Choosing the best way to quit
You probably already know that quitting is tough. And you’ve heard about a lot of different ways to quit. But everybody is different. So how do you know which way to choose?
1
Coaching
2
+
Medication
= YOUR BEST CHANCE OF QUITTING Get some coaching
Use quitting medications
You increase your chances of succeeding at quitting.
If you are addicted, you can double your chances of quitting successfully.
Your coach might be:
There are two kinds of medication:
g
a Quitline advisor
g
a website
g
a self-help book
g
a quitting course leader
g
a doctor or other health professional with special training to help people quit.
g
nicotine replacement products (patch, gum, lozenge, tablet, inhaler)
g
prescription medications.
Contents Find your way through the quitting maze. Use the checklists and tables to select the best help for you.
1
Get some coaching g
g
g
g
g
2
+
Use quitting medications 14
4
What kind of coaching?
6
What do you want from your coach?
9
Coaching selection guide 10 How do you choose a good coach?
12
Quality checklist
13
g
Would quitting medications help you? 15
g
What kind of quitting medication?
16
Using your medication correctly
18
What do you want from your quitting medication?
19
g
g
g
Quitting medications selection guide 20
Ready to quit? g
My selection
22
1
Get some coaching
g
a Quitline advisor
g
a website
g
a self-help book
g
g
a quitting course leader a doctor or other health professional with special training to help people quit
Coaching helps all smokers You increase your chances of succeeding at quitting.
Why does coaching help? Because a coach gives you structure, motivation, support, new skills and confidence. It is much harder to get these things when you try to quit on your own. Getting coaching means you have contact with someone else who wants you to succeed and knows what you need to do. It helps you to work out for yourself why quitting is so important.
Your coach: g
provides structure They help you to organise what you need to do and remind you to do it at the right times.
g
provides motivation They remind you of your reasons for quitting and help you talk through concerns you might have.
g
provides support It’s someone else to talk to and to cheer you on.
g
helps you learn essential skills The skills to manage cravings, withdrawal symptoms or weight, or to explore new ways of relaxing, using your time, and dealing with emotions.
g
provides confidence When things are hard, they’ll remind you that it will get easier and how. You can discuss unexpected cravings or events, and benefit from others’ experiences.
What kind of coaching? You can choose from different kinds of help. Choosing a person is best, but using Internet and self-help resources can be useful as well. If you decide to use a personal coach, choose someone who has been trained to help people quit.
Low-cost help everyone can find easily Call a Quitline advisor Quitline advisors offer help with quitting for the cost of a local call. Your Quitline advisor is trained and experienced and knows how tough quitting can be. They will talk with you about your difficulties in quitting and will give you reliable information and support. Your call is confidential. This means you don’t have to give your name if you don’t want to. You can talk with your Quitline advisor once or as many times as it is helpful. You can arrange to have a Quitline advisor call you: this has been shown to be very effective in helping smokers quit and stay quit. Contact: 13 QUIT (13 7848)
Go online with the QuitCoach This is a computer program available on the Internet at www.QuitCoach.org.au. The QuitCoach asks you questions and then gives you ideas and suggestions to suit your lifestyle and where you are at with your smoking. The QuitCoach helps you before and after you quit. It is best used several times to help guide you through the different stages from quitting to becoming comfortable as a non-smoker. It’s confidential and interactive. Contact: www.QuitCoach.org.au
Use self-help books, brochures or Internet sites These are generally not as helpful as having personal support. However, if you don’t think you need personal help, they can provide some structure and valuable advice. The Quitline provides a free Quit Pack, which is well researched and has been rated highly by smokers. Contact: Call the Quitline on 13 7848 or go to the back page of this booklet for Internet information.
Help that may be harder to find If you have tried to quit several times before, or think you will need lots of help, you could try a face-to-face program. Look for someone in your area who is specially trained to help people quit.
A quitting group course These courses are run by a trained leader. They help you and the other people in the group understand why you smoke and provide strategies to quit. You learn skills to help you resist smoking and to cope better without cigarettes. Courses include the Fresh Start course (available in most states and territories). Quit’s courses are evidence-based. This means that the course was put together using research on smokers’ experiences of quitting and what helps them stay quit. Contact: See the back cover for extra details.
