Clearing 

the Air

Quit

Smoking

Today

U.S. DEPARTMENT OF 

HEALTH AND HUMAN SERVICES

National Institutes of Health

National Cancer Institute
Introduction 2

How to use this booklet 3

Before You START a Smoke-Free Life 3

Why is quitting so hard? 3

Some things to think about before you START... 5

Now Let’s START 12

Set a quit date 12

Tell your family, friends, and co-workers 

that you plan to quit 13

Anticipate and plan for the challenges 

you’ll face while quitting 14

Remove cigarettes and other tobacco 

from your home, car, and work 15

Talk to your doctor about getting help to quit 16

The week before you quit 22

Today’s the Big Day—Your Quit Date! 23

Keep busy 23

Stay away from what tempts you 24

Plan to reward yourself 25

When you really crave a cigarette 25

Remember the instant rewards of quitting 26

Find new things to do 27

Quitting for Good 28

Stick with it 28

If you do slip up 30

A note about gaining weight 31

Finally...the long-term rewards of quitting 34

For More Information 35

1

Table of Contents
From those of us at the National Cancer Institute1

:

Congratulations! You are taking the first step to 

quitting cigarette smoking. 

We wrote this booklet with the help of ex-smokers

and experts. It can help you get ready to quit. It can

also help you through the days and weeks after 

you quit. The booklet tells you about tools to help

you become a non-smoker. It also tells you what

problems to expect when you quit. Being prepared

can help you through the hard times. 

There are many ideas in this booklet. Use the tips

that work best for you. You can quit for good, even 

if you’ve tried before. In fact, most smokers try to

quit many times before they succeed. Stay upbeat.

Keep trying. Use what you’ve learned until you can

quit for good.

2

1 The National Cancer Institute (NCI) is part of the National Institutes of Health (NIH), one

of eight agencies in the U.S. Department of Health and Human Services (DHHS). The NCI

is the Federal Government's principal agency for cancer research and training.

Introduction
Why is quitting so hard?

Many ex-smokers say quitting was the hardest thing

they ever did. Do you feel hooked? You’re probably

addicted to nicotine. Nicotine is in all tobacco 

products. It makes you feel calm and satisfied. At 

the same time, you feel more alert and focused. The

more you smoke, the more nicotine you need to feel

good. Soon, you don’t feel “normal” without nicotine. It takes time to break free from nicotine addiction. It may take more than one try to quit for good. 

So don’t give up too soon. You will feel good again.

Quitting is also hard because smoking is a big part

of your life. You enjoy holding cigarettes and puffing

on them. You may smoke when you are stressed,

bored, or angry. After months and years of lighting

up, smoking becomes part of your daily routine. 

You may light up without even thinking about it.

3

Before You START a 

Smoke-Free Life

How to use this booklet

This booklet has five parts that you can read in order,

or you can read just the information you want: 

1. Before You START a Smoke-Free Life 

2. START by Preparing 

3. Today’s the Big Day—Your Quit Date!

4. Quitting for Good 

5. For More Information 

Parts 1, 2, 3, and 4 take you step-by-step through the

process of quitting. Part 5 is a list of groups that offer

more information and programs to help you quit.
Smoking goes with other things, too. You may light 

up when you feel a certain way or do certain things. 

For example: 

• Drinking coffee, wine, or beer

• Talking on the phone

• Driving

• Being with other smokers 

You may even feel uncomfortable not smoking at

times or in places where you usually have a cigarette.

These times and places are called “triggers.” That’s

because they trigger, or turn on, cigarette cravings.

Breaking these habits is the hardest part of quitting

for some smokers.

Quitting isn’t easy. Just reading this booklet 

won’t do it. It may take several tries. But you learn

something each time you try. It takes will power 

and strength to beat your addiction to nicotine.

Remember that millions of people have quit smoking

for good. You can be one of them!

Just thinking about quitting may make you anxious.

But your chances will be better if you get ready first.

Quitting works best when you’re prepared. Before you

quit, START by taking these five important steps: 

S = Set a quit date.

T=Tell family, friends, and co-workers that 

you plan to quit.

A = Anticipate and plan for the challenges 

you’ll face while quitting.

R = Remove cigarettes and other tobacco 

products from your home, car, and work.

T=Talk to your doctor about getting help 

to quit. 4

Keep in Mind...

Your body gets more

than nicotine when 

you smoke.

There are more than 

4,000 chemicals in 

cigarette smoke. Some 

of them are also in wood

varnish, the insect poison

DDT, arsenic, nail polish

remover, and rat poison. 

The ashes, tar, gases, 

and other poisons in 

cigarettes harm your 

body over time. They 

damage your heart and

lungs. They also make 

it harder for you to 

taste and smell things, 

and fight infections.

Source: U.S. Department of Health and

Human Services. Reducing Tobacco Use: 

A Report of the Surgeon General. Centers 

for Disease Control and Prevention, 2000.
Some things to think about before 

you START...

