Stopping smoking

Get help straight away if

These are uncommon, but they need same-day care — go to an emergency department, do not wait for an appointment.

Contact us promptly if

Not an emergency, but worth being seen sooner rather than waiting it out.

• Taking medication for a mental health condition, epilepsy, asthma or a blood thinner and planning to stop smokingWorth telling us before you stop. Smoking changes how the body clears several medications, and stopping can raise their levels enough to need a dose change.
• A cough that has changed, coughing blood, or breathlessness that is newWorth being seen regardless of whether you are stopping.

What usually happens

Stopping is not mainly a test of willpower, and the people who have tried and failed repeatedly have usually tried unaided. Medication plus support makes success several times more likely than determination on its own, which is a statement about nicotine rather than about you.

Cutting down is not a smaller version of stopping. People who smoke fewer cigarettes compensate by drawing more deeply on each one, and the health benefit is much smaller than the reduction in number suggests. Cutting down as a step towards a quit date is useful; as a destination it is not.

Most people who stop for good did not manage it the first time. Relapse is a normal part of the process rather than evidence it will not work, and what matters is what you change for the next attempt.

The benefits start immediately and continue for years — blood pressure and carbon monoxide within a day, circulation and lung function within months, cardiovascular risk falling substantially over the following years. It is worth doing at any age and after any length of smoking.

Vaping is considerably less harmful than smoking and is not harmless. As a way of getting off tobacco it works for many people; as something to take up otherwise it is not a good idea, and the aim is eventually to be off both.

At your appointment

Questions about how soon after waking you smoke and how many a day, because those predict how strong the dependence is and therefore what treatment is likely to work.

A discussion of the options, usually combining something long-acting with something you can use when a craving hits — using two together is more effective than either alone.

A quit date, and follow-up in the first weeks when relapse is most likely, rather than a prescription and no contact.

A review of your other medications, since a few need adjusting when you stop.

Worth asking

• —Which treatment is most likely to suit me?
• —How long should I stay on it?
• —What should I do if I slip and have one?
• —Do any of my medications need changing when I stop?