One-on-one face-to-face coaching Some health professionals have been trained to help people quit. For example, your doctor, dentist, pharmacist, psychologist, community health nurse or cardiac rehabilitation nurse may be trained to help you. Health professionals have different amounts of expertise and experience. Their fees and the time they can spend with you may not be the same either. Contact: Ask your health professional or local health service if they’ve had training to help people stop smoking, or can refer you to somebody who can help.
What do you want from your coach? Tick the boxes that suit you. Then turn the page and use your answers to find the coach that best fits your needs.
Level of support A low level of support may suit you if you just want to talk things over now and then. Or you may want a high level of support to guide you through the quitting process. c low
c medium
c high
Cost Quality coaching doesn’t have to be expensive. Try a cheaper option first. Can you get some money back from Medicare or through private health cover? c free
c low
c not important
Availability Do you want support to be available all of the time? Would you prefer to set a regular time aside for support? c constant
c daily
c set times
Personal style Do you like using a phone, a computer, or do you prefer face-to-face contact? Would you prefer to learn alone or in a group? c phone
c Internet
c one-on-one or group
Coaching selection guide Use the checklist from page 9 to help you choose.
Method
Respected provider
Level of support
Cost
Quitline advisor
Yes
You can choose low, medium or high
Cost of a local call (except mobile phones)
Yes
Medium
Cost of Internet access
Self-help books, brochures and Internet sites
Use the Quality checklist (page 13) to make sure.
Low
Varies, often free
Quitting group course
Use the Quality checklist (page 13) to make sure. The course should provide evidence of success rates based on all participants at least six months after the end of the course.
High
The Fresh Start course as an example costs around $100 for 8 sessions
One-on-one face-to-face coaching
Use the Quality checklist (page 13) to make sure. See a registered health professional who is trained in helping people quit smoking.
High
Varies
13 QUIT (13 7848)
QuitCoach QuitCoach.org.au
10
Availability
Personal style
Tips to get the best results
Available by phone most days
People who like talking on the phone, like oneto-one contact and want strong support.
Call the Quitline before you quit. Your chances of quitting are better if you speak with an advisor several times. Ring before you quit to get help with your plan.
Constant
People who prefer using a computer.
Use the QuitCoach several times while you are quitting.
Constant
People who like to read and learn alone and people who prefer using a computer and don’t need much support.
Give the suggested exercises and activities a go – don’t just read through them.
Set times and locations
People who like groups and want a high level of support.
The more sessions you have, the better your chance of quitting so attend the whole course. You should have sessions before and after you have quit.
Usually at set times and locations
People who prefer a one-to-one contact and want to talk to an advisor at scheduled times.
Check the advice covers problem solving and skills training, such as recognising smoking triggers and planning for tempting occasions/times.
11
How do you choose a good coach? When you have chosen the type of coaching you think will suit you, it can be hard to make sure you select a quality coach.
Coaching of known quality If you have chosen to: g
call the Quitline (13 7848)
g
go online with the QuitCoach www.QuitCoach.org.au
g
get a Quit pack (by calling 13 7848)
you can be confident that you have chosen a coach that has been proven to work.
Coaching of unknown quality If you have chosen: g
other self-help books, brochures or Internet sites
g
a quitting course
g
a one-on-one face-to-face coach
it can be harder to know whether the coach is a good one. Use the quality checklist opposite to guide you in selecting one that will give you the support you need. Follow the tips in the coaching selection guide (page 10) to get the best from your coach.
12
Quality checklist Ask a few questions before you start. Reputation c Is the coaching offered by a well-known and respected organisation or health professional? Training c Does the coach have special training in helping people to quit smoking? Success rates c Does the coach offer realistic success rates? Ask how many people they have helped to quit and how many succeeded in quitting for at least six months. Be cautious if they claim more than half succeed. Ideas c Do you understand what you will be doing? Coaching only really works if you understand what you are doing. Be careful of people who use complex ideas that you can’t easily understand. Length c Is the number of sessions too high or too low? If there are less than four sessions you are likely to need extra support from another coach. You do not usually need more than ten sessions. Workload c Will you have to do some work? A good coach will expect you to do your share of the work. Be cautious if they claim you can quit without having to do anything.
