolate cravings can be satisfied with instant, no-sugar
    chocolate pudding.

4.  If you exercise at least three times per week along with your new
    dietary program, you will find that weight gain will probably be
    manageable and temporary.

5.  Should you gain more than 5 pounds after quitting, remember that it
    would take 100 pounds or more excess weight to do as much damage to
    your body as smoking does. Even with extra weight, you will feel and
    look better\... remember that smoking causes body odor, bad breath,
    yellowed skin, etc.

    **Spiritual Care - Smoking and Tobacco Use Cessation**

Illness, surgery, traumatic events, and life stresses can affect how you
see the world and others in it, including your spiritual life and
values. In these situations, you may have concerns about your spiritual
beliefs and relationships with others. The VA is concerned about you as
a whole person and committed to offering spiritual care as part of your
treatment.

For many people, illness extends beyond physical effects. If you are
ill, you may fear loss of family or close friendships, loss of respect
from others, loss of your ability to participate in activities you find
enjoyable, or financial loss. It is common for people who are ill to
experience worry, nervousness, or grief about such losses.

For most people, having surgery is stressful. If you are scheduled for
surgery, you may experience shock, denial, anger, guilt, sadness,
acceptance, and so on. You may be afraid that bad things might happen to
you. For example, you may worry about having serious complications or
other life changes after surgery.

When traumatic events happen, they may cause you to question your
spiritual and/or religious beliefs, to feel anxiety, depression, shame,
guilt, or anger at what has happened. You may even experience a loss of
trusting relationships or withdrawal from others. While the most
familiar traumatic experience for veterans is combat, other traumas may
have occurred. These events include but are not limited to serious
accidents, natural disasters, child abuse, or rape.

Stress from these events may cause spiritual and/or religious conflicts
for you and affect your feelings about your beliefs, your relationships
with family, friends, your spiritual faith community, or your
understanding of God. For example, you might wonder why God allowed the
illness or event to happen to you or someone close to you. This
spiritual distress might affect deeply held beliefs about the goodness
of the world, the meaning of your life, your sense of self-worth, or
your sense of safety. These concerns and questions can have an effect on
your overall health. As a result, you may seek spiritual guidance or
support. Such reactions are normal and often serve as a spring board to
growth and healing. Discussing these spiritual and/or religious issues
with a chaplain may help you deal with these situations.

If you decide that you would like to talk with a chaplain, there are
chaplains at VA Medical Centers. They are part of the healthcare team
that provides care for you. Chaplains can help you address pain that
comes from spiritual distress. They provide a safe, non-judgmental
presence. You may talk to a chaplain about how your illness or traumatic
event affects you and your relationships with God and others. Chaplains
will work with you to find out what your needs are based on your
personal experience and areas of spiritual conflict. You may also want
to discuss with a chaplain your resources for hope and spiritual
strength that help you heal and cope with life\'s circumstances.

Based on this assessment, chaplains create a plan that addresses your
spiritual concerns. Spiritual care may be provided through chaplain
visits, referral to community clergy, individual spiritual guidance,
individual and group prayer, study of scripture, spirituality groups,
life review, guided imagery, and meditation. Chaplains provide care that
relates to your health as a whole person, your deeply held values and
beliefs, and your key relationships that offer meaning and hope in the
midst of spiritual suffering.

Chaplains do not take the place of other healthcare professionals. Most
chaplains are not trained as therapists who do in-depth psychological
counseling, although some chaplains have specialized training as
counselors. If you have spiritual issues with which you feel a chaplain
can help, please call the Chaplain Service at your closest VA Medical
Center.

VA medical centers are listed in the phone book in the blue Government
pages. Under \"United States Government Offices,\" look in the section
for \"Veterans Affairs, Dept of.\" In that section look for VA Medical
Centers and call the one nearest to where you live. Or, you can call:

-   The VA Health Benefits Service Center toll free at 1-877-222-VETS

For online help go to [[Facilities Locator &
Directory]{.underline}](http://www1.va.gov/directory/guide/home.asp?isFlash=1)
and look for the VA Medical Center nearest to where you live.

#### Coping Skills - Smoking and Tobacco Use Cessation

Quitting smoking and tobacco use can be very challenging. Your decision
to remain tobacco free is the first step in achieving this goal. Every
day you will face the decision, \'to smoke or not to smoke.\' Each day
you remain smoke free becomes a victory. Learn what you can do to
[[manage your urge to smoke and secure your daily
victories]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/Coping With Smoking Triggers.pdf)
(PDF).

The key to successfully stop smoking or using tobacco products is
changing your behavior. It can be as easy as keeping a record of what
you do and what you would like to change. Avoid situations that trigger
bad habits. Stay motivated by setting realistic goals and plan ahead.
Adopt a positive attitude.

Weigh the advantages and disadvantages of change using [[Weighing Your
Options!]{.underline}](http://www.move.va.gov/download/NewHandouts/BehavioralHealth/B11_WeighingYourOptions.pdf)
(MOVE! Weight Management Program) (PDF).