Think about why you want to quit

Decide for sure that you want to quit. Promise yourself that you’ll do it. It’s OK to have mixed feelings.

Don’t let that stop you. There will be times every day

that you don’t feel like quitting. You will have to stick

with it anyway.

Find reasons to quit that are important to you. 

Think of more than just health reasons. For example,

think of:

• How much money you’ll save by not buying 

cigarettes

• The time you’ll have for yourself instead of 

taking cigarette breaks, rushing out to buy a 

pack, or searching for a light

• Not being short of breath or coughing as much

• Setting a better example for your children

Write down all the reasons why you want to quit. 

List ways to fight the urge to smoke, too. (You will 

find tips for coping later in this booklet.) Keep your 

list where you’ll see it often. Good places are:

• Where you keep your cigarettes

• In your wallet or purse

• In the kitchen

• In your car 

5

Keep in Mind...

Even a little 

second-hand smoke 

is dangerous.

Second-hand smoke 

can cause cancer in nonsmokers. It can also cause

breathing problems and

heart disease. People 

who breathe second-hand

smoke get colds and flu

more easily. And they often

die younger than those

who don’t breathe it.

Pregnant women who

breathe second-hand

smoke have many risks:

• They may lose their

babies. 

• Their babies may be

born small. 

• Their babies are more

likely to die of SIDS

(Sudden Infant Death

Syndrome). 

• Their children may be

cranky, restless, and 

get sick more often.

• Their children are more

likely to have learning

problems.

Children who breathe 

second-hand smoke have

troubles too. They are

much more likely to have

breathing problems such 

as asthma. They also get

more ear and lung infections (like pneumonia).

Source: U.S. Department of Health and

Human Services. Smoking and Tobacco

Control Monograph 10: Health Effects of

Exposure to Environmental Tobacco Smoke.

National Cancer Institute, August 1999.
6

When you reach for a cigarette you’ll find your list. 

It will remind you why you want to stop. 

Here are some examples of reasons to quit:

■ I will feel healthier right away. I will have more

energy and better focus. My senses of smell and

taste will be better. I will have whiter teeth and

fresher breath. I will cough less and breathe better.

■ I will be healthier the rest of my life. I will lower

my risk for cancer, heart attacks, strokes, early

death, cataracts, and skin wrinkling.

■ I will make my partner, friends, family, kids,

grandchildren, and co-workers proud of me.

■ I will be proud of myself. I will feel more in 

control of my life. I will be a better role model 

for others.

■ I will no longer expose others to my 

second-hand smoke.

■ I will have a healthier baby. (If you’re pregnant) 

■ I will have more money to spend. 

■ I won’t have to worry: “When will I get to 

smoke next?” or “What do I do when I’m in a

smoke-free place?”

Other reasons:

___________________________________________

___________________________________________

___________________________________________

___________________________________________
Nicotine Addiction Test

Find out how much you depend on nicotine

Knowing how addicted you are to nicotine can help you quit. It can help you 

decide if you need extra help, such as medicine or support from a program. 

Take this test to find out how hooked you are. 

Check the box for every “yes” answer:

■ Do you usually smoke your first cigarette within a half hour after you wake up?

■ Do you find it hard not to smoke where smoking isn’t allowed? 

(At the library, movie theater, or doctor’s office?)

■ Do you smoke 10 or more cigarettes a day? 

■ Do you smoke 25 or more cigarettes a day? 

■ Do you smoke more during the morning than during the rest of the day?

■ Do you smoke even when you’re sick? 

How many boxes did you check? ______ 

The more boxes you checked, the more addicted you are. 

You’ll have to work hard to quit, even if you checked only one box or no boxes at all.

You may be very addicted to nicotine if you checked more than three boxes. 

Medicine can help you quit. Read about these medicines starting on page 17.

Remember, no matter how hooked you are, you can stop smoking! 

The key is staying strong and sticking with it.

Modified from Fagerstrom KO, Schneider NG. Measuring nicotine dependence: A review of the Fagerstrom Tolerance Questionnaire. 

Journal of Behavioral Medicine 1989; 12 (2): 159-182.

7
Keep track of when and why you smoke

Think about when you smoke and why you smoke. 

Do this for the next few weeks. Keep a record of

every cigarette you smoke. Copy the Craving Journal

on page 11. You will probably need one copy for

every day.

You will find that you light up a lot without 

thinking about it. And you may be tempted to skip

writing down some of the cigarettes you smoke. But

keeping this journal is very helpful if you do it right.

You’ll learn about your smoking triggers. And you’ll

learn which cigarettes are your favorites. These facts

will help you prepare to fight your urge to smoke.

Know your triggers

Certain things trigger, or turn on, your need for a

cigarette. They can be moods, feelings, places, or

things you do. 

Think about what might tempt you to smoke. 