13
2
Use quitting medications
g
g
14
nicotine replacement products (patch, gum, lozenge, tablet, inhaler) prescription medications
Quitting medications help addicted smokers, especially smokers who have tried to quit before If you are addicted and you use the medications properly, you can double your chances of quitting successfully.
Would quitting medications help you? Do you: g
smoke within 30 minutes after waking up?
g
smoke at least ten cigarettes a day?
g
get withdrawal symptoms when you try to quit?
These are signs of addiction. If you are addicted, quitting medications can help you.
How do quitting medications help? Quitting medications reduce withdrawal symptoms such as cravings, irritability, mood swings and anxiety. The help you get from medications is greatly reduced if they are not used properly. They usually do not stop withdrawal symptoms altogether. Most people’s smoking is linked to habits and emotions. So you are likely to still get some cravings in situations where you used to smoke. Coaching can help you handle these times and adjust to life without cigarettes. 15
What kind of quitting medication? There are two kinds of medication. g
Nicotine replacement products (patch, gum, lozenge, tablet, inhaler), which are widely available. Talk to your pharmacist about these.
g
Prescription medications, like bupropion or varenicline (Champix), which you need to talk to your doctor about.
Nicotine replacement products Nicotine replacement products are much safer than cigarettes. Most smokers end up taking in less nicotine than they would if they were smoking. Nicotine by itself has not been shown to cause cancer or heart disease. Nicotine replacement products do not contain the many dangerous chemicals found in tobacco smoke. The cost of using nicotine products is about the same as your smoking. All nicotine replacement products work equally well. So your choice comes down to what you want, based on cost, side effects and ease of use. Ask your doctor or pharmacist before taking nicotine replacement if you: g
are pregnant
g
have an illness
g
are taking other medication
g
are under 18. 16
Prescription medications Bupropion and varenicline are current medications prescribed by your doctor for stopping smoking. You are allowed one course per year of one of these medications on the Pharmaceutical Benefits Scheme (PBS). One course is usually enough if used correctly. Further courses in the same year are expensive. Bupropion and varenicline may not be suitable for some people. Talk to your doctor if you think it might be what you need.
There are different nicotine replacement products: g
Nicotine patch – a sticky patch you wear on your skin available in a 16 hour (15 mg) & 24 hour (21 mg) variety
g
Nicotine chewing gum – gum that is chewed for a short while and releases nicotine while you rest it in the side of your mouth available in standard (2 mg) strength and extra (4 mg) strength
g
Nicotine lozenge – a tablet that dissolves in your mouth available in standard (2 mg) strength and extra (4 mg) strength
g
Nicotine tablet – a tablet that dissolves under your tongue available in standard (2 mg) strength
g
Nicotine inhaler – a mouthpiece and plastic tube with a cartridge loaded with nicotine, which is released into your mouth when you draw air through the inhaler strength is similar to the standard (2 mg) strength of the gum, lozenge and tablet
17
Using your medication correctly After choosing a medication, it is important to read and follow the instructions for your medication carefully. If you do not use it correctly, it will not work as well. You may have increased side effects (too much) or withdrawal symptoms (not enough). It is important to follow a complete course of the medication you have chosen. Talk to your doctor or your pharmacist about any concerns you might have before you start. The Quitline (13 7848) can advise you about using your chosen quitting medication.
A note on side effects Quitting medications can cause a range of side effects. Read the information about side effects on the packaging carefully. If you are concerned, talk to your doctor, pharmacist or the Quitline (13 7848).
18
What do you want from your quitting medication? Tick the boxes that suit you. Then turn the page and use your answers to find the medication that best fits your needs.
Recommended Does your doctor or pharmacist recommend the medication? c yes
c no – you may want to check before use
Response Do you have strong cravings in the morning or in particular situations? If you do, a quick response medication may suit you better. Or would you prefer a steady dose of nicotine all day? c quick
c steady
Suits Do you mind if others know you are using medications? Would you prefer to use something that mimics smoking? c private
c mimics smoking (but less private)
Would you like to be able to choose how much nicotine you take at different times in the day? c choose nicotine intake
19
Quitting medications selection guide Use the checklist from page 19 to help you choose.