#### Track Health - Smoking and Tobacco Use Cessation

When you quit smoking your body changes. You may notice an improvement
in your breathing, blood pressure, heart rate and body temperature.
Walking becomes easier and your energy level rises. You should keep
track of these positive changes.

Use My Health***[e]{.underline}***Vet to keep track of your activities
in one convenient location. In [[Track
Health]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=trackHealthHome),
you can record and monitor your breathing, blood pressure, heart rate,
body temperature, body weight and more in the [[Vitals &
Readings]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=vitals)
section. In addition, you can document your physical activity and food
intake in the
[[Journals]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=journalsHome)
section. As your body recovers from the effects of tobacco, keep track
of your [[Labs &
Tests]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/?_nfpb=true&_pageLabel=labsTests)
to see the difference quitting can make. Start tracking your health
today!

**Learning New Skills and Behaviors - Smoking and Tobacco Use
Cessation**

Developing new skills and making behavior changes are key factors to
successfully quitting tobacco use and help you joining the ranks of
people who call themselves former smokers.

-   [[Coping with Smoking
    Triggers]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/Coping With Smoking Triggers.pdf)
    (PDF)

-   [[Should I Quit
    Smoking?]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/Should I Quit Smoking.doc)
    (Word Doc)

-   [[What Happens When You Stop
    Smoking?]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/What Happens When You Stop Smoking.doc)
    (Word Doc)

-   [[Clearing the Air---Quit Smoking
    Today]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/Smoking Cessation Clearing the Air.pdf)
    (PDF)

-   [[How Can I Kick the
    Habit?]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/How Can I Kick the Habit.doc)
    (Word Doc)

-   [[HealthPower---Tips to Quit
    Smoking]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/HealthPower Tips to Quit Smoking.doc)
    (Word Doc)

-   [[How to Avoid Gaining
    Weight]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/How to Avoid Gaining Weight.doc)
    (Word Doc)

-   [[How Can I Avoid the Temptation to Smoke
    Again?]{.underline}](https://www.myhealth.va.gov/mhv-portal-web/ShowDoc/BEA Repository/healthy_living/How Can I Avoid the Temptation To Smoke Again.doc)
    (Word Doc)

[[Quit Smoking now!]{.underline}](http://www.smokefree.gov/) (National
Cancer Institute and Centers for Disease Prevention and Control)

[[Tobacco Information and Prevention Source
(TIPS)]{.underline}](http://www.cdc.gov/tobacco/index.htm) (Centers for
Disease Prevention and Control) --- See under \"How to Quit\"

[[Smoking
Cessation]{.underline}](http://www.surgeongeneral.gov/tobacco/) (Health
and Human Services)

**Staying on Track --- *How Can I Avoid The Temptation To Smoke
Again?***

***The Week Before You Quit:***

-   Tell family, friends, co-workers, and providers that you are
    quitting.

-   Take a time-out: Wait 3-5 minutes before you grab your pack.

-   Only smoke outside and in uncomfortable places.

***On Your Quit Day:***

-   Remove smoking triggers from your home, car, and work site. This
    means throwing away ALL of your cigarettes, ashtrays, and lighters.

-   Clean your home and car. Fresh smells and cleanliness are rewards of
    being smoke-free.

-   Celebrate your new healthy look: get a haircut and wear clean
    clothes.

***After You Quit:***

-   Make sure you get enough rest.

-   Eat a balanced diet.

-   Bring water and healthy snacks along with you?ou\'ll be less likely
    to reach for a smoke when you have something better for you at your
    fingertips.

-   Avoid alcohol and illegal drugs.

-   Cut down on caffeine.

-   **Follow an exercise program.**

-   Work off anger and stress with positive physical activities. For
    example, take a 5-minute walk around the block before reaching for a
    cigarette.

-   Stay away from smoking triggers.

-   Learn and use deep breathing exercises.

-   Take time to relax and get away from it all.

-   Avoid thinking or speaking badly about yourself.

-   **Ignore unneeded worries. Change what you can and accept what you
    cannot change.**

-   Put the money you would normally spend on cigarettes in a jar, and
    spend that money on something enjoyable\... like a CD or a movie.

***Long-Term:***

-   **Remind yourself of your new identity as a non-smoker.**

-   Like you, most people are non-smokers. Surround yourself with
    non-smokers if you have to be in a tempting situation.

-   Never allow yourself to think, \"One won\'t hurt,\" because it will!

-   Only eat in smoke-free restaurants and only visit smoke-free
    establishments. Second-hand smoke is not only a trigger for relapse,
    but is also deadly.

-   Take up healthy hobbies. You\'ll notice that you can enjoy them now
    that you have more energy.

-   Keep track of your successes.

-   **Reward Yourself Often!**

#### Local Resources - Smoking and Tobacco Use Cessation

You can talk with your health care provider about counseling to quit use
of tobacco products. In addition, ask about a prescription for the
nicotine gum, patch, lozenge or another medication for smoking
cessation, bupropion. You can also ask for a referral to a Smoking
Cessation Clinic if you would like to receive one. Smoking Cessation
Clinics may have group or individual counseling if you would prefer
that.