Put a check next to things that tempt you to smoke:

___________________________________________

___________________________________________

8

■ Feeling stressed

■ Feeling down

■ Talking on the phone

■ Drinking liquor, like

wine or beer

■ Watching TV

■ Driving your car

■ Finishing a meal

■ Playing cards

■ Taking a work break

■ Being with other 

smokers

■ Drinking coffee

■ Seeing someone else

smoke

■ Cooling off after a

fight

■ Feeling lonely

■ After having sex

■ Other triggers:
Meet these triggers head-on

Knowing your triggers is very important. It can 

help you stay away from things that tempt you to

smoke. It can prepare you to fight the urge when 

you are tempted. 

• Stay away from places where smoking is allowed. 

Sit in the non-smoking section at restaurants.

• Keep your hands busy. Hold a pencil or paper

clip. Doodle or write a letter. Carry a water bottle.

• Stay away from people who smoke. Spend time

with non-smoking friends.

• Put something else in your mouth. Chew sugarfree gum. Snack on a carrot or celery stick. Keep

your mouth and hands busy with a toothpick,

sugarfree lollipop, or straw.

• Drink less or stay away from alcohol. Drinking

alcohol often makes people want to smoke. Drink

juice, soda, or ice water instead.

• Remember: The urge to smoke only lasts 3 to 5

minutes. Try to hold off until the urge passes.

Want some tips for fighting the urge to smoke? 

See “Today’s the Big Day — Your Quit Date!” starting

on page 23.

9
Craving Journal

Keep track of each cigarette you smoke and how

much you wanted it. Every time you light up, write

down:

• The time

• Where you were

• What you were doing

• Who was with you

Rate how strongly you wanted to smoke:

1 = just a little

2 = some

3 = a lot

10
11

Craving Journal

Date: ______________

Cigarette Time of Craving What I was Who I was How I was

number day level doing with feeling 

Example 10:45 a.m. 3 at work alone stressed out

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

Adapted from One Step At A Time Program – Book 3. Canadian Cancer Society, 1998.
12

S

My Quit Date is: 

_________________________________

Set a quit date

Pick a date within the next two weeks to quit. 

That gives you enough time to get ready. But it’s 

not so long that you will lose your drive to quit. 

Think about choosing a special day:

• Your birthday or wedding anniversary

• New Year’s Day

• Independence Day (July 4)

• World No Tobacco Day (May 31)

• The Great American Smokeout 

(the third Thursday of each November) 

If you smoke at work, quit on the weekend or 

during a day off. That way you’ll already be 

cigarette-free when you return.

Now Let’s START
13

TTell your family, friends, and 

co-workers that you plan to quit 

Quitting smoking is easier with the support of 

others. Tell your family, friends, and co-workers that 

you plan to quit. Tell them how they can help you. 

Some people like to have friends ask how things

are going. Others find it nosy. Tell the people you

care about exactly how they can help. Here are 

some ideas: 

• Ask everyone to understand your change in

mood. Remind them that this won’t last long.

(The worst will be over within two weeks.) 

Tell them this: “The longer I go without cigarettes,

the sooner I’ll be my old self.”

• Does someone close to you smoke? Ask them 

to quit with you, or at least not to smoke 

around you.

• Do you take any medicines? Tell your doctor and

pharmacist you are quitting. Nicotine changes

how some drugs work. You may need to change

your prescriptions after you quit.

• Get support from other people. You can try talking with others one-on-one or in a group. You can

also get support on the phone. You can even try

an Internet chat room. This kind of support helps

smokers quit. The more support you get, the 

better. But even a little can help. See page 21 or

the resource list starting on page 35 to find this

kind of help.
14

Withdrawal: How You

May Feel When You Quit

Common feelings of 

smoking withdrawal 

include:

• Feeling depressed

• Not being able to sleep

• Getting cranky, 

frustrated, or mad

• Feeling anxious, 

nervous, or restless

• Having trouble thinking 

clearly

• Feeling hungry or 

gaining weight

Not everyone has feelings 

of withdrawal. You may 

have one or many of these

problems. And they may 

last different amounts 

of time. The medicines

described on pages 17

through 20 can help.

Source: Diagnostic and Statistical Manual of

Mental Disorders, Fourth Ed. (1994). American

Psychiatric Association. Washington, D.C

AAnticipate and plan for the challenges 

you’ll face while quitting

Expecting challenges is an important part of getting

ready to quit. 

Most people who go back to smoking do it within

three months. Your first three months may be hard.

You may be more tempted when you are stressed or

feeling down. It’s hard to be ready for these times

before they happen. But it helps to know when you

need a cigarette most.

Look over your Craving Journal. See when you

may be tempted to smoke. Plan for how to deal 

with the urge before it hits. 

You should also expect feelings of withdrawal.

Withdrawal is the discomfort of giving up nicotine. 

It is your body’s way of telling you it’s learning to 

be smoke-free. These feelings will go away in time.