Method
Response
Nicotine replacement products
Your pharmacist can help you choose the right strength of nicotine replacement product.
Bupropion, varenicline (Champix)
Suits
Steady response: l patch Nicotine patches help by giving you a steady dose of nicotine while the patch is on.
Most people particularly if: l your need to smoke is constant across the day l you want to use privately. If your need to smoke varies across the day, a quick response product might suit you better.
Quick response: l gum l lozenge l tablet l inhaler These forms help by giving you the nicotine you crave when you need it most without maintaining the dose.
Most people particularly if: l you want to control how much nicotine you take l you have bad morning cravings l you get most of your cravings in particular situations l you want to use privately. Using the inhaler: l mimics smoking which may suit you l is less private than the others which may not suit you.
You need to see your doctor for a prescription and supervision. Bupropion and varenicline work well for some but are not suitable for all people. Ask your doctor.
20
Tips to get the best results
You may need to experiment to find the right dose. l The 21 mg/24 hour patch may help more than the 15 mg/16 hour patch if you have bad morning cravings – it takes a while after you put on the 16 hour patch for your nicotine levels to rise. l The 21 mg/24 hour patch causes insomnia and vivid dreams for some but improves sleep for others. l You can use the 15 mg /16 hour patch and the 2 mg gum at the same time if you need to. The patch is not suitable if you have a skin disorder. Take: l at regular times over the day to help prevent cravings l just before entering situations where you expect cravings l more than one or extra strength varieties at times when you expect strong cravings l more than one or extra strength varieties in the morning if you are a heavy smoker or smoke within 30 minutes of waking. You can use the 15 mg /16 hour patch and the 2 mg gum at the same time if you need to. Gum is not suitable if you have dentures or some types of dental work.
You need a doctor’s supervision – overdosing can cause serious side effects.
21
Ready to quit? Most smokers will benefit from using both coaching and quitting medications.
Important g
Are you using any type of medication regularly? Chemicals in cigarettes change the way some medications work.
g
Have you had depression, anxiety or other mental health problems? Stopping smoking can be stressful and it’s good to have your doctor’s help and encouragement.
If either of these applies to you, talk to your doctor before quitting.
My selection 1
I will use this coach:
2
I will benefit from quitting medication and choose to use:
Make sure you follow the tips in the selection guides on page 10 and page 20 to get the most benefit from your choices.
22
Still unsure? If you want more help choosing what will suit you best, call the Quitline on 13 QUIT (13 7848) or talk to your doctor or pharmacist and have them work through the options with you.
If you don’t succeed Remember, most people make several attempts before they quit for good. Ask yourself: c Did I give quitting a good go? c Did I get enough coaching? c Did I need medication and did I use it properly? Next time: Think about the commitment you need to make, and the level of coaching and medication that will suit you best.
A note on unproven tools Many approaches and products are promoted and sold to smokers wanting to quit. However, many have not been studied, or there is not enough evidence to show that they make a difference. These include acupuncture and hypnotherapy, glucose tablets, lobeline, silver compounds, herbal cigarettes and filters or filter blockers. Switching to low tar or weaker-tasting cigarettes doesn’t help you quit and does not reduce the harm from smoking.
23
Get some coaching Call a Quitline advisor
a Quitline advisor can also send you a Quit Pack or let you know where quitting courses are running.
Go online with the QuitCoach
Produced with funds from the Department of Health and Ageing
Quit Victoria PO Box 888 Carlton South Victoria 3053 Australia Quit Victoria is a joint initiative of the Cancer Council Victoria, the Department of Human Services, the National Heart Foundation and the Victorian Health Promotion Foundation.
Printed by a carbon neutral process using world’s best practice ISO14001 Environment Management Systems. © Quit Victoria 2007 ISBN: 978-1-74187-087-9
® The Quit, Quitline and QuitCoach logos are registered trademarks of the Cancer Council Victoria
9/08