TORONTO - Anyone who quit smoking as a new year's resolution is probably going through a rough period now, dealing with cravings, and more cravings, and a whole host of physical and emotional responses and reactions.
Quitters may want a cigarette every time they have a cup of coffee, or when they see someone else light up, said Dr. Peter Selby, an expert in tobacco addiction at the Centre for Addiction and Mental Health in Toronto.
By Day 4 or so, they could be feeling pretty crummy.
"They're going to find themselves feeling like they may have a minor headache, they may feel their loss of concentration, they may feel that their bowels don't work properly, they may have a loss of appetite, they may feel anxious, they may be feeling sad and irritable," he said.
"For some people that can be quite mild and manageable, and for others it can be quite difficult."
It takes two to three days for nicotine, as a molecule, to leave the bloodstream, Selby explained, but the addiction effects of nicotine stay a lifetime.
"Even if you've quit smoking your vulnerability to going back is always there," he said.
Cigarettes contain a variety of chemicals that are toxic that last in the body for years, and these compounds are associated with health problems such as lung cancer, chronic obstructive pulmonary disease, heart disease and osteoporosis, he noted.
An estimated 20,500 people died from lung cancer in Canada in 2009. About 85 per cent of lung cancers are caused by smoking.
The first week of trying to butt out is when most people relapse, Selby said. Many smokers who are determined to kick the habit can distract themselves and carry on, but for others it can be quite, well, overwhelming.
For those people, Selby said there are several approaches that can help. The environment needs to stop being the stimulus for someone to smoke -- they shouldn't watch others smoke or allow themselves access to cigarettes.
"Until you're ready to go out there and face and see other people smoking and not let that lead to a relapse, you may need to stay away from it," he said.
Regular chewing gum, drinking sweet liquids and water, and cutting back on coffee can help some of the symptoms go away, he suggested.
Nicotine replacement will also help mitigate the withdrawal symptoms. Low-level smokers can usually manage on the gum, lozenges or inhalers, he said, while heavier smokers are going to have some significant withdrawal and may require a nicotine patch.
Some people can get along without nicotine replacement, such as those with strong willpower, few triggers in their environment, few stressors, and those who find they're not experiencing mood changes, he noted.
Dianna Watson, 50, quit "cold turkey" on Feb. 13, 2008, after smoking for more than 32 years - almost two packs a day in the later years.
"I did it all on my own," she said from her home in Copper Cliff, Ont., noting she didn't have a helping hand from nicotine replacement products.
"I was eating everything in sight, and drank a lot of water," she said of the early days, then decided she needed another tactic to prevent herself from overeating.
So she cut up drinking straws to the size of cigarettes and held them and inhaled and chewed on them at times to mimic the feeling of holding a cigarette. And she went to her daughter's place and cleaned it top to bottom to keep busy.
A study this week in the Annals of Internal Medicine found that people who quit smoking have a 70 per cent increased risk of developing Type 2 diabetes in the first six years without cigarettes compared to people who never smoked. The risks were highest in the first three years after quitting and were back to normal after a decade. Those who continued smoking also had a higher risk of developing diabetes than non-smokers, but not as high a risk as the quitters.
The researchers at Johns Hopkins University School of Medicine suspect the elevated risk is due to extra pounds people put on after quitting, but say no one should use the findings as an excuse to continue smoking. They want doctors to keep the results in mind as they're counselling people to quit, and to recommend aggressive weight management if it's needed.
Selby said when someone is trying to quit, those around the individual shouldn't sabotage the effort by lighting up if they themselves are smokers.
"Understand that quitting is a process and not an event, that some people may be struggling, and ... understand that the struggle is normal. Keep them distracted."
Telephone helplines and online web programs, in particular chatrooms, can assist people who need encouragement to stick with their goal.
"Sharing information with each other as to the strategies they've used can be quite helpful," he said.
Jordan Moore, a spokeswoman for the Canadian Cancer Society's Smokers' Helpline (smokershelpline.ca), said this is typically one of the busiest times of year for the service.
She advises smokers to write down their reasons for smoking, and for quitting. Then if they experience a craving, they should pull out the list to remind themselves of why they wish to stop. They should think of things like self-image, their health and the extra money they'll have by not smoking.
The support line offers four Ds to help people cope with cravings: distraction, delay wanting to have a cigarette, drink water and take deep breaths.
And in Ontario, smokers can register until Feb. 28 to take part in a contest at driventoquit.ca, where they pledge to quit and become eligible to win prizes if they succeed.
Watson, who won a car in that contest when she quit, is a winner in another way. She said she feels a lot better nowadays, and breathes easier going upstairs. And she doesn't "cough my head off" like she used to when she smoked.
"Don't give up. If you don't succeed the first time, keep trying," Watson advised, explaining that she had tried to quit previously in 2001 but only lasted six months. "Once you get past, I find, the first two weeks, it ... gets easier."
Selby agreed that if it doesn't work the first time, try again.
"You may have learned something from the previous time and you're going to be successful this time out."