Keep reading for tips on handling urges and 

withdrawal.
15

RRemove cigarettes and other tobacco from

your home, car, and work

Getting rid of things that remind you of smoking 

will also help you get ready to quit. Try these ideas:

• Make things clean and fresh at work, in your car,

and at home. Clean your drapes and clothes.

Shampoo your car. Buy yourself flowers. You will

enjoy their scent as your sense of smell returns.

• Throw away all your cigarettes and matches. 

Give or throw away your lighters and ashtrays.

Remember the ashtray and lighter in your car!

• Have your dentist clean your teeth to get rid of 

smoking stains. See how great they look. Try to

keep them that way.

• Some smokers save one pack of cigarettes. 

They do it “just in case.” Or they want to prove

they have the willpower not to smoke. Don’t!

Saving one pack just 

makes it easier to start smoking again. 

Don’t use other forms of tobacco 

instead of cigarettes

Light or low-tar cigarettes are just as harmful as 

regular cigarettes. Smokeless tobacco, cigars, pipes,

and herbal cigarettes also harm your health. For

example, bidi cigarettes are just as bad as regular 

cigarettes. Clove cigarettes are even worse. They 

have more tar, nicotine, and deadly gases. All tobacco products have harmful chemicals and poisons. 
16

Pregnant or Thinking

About Having a Baby?

There’s no better time 

to quit than now.

Women who smoke have 

a harder time getting 

pregnant. And you face

more dangers if you do 

get pregnant:

• You may lose the baby

or have a stillborn 

(dead) baby.

• Your baby may be 

born small. 

• Your baby is more likely

to die of Sudden Infant

Death Syndrome (SIDS). 

• Your baby may be

cranky, restless, and 

get sick more often.

• Your baby is more 

likely to have learning

problems.

The good news is that 

quitting can help you 

have a healthy baby. It

helps to quit at any time

while you are pregnant. 

It’s even better to quit

before you get pregnant.

Adapted from Women and Smoking: 

A Report of the Surgeon General – 2001.

U.S. Department of Health and Human

Services, 2001.

TTalk to your doctor about getting help to quit

Quitting “cold turkey” isn’t your only choice. Talk to

your doctor about other ways to quit. Most doctors 

can answer your questions and give advice. They can

suggest medicine to help with withdrawal. You can

buy some of these medicines on your own. For others,

you need a prescription. 

Your doctor, dentist, or pharmacist can also point

you to places to find support or toll-free quit lines.

(The National Cancer Institute’s Smoking Quitline can

help, too. It can help you find support in your area.

See “Where to Find Help” on page 21.)

If you cannot see your doctor, you can get some 

medicines without a prescription that can help you

quit smoking. Go to your local pharmacy or grocery

store for over the counter medicines like the nicotine

patch, nicotine gum, or nicotine lozenge. Read the

instructions to see if the medicine is right for you. 

If you’re not sure, ask a pharmacist.
2 These are the names of some of the medications you can use to help

you quit. Many large drug stores or pharmacies sell their own brands of

nicotine gum and nicotine patch. The following is not intended to be a

complete list of products nor does it constitute endorsement of any

brand or product by the National Cancer Institute, National Institutes

of Health, or the Department of Health and Human Services. 

Bupropion SR pills Zyban®, Wellbutrin®

Nicotine gum drug store brands, Nicorette®, Nicotrol®

Nicotine inhaler Nicotrol®

Nicotine lozenge CommitTM

Nicotine nasal spray Nicotrol® 

Nicotine patch drug store brands, Nicoderm®

Medicines that help with withdrawal

When you quit smoking, you may feel strange at

first. You may feel dull, tense, and not yourself.

These are signs that your body is getting used to life

without nicotine. It usually only lasts a few weeks.

Many people just can’t handle how they feel after

they quit. They start smoking again to feel better.

Maybe this has happened to you. Most people slip

up in the first week after quitting. This is when feelings of withdrawal are strongest. 

There are medicines2 that can help with feelings of

withdrawal:

• Bupropion SR pills 

• Nicotine gum 

• Nicotine inhaler

• Nicotine lozenge 

• Nicotine nasal spray 

• Nicotine patch

17
18

Using these medicines can double your chances 

of quitting for good. Ask your doctor for advice. 

But remember: Medicine alone can’t do all the 

work. It can help with cravings and withdrawal, 

but quitting will still be hard at times.

Here is more information about the 

different medicines.

Nicotine Gum, Patch, Inhaler, Spray, 

and Lozenge (NRT)

Nicotine gum, patches, inhalers, sprays, and lozenges

are called nicotine replacement therapy (NRT). 

That’s because they take the place of nicotine from

cigarettes. NRT can help with withdrawal and lessen

your urge to smoke. 

You need a prescription to buy the inhaler and 

nasal spray. But you can buy nicotine gum, nicotine

patches, and nicotine lozenges on your own.

