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Commit to Quit

Make a Resolution to Stop Smoking for Good

by Danielle Peereboom, MPH, Jody Nicoloso, BA, and Frank Leone, MD, MS

Photo by Cancer Type

Many smokers who have been diagnosed with cancer continue to smoke, though they may not understand why. After all, they are well aware of the dangers of smoking and may have even experienced them first-hand. Is this the situation you’re finding yourself in? Has your family pleaded with you to quit, even given you incen­tives or made threats? Have you ever wondered why you don’t have the will­power to just stop already? The answer can be found by examining the addictive effect of nicotine on the brain.

Take notice of when you smoke, and make slight modifications to your routines surrounding those times.

Author of Article photo

Danielle Peereboom

Nicotine acts as an imposter “safety signal” to the basic survival area of the brain. As a result, the absence of nico­tine in the addicted brain translates to a threat to survival, which creates a compulsion to smoke. So even though you keep telling yourself to quit smok­ing, your addicted brain keeps telling you to pick up that cigarette. In the fight between logic and instinct in the brain, instinct usually wins.

The good news, however, is that there are effective ways to turn down the vol­ume on your brain’s instinct messages.

Author of Article photo

Jody Nicoloso

Talk to your doctor about nicotine replacement therapy and medication.
Most people with cancer who smoke at the time of their diagnosis attempt to quit without formal treatment, but studies show that only 3 to 5 percent of smokers can effectively quit cold turkey. Luckily, a variety of nicotine replacement options have been proven to be safe and effective in helping peo­ple gradually quit smoking, including over-the-counter cessation aids (gums, lozenges, patches) and prescription medications (inhalers, nasal sprays). Medication to reduce the desire to smoke is also available and can work in combination with nicotine replace­ment therapy. Talk to your doctor about which options might be best for you and whether you should combine therapies to maximize effectiveness.

Author of Article photo

Dr. Frank Leone

Get support from family and friends.
Your loved ones may not know how to best support you; they may fear that the things they say will make you feel ashamed rather than supported. Let them know what they can do to encourage you. Ask your relatives and friends who smoke not to smoke in front of you and not to give you cigarettes. You can get additional support online (, at a class, or through your state’s Quitline (1-800-784-8669).

Examine your routines and identify triggers.
Our days are filled with sig­nals telling us how to act and respond in certain situations. The end of a meal can signal time for a smoke. Having a cup of coffee can be the cue to light up. Even just waking up in the morning can be a trigger if a morning smoke was part of your daily routine. Take notice of when you typically smoke, and make slight modifications to your routines surrounding those times. Hold the cigarette in the opposite hand, sit in a different spot on the patio when you smoke, or try keeping your cigarettes in different places from normal. You can even change the order of your rou­tines. This will help desensitize your brain to those triggers. Even small changes in routines can lead to big success in the quitting process.

Prepare, prepare, prepare.
Come up with a detailed action plan of how you will deal with triggering situations. Practice it over and over in your head, and don’t be afraid to seek the help of a counselor in planning and implement­ing your strategy. For example, place your cessation aid of choice in strategic locations so you can use it when you anticipate a trigger or promptly after a craving arises.

The first step to quitting smoking is to understand that quitting is a process, not a single pass-or-fail test. This means that quitting re­quires a plan that leaves room for both setbacks and the development of coping skills along the way. With the help of health profes­sionals, your support system, and effective medica­tion, you can kick the habit for good.

♦ ♦ ♦ ♦ ♦

Danielle Peereboom and Jody Nicoloso coordinate public health initiatives at the Comprehensive Smoking Treatment Program at the University of Pennsylvania in Phila­delphia, PA. Dr. Frank Leone is an associate professor of medicine and program director of the Comprehensive Smoking Treatment Program at the University of Pennsylvania.

This article was published in Coping® with Cancer magazine, January/February 2014.