Many patients may find it helpful to get help with quitting tobacco use
through a free, telephone counseling quitline. In addition to talking to
your VHA health care provider, you can call 1-800-QUIT-NOW to be
connected to a free telephone counseling quitline in your home state.
This is an important service that is offered by state health departments
and the U.S. Department of Health and Human Services, it is free to
anyone in the U.S., and it can really help make a difference.

1-800-QUIT-NOW

**Support and Encouragement - Smoking and Tobacco Use Cessation**

When you decide to stop smoking or using tobacco, one important thing
you can do is to get support and encouragement from other people. When
others give you lots of encouragement, it makes you feel like you can do
anything! It is really motivating!

Tell your family and friends what they can do to help. Let them know
that their support is extremely important to you.

Enlist someone that has successfully been able to quit smoking as a
partner to help you stay motivated.

It is also encouraging to learn how other people successfully quit
smoking or stopped using tobacco products.

**Success Stories**

A veteran\'s family member shared the importance of support from others
when quitting:

*My father, a World War II veteran, smoked a lot for a long time. My
mother used to nag him about smoking, tell him to put those nasty things
down, & make him smoke outside, etc. When his first grandchild,
Elizabeth, was old enough to understand what was going on, my mother
said to him \"It\'s too bad Elizabeth will grow up seeing you smoke. You
know how she looks up to you and thinks you are the center of her world.
She will probably think that there is no harm in smoking because, after
all, you do it and she may even think it\'s OK to smoke because you
do.\" Immediately after my mother said this, my father pulled the
cigarettes out of his pocket, twisted them up and put them in the trash.
From that moment, he quit cold turkey & never smoked again, ever. And
Elizabeth, at age 23, remains a non-smoker. Dad would be proud.*

This is what one veteran said when he realized that smoking was an
addiction:

*I inquired about the smoking cessation group and enrolled. The group
leaders led the group sessions in a proficient and helpful manner. I
immediately put the coping skills to work and added some more from what
I had learned in overcoming my own drug addiction and working with
others. Today I am smoke free!*

Here is another experience from a veteran who saved money by quitting
smoking

*While attending a day program at the VA Connecticut Healthcare System,
Newington Campus, I was offered the smoking cessation program. The
negative effects of smoking, both medically and socially, coupled with
the ever-rising cost of cigarettes, were the main factors in my decision
to participate in the program.\
\
In the smoking cessation program I was given information, strategies,
and tips to help me quit smoking and cope with subsequent urges to
smoke. Nicotine patch instructions and precautions were also provided. I
wore nicotine patches for 8 weeks in decreasing strength (24 mg, 14 mg,
7 mg) with no ill effects.\
\
The minor discomfort, both mental and physical, that I experienced in
the first few days of quitting smoking was well worth it. I am now
healthier, happier, and smell better. I can participate in all social
situations without having to duck out for a cigarette, and I have a lot
more discretionary spending money.*

This description is from a veteran who quit smoking after staring up
again:

*It has now been only 81 days since I terminated my smoking. I was on
the Nicotine Patch. Initially I smoked anywhere from 10-15 cigarettes a
day. My first week was the hardest but I continued to keep myself busy
and \"stress free\". The urge to smoke was not as bad as I thought it
was going to be. I found that when I quit this time, I didn\'t actually
need the patches for the entire 8 weeks, after the second week, I really
forgot to put them on sometime and did not have the urge to smoke. But I
must say, I have gained 8lbs. (originally I was 116lb and can stand a
few more) so I won\'t complain about that. As it stands right now, I
don\'t even think about smoking and my sense of smell has become so
keen, that a lot of odors are sickening, especially smoke.*

#### Caregiver Information - Smoking and Tobacco Use Cessation

**Caregiver Information:** A caregiver is someone who supports and takes
responsibility for the care and wellness of another person or plays a
role in certain parts of the care required for someone. You may be a
relative, significant other, neighbor, or friend. Whatever your role may
be, it is important for you to learn also. Your support for someone you
care for, as they begin the journey to quit tobacco use can add to his
or her quality of life. Learn more and you will be better able to help.

Remember. When caring for another person it is important to take care of
yourself too! Seek assistance from others when needed and be aware of
your own limitations. Try these websites selected just for you!

[[Who\'s Caring for the Caregivers? (Report on Trends in Support for
Family
Caregivers)]{.underline}](http://www.aarp.org/research/press-center/presscurrentnews/caring_for_caregivers.html)
(AARP)

[[Caring for Those You Care
About]{.underline}](http://www.aarp.org/learntech/family_care) (AARP)

[[Family Caregivers]{.underline}](http://www.caregiving.org/fcrc.htm)
(National Alliance for Caregiving)

[[Caregiving Tips]{.underline}](http://www.caregiving.org/tips/)
(National Alliance for Caregiving)

[[National Family Caregivers
Association]{.underline}](http://www.nfcacares.org/) (National Family
Caregivers Association)

[[Family Caregiver
Alliance]{.underline}](http://www.caregiver.org/caregiver/jsp/home.jsp)
(Family Caregiver Alliance)

#### Local Resources for Caregivers

Use your local VA medical center, local community center, YMCA, sports
clubs, and church groups, etc. as resources to help find related
activities that might be of interest to you.