Other Medicines

Bupropion SR is a medicine that has no nicotine. 

You need a prescription to get these pills. They 

seem to help with withdrawal and lessen the urge 

to smoke. 

Some people have side effects when using 

bupropion SR pills. The side effects include dry

mouth and not being able to sleep. 
Thinking About Using NRT?

Bottom line: Read the instructions that come with the medicine. 

Talk to your doctor or pharmacist if you have any questions.

• Ask your doctor, dentist, or pharmacist if nicotine gum, the patch, or some

other kind of NRT is right for you. These medicines can cause side effects in

some people. Some people should not use NRT without a doctor’s help. Pregnant

women are a good example.

• Be patient. Using NRT correctly can take some getting used to. Follow the 

instructions and give it some time.

• Don’t mix tobacco and NRT. Having one or two cigarettes while you use the 

gum, patch, nasal spray, inhaler, or lozenge is not dangerous, but your goal is 

to quit smoking for good. Use NRT only when you are ready to stop smoking. 

If you do slip up and smoke a cigarette or two, don’t give up on NRT. Keep trying.

• Start out using enough medicine. Use the full amount of NRT in the instructions.

Don’t skip or forget to use your NRT after you first stop smoking.

• Slowly use less and less medicine. But don’t stop completely until you’re ready. 

You can set up a schedule with your doctor or pharmacist. 

• Keep some of the medicine with you after you stop using it. This way you’ll 

be ready for an emergency.

• Wait a half hour after using the gum, lozenge, or inhaler before you eat 

or drink anything acidic. Acidic foods and drinks can keep nicotine gums and

inhalers from working. Acidic foods and drinks include tomato sauce, tomatoes,

oranges, lemons, grapefruit, coffee, soda, orange juice, and grapefruit juice. 

Source: NRT Product User's Guides. GlaxoSmithKline Consumer Healthcare, Pittsburgh, PA, 2002.

19
This medicine isn’t right for:

• Pregnant women

• People who have seizures

• People with eating disorders

• Heavy drinkers

Ask your doctor, dentist, or pharmacist if this 

medicine is right for you. Make sure to use it the

right way if your doctor prescribes it.

Join a quit-smoking program

You may want to try a quit-smoking program or 

support group to help you quit. These programs 

can work great if you’re willing to commit to them. 

How do quit-smoking programs and support

groups work? They help smokers spot and cope 

with problems they have when trying to quit. The

programs teach problem-solving and other coping

skills. A quit-smoking program can help you quit 

for good by:

• Helping you better understand why you smoke

• Teaching you how to handle withdrawal 

and stress

• Teaching you tips to help resist the urge to smoke

20
Where to Find Help

1. Your state may have a toll-free telephone quitline. 

Call the quitline to get one-on-one help. 

2. Call the National Cancer Institute’s Smoking

Quitline at 1-877-44U-QUIT (1-877-448-7848).

This number works anywhere in the U.S. You 

can get one-on-one help quitting. Or you can ask

where to get help in your state.

3. Visit the National Cancer Institute’s smokefree.gov

Web site at http://www.smokefree.gov. This Web

site offers science-driven tools, information, and

support that has helped smokers quit. You will

find state and national resources, free materials,

and quitting advice from the National Cancer

Institute and its partners.

4. More and more workplaces have help for workers 

who want to quit. Some offer quit-smoking clinics 

and support on the job. Others will pay for 

outside programs for their workers. Ask at work

about the choices open to you. 

5. Your doctor may know about a quit-smoking 

program or support group near you. 

6. See “For More Information” beginning on page 35

in this booklet. It lists groups that offer:

• One-on-one support

• Group support

• Support from a former smoker

Write down your plan for quitting in the space

below. Write what you will do when you are 

triggered to smoke. Writing the steps you’ll take

before you quit will help you stop smoking for good.

21
Steps I’ll take before quitting:

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

How I’ll handle triggers:

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

The week before you quit 

Date: _______________ to _______________

22
Keep in Mind...

If you decided to use a

support program, use it

fully. Go to the sessions.

Call your telephone quitline. Visit your Internet site.

The more support you get,

the more likely you will

quit for good.

Are you using medicine to

help you quit? If so, follow

the directions. If you don’t,

you’re more likely to go

back to smoking. Also,

don’t rush to stop using

the medicine. Stick with it

for at least 12 weeks. Or

follow your doctor’s advice. 

Today’s the day you start your smoke-free life!

Remind your family and friends that today is your

quit date. Ask them to support you during the first

few days and weeks. They can help you through 

the rough spots.

Here are more tips to help you get through this

very important day. 

Keep busy

• Keep very busy today. Go to a movie. Exercise.

Take long walks. Go bike riding.

• Spend as much free time as you can where 

smoking isn’t allowed. Some good places are

malls, libraries, museums, theaters, department

stores, and places of worship.

• Do you miss having a cigarette in your hand?

Hold something else. Try a pencil, a paper clip, 

a marble, or a water bottle.

• Do you miss having something in your mouth?

Try toothpicks, cinnamon sticks, lollipops, hard

candy, sugarfree gum, or carrot sticks.

• Drink a lot of water and fruit juice. Avoid 

drinks like wine and beer. They can trigger you 

to smoke.

23

Today’s the Big Day—

Your Quit Date!
Stay away from what tempts you

• Instead of smoking after meals, get up from the

table. Brush your teeth or go for a walk.

• If you always smoke while driving, try something

new: Listen to a new radio station or your favorite

music. Take a different route. Or take the train or 

bus for a while, if you can.

• Stay away from things that you connect with

smoking. Do it today and for the next few weeks.

These may include:

– Watching your favorite TV show 

– Sitting in your favorite chair

– Having a drink before dinner

• Do things and go places where smoking is not

allowed. Keep this up until you’re sure that you

can stay smoke-free.

• Remember, most people don’t smoke. Try to be

near non-smokers if you must be somewhere

you’ll be tempted to smoke, for example at a 

party or in a bar.

24
Plan to reward yourself

• You will save money by becoming smoke-free. 

Is there something you’d like to buy for 

yourself or someone else? Make a list. Figure 

out what these things cost. Then start putting

aside “cigarette money” to buy some of them.

• Buy yourself something special today to celebrate.

See a movie. Buy a CD you’ve been wanting. 

Or buy some other treat. Be careful with food

treats. You need less food when you don’t smoke.

This is true no matter how much you want to 

put something in your mouth. 

When you really crave a cigarette

Remember: The urge to smoke usually lasts only

three to five minutes. Try to wait it out. Or look 

at the plan you made last week. (See page 22.) 

You wrote down steps to take at a time like this. 

Try them! You can also try these tips:

• Keep other things around instead of cigarettes. 

Try carrots, pickles, sunflower seeds, apples, 

celery, raisins, or sugarfree gum.

• Wash your hands or the dishes when you want 

a cigarette very badly. Or take a shower.

25
• Learn to relax quickly by taking deep breaths. 

Take 10 slow, deep breaths and hold the last one.

Then breathe out slowly. Relax all of your muscles. Picture a soothing, pleasant scene. Just get

away from it all for a moment. Think only about

that peaceful image and nothing else.

• Light incense or a candle instead of a cigarette.

• Where you are and what is going on can make

you crave a cigarette. A change of scene can 

really help. Go outside, or go to a different room.

You can also try changing what you are doing.

• No matter what, don’t think, “Just one won’t 

hurt.” It will hurt. It will undo your work so far. 

• Remember: Trying something to beat the urge is

always better than trying nothing.

Remember the instant rewards of quitting

Your body begins to heal within 20 minutes after

your last cigarette. The poison gas and nicotine 

start to leave your body. Your pulse rate goes back 

to normal. The oxygen in your blood rises to a 

normal level.

Within a few days you may notice other things: 

• Your senses of taste and smell are better. 

• You can breathe easier.

• Your “smoker’s hack” starts to go away. 

(You may keep coughing for a while, though.) 

26
The nicotine leaves your body within three days. 

Your body starts to repair itself. At first, you may feel

worse instead of better. Withdrawal feelings can be

hard. But they are a sign that your body is healing.

(See “Withdrawal: How You May Feel When You

Quit” on page 14.)

Find new things to do

Starting today you may want to create some 

new habits. 

Here are some things you might try:

• Swimming, jogging, playing tennis, bike riding, 

or shooting baskets. It’s hard to smoke and do 

these things at the same time. How about walking

your dog?

• Keep your hands busy. Do crossword puzzles or

needlework. Paint. Do woodworking, gardening,

or household chores. You can also write a letter 

or paint your nails.

• Enjoy having a clean tasting mouth. Brush your

teeth often and use mouthwash.

• Take a stretch when you’re tempted to reach for 

a cigarette. 

Set aside time for the activities that satisfy you and

mean the most to you. There are natural breaks 

even during a busy day. After dinner, first thing in

the morning, or just before bed are good examples.

You’ll also need plenty of rest while you get used 

to your smoke-free lifestyle. 

27
Stick with it

Look at page 3 again. Beating an addiction to nicotine takes a lot of will power and determination. 

You should feel great about yourself for making it 

so far. Now’s the time to focus on sticking with it. 

Keep your guard up

Your body has changed since you began to smoke.

Your brain has learned to crave nicotine. So certain

places, people, or events can trigger a strong urge to

smoke, even years after quitting. That’s why you

should never take a puff again, no matter how long 

it has been since you quit.

At first, you may not be able to do things as well 

as when you were smoking. Don’t worry. This won’t

last long. Your mind and body just need to get used

to being without nicotine. 

After you’ve quit, the urge to smoke often hits at

the same times. For many people, the hardest place

to resist the urge is at home. And many urges hit

when someone else is smoking nearby. Look at your

Craving Journal to see when you might be tempted.

Then use the skills you’ve learned to get through

your urges without smoking.

28

Quitting for Good
after... ...you’ve saved

1 day . . . . . . . . . . . . . . . . . . . . . . . . .$5 

1 week . . . . . . . . . . . . . . . . . . . . . . . .$35

1 month . . . . . . . . . . . . . . . . . . . . . . .$150

1 year . . . . . . . . . . . . . . . . . . . . . . . . .$1,820

10 years . . . . . . . . . . . . . . . . . . . . . . .$18,200

20 years . . . . . . . . . . . . . . . . . . . . . . .$36,400

Prices are based on a 2001 average of $5.00 per pack. The cost of a pack 

of cigarettes may differ, depending on where you buy them.

Fight the urges

Review the tips in this booklet to help you fight 

the urge to smoke. These tips are meant to help 

you stay a non-smoker.

Stay upbeat

As you go through the first days and weeks without

smoking, keep a positive outlook. Don’t blame or

punish yourself if you do have a cigarette. Don’t

think of smoking as “all or none.” Instead, take it 

one day at a time. Remember that quitting is a 

learning process. 

Keep rewarding yourself for not smoking

Now that you aren’t buying cigarettes, you probably 

have more spending money. For example, if you

used to smoke one pack per day: 

29

Think about starting a “money jar” if you haven’t

already. Put your cigarette money aside for each day

you don’t smoke. Soon you’ll have enough money to

buy a reward for yourself. 
If you do slip up

Don’t be discouraged if you slip up and smoke one

or two cigarettes. It’s not a lost cause. One cigarette 

is better than an entire pack. But that doesn’t mean

you can safely smoke every now and then...

no matter how long ago you quit. One cigarette may

seem harmless, but it can quickly lead back to one 

or two packs a day.

Many ex-smokers had to try stopping many times

before they finally succeeded. When people slip up,

it’s usually within the first three months after 

quitting. Here’s what you can do if this happens:

• Understand that you’ve had a slip. You’ve 

had a small setback. This doesn’t make you a

smoker again.

• Don’t be too hard on yourself. One slip up doesn’t

make you a failure. It doesn’t mean you can’t 

quit for good. 

• Don’t be too easy on yourself either. If you slip

up, don’t say, “Well, I’ve blown it. I might as well

smoke the rest of this pack.” It’s important to 

get back on the non-smoking track right away.

Remember, your goal is no cigarettes — not even

one puff.

• Feel good about all the time you went without

smoking. Try to learn how to make your coping

skills better. 

• Find the trigger. Exactly what was it that made

you smoke? Be aware of that trigger. Decide 

now how you will cope with it when it comes 

up again.

30
• Learn from your experience. What has helped 

you the most to keep from smoking? Make sure 

to do that on your next try.

• Are you using a medicine to help you quit? Don’t

stop using your medicine after only one or two

cigarettes. Stay with it. It will help you get back

on track.

• Know and use the tips in this booklet. People

with even one coping skill are more likely to stay

non-smokers than those who don’t know any.

START to stop again!

• See your doctor or another health professional. 

He or she can help motivate you to quit smoking.

A note about gaining weight

Your body uses food more slowly when you first stop

smoking. You may eat more when you quit too.

There is a good chance you will gain weight. But not

everyone does.

Are you worried about gaining weight? Think

about this: What you get from quitting far outweighs

the drawbacks of adding a few pounds. You’d have

to gain a lot of weight to offset the health rewards 

of quitting. 

Here are some tips to keep from gaining too 

much weight. 

31
Get in shape

• Make time to exercise every day. Or join a fitness

group. Even walking will improve your health.

And all exercise burns calories, which helps you

gain less weight. 

• Exercising can distract you from smoking. It lowers the stress that makes you crave a cigarette.

• Are you starting a new exercise program? Begin

with as little as 10 minutes. Slowly build up to

longer periods of time. In fact, it’s a good idea 

to talk to your doctor before you start. Your 

doctor can suggest what will keep you safe and

get you healthy.

• Get plenty of rest.

• As you get in shape, you will build muscle.

Muscle weighs more than fat. So you may 

find that clothes become looser even if you 

weigh more. 

32
33

3 The Food Guide Pyramid was created by the U.S. Department of Agriculture to help you

choose what foods to eat and how much to eat to stay healthy.

Fats, Oils, & Sweets

Use Sparingly

Milk, Yogurt &

Cheese Group

2-3 Servings

Vegetable Group

3-5 Servings

Meat, Poultry, Fish, Dry

Beans, Eggs, & Nuts Group

2-3 Servings

Fruit Group

2-4 Servings

Bread, Cereal, Rice, & 

Pasta Group

6-11 Servings

Key

■ Fat (naturally occurring and added)

Sugars (added)

These symbols show fat and 

added sugars in foods.

Eating tips for the new non-smoker

• Follow the Food Guide Pyramid3

. Stay away from

sweets and high-calorie foods. But don’t cut back

on eating to lose weight. Craving both food and

cigarettes is tough to handle.

• Have healthy, low-calorie foods on hand if you

like to snack. Try fresh fruits and vegetables,

juices, yogurt, or air-popped popcorn without

butter.

• Drink water before your meals and between

meals. Drinking plenty of water is healthy for

everyone. It can also give you something to do

instead of smoking a cigarette.

• Chew sugarfree gum or suck on sugarfree candy 

if you crave sweets.

Food Guide Pyramid: A Guide to Daily Food Choices

▲
Finally...the long-term rewards of quitting

Tobacco use in the United States causes more than

450,000 deaths each year. Of those deaths, 170,000

are from cancer. 

After you’ve quit, you’ve added healthy, full days 

to each year of your life. You’ve greatly lowered your

risk of death from lung cancer and other diseases

including: 

• Heart disease

• Stroke

• Chronic bronchitis

• Emphysema

• At least 13 other kinds of cancer

You’ve also cut back on dangerous second-hand

smoke for your loved ones. Finally, by quitting

smoking, you’re setting a good example. You’re

showing young people that a life without cigarettes 

is a longer, healthier, happier life.

34

Keep in Mind...

Almost four out of

every five smokers

would like to quit. 

And almost half of all

adult smokers have

already quit.

It doesn’t matter how 

old you are or how long

you’ve smoked. You

become healthier and

stronger each day you 

are tobacco-free.

Source: Cigarette Smoking Among Adults –

United States, 1993. 43(43):785, November

4, 1994.
National Cancer Institute (NCI)

Cancer Information Service

Suite 3036A 

6116 Executive Boulevard, MSC 8322 

Bethesda, MD 20892-8322 

You may want more information for yourself, your

family, and your doctor. The NCI’s Smoking Quitline

is staffed by specialists who can help you quit smoking. Toll-free: 1-877-448-7848 (1-877-44U-QUIT)

The smokefree.govTM Web site is another source 

of information about quitting. You can get 

live help and links to sources of help in your area.

http://www.smokefree.gov

In addition to help quitting smoking, the NCI’s

Cancer Information Service (CIS) provides accurate,

up-to-date information on cancer. Information specialists can assist you with quitting and also explain

the latest cancer information in understandable 

language in English, Spanish, or on TTY equipment.

Toll-free: 1-800-422-6237 (1-800-4-CANCER)

TTY: 1-800-332-8615

The NCI's Cancer.govTM Web site provides information from numerous NCI sources, including LiveHelp,

an instant messaging service. Information specialists

provide live, online assistance to users of Cancer.gov,

the NCI’s Web site. The staff can assist smokers, in

addition to providing cancer information and helping

users to navigate the Web site. Click on the LiveHelp

link, Monday through Friday. http://cancer.gov

35

For More Information
American Cancer Society (ACS)

1599 Clifton Road, NE

Atlanta, GA 30329

1-800-227-2345 (1-800-ACS-2345)

Check your phone book to find your local office.

www.cancer.org

The American Cancer Society (ACS) has volunteers 

and offices all over the country. ACS helps people

learn about the health hazards of smoking and how

to become ex-smokers. Its programs include “The

Great American Smokeout®” in November of each

year and the Cancer Crusade every April. It also has

many booklets and other information that can help.

American Heart Association (AHA)

7272 Greenville Avenue

Dallas, TX 75231

1-800-242-8721 (1-800-AHA-USA1)

Check your phone book to find your local office.

www.americanheart.org

The American Heart Association (AHA) has thousands of volunteers. It has 130,000 members 

(doctors, scientists, and others) in 55 state and

regional groups. AHA makes books, tapes, and

videos about the effects of smoking on the heart.

AHA has also written a guidebook on weight-control

in quit-smoking programs.

36
American Lung Association (ALA)

61 Broadway, 6th Floor

New York, NY 10006

1-800-586-4872 (1-800-LUNG-USA)

Check your phone book to find your local office.

www.lungusa.org

The American Lung Association (ALA) helps 

smokers who want to quit through its Freedom 

From Smoking® self-help quit-smoking program.

ALA actively supports laws and information 

campaigns for non-smokers’ rights. It also gives 

public information programs about the health 

effects of smoking.

Centers for Disease Control and Prevention

(CDC)

Office on Smoking and Health

Mail Stop K-50

4770 Buford Highway, NE

Atlanta, GA 30341-3724

1-800-311-3435 or (770) 488-5705

www.cdc.gov 

The CDC’s Office on Smoking and Health (OSH) is

the government’s lead agency on smoking control.

OSH funds booklets on smoking topics, such as

relapse, helping a friend or family member quit

smoking, the health hazards of smoking, and the

effects of parental smoking on teenagers.
NIH Publication No. 03-1647

April 2003