Smokeless Tobacco: Quitting

Can you quit? -- Yes you can. It may be hard because nicotine is addictive. The best thing to do is to not even start, but if you are addicted, the sooner you quit, the better it is for your health. Quitting smokeless tobacco and staying quit can lower your risk of cancer.

How can you quit? -- The first and most important step is deciding to quit. Once you decide, make sure you tell your friends, family, doctor or dentist, and others so they can support you in quitting.

Here are some ways to help you quit. You may want to use a combination of methods.

Talk to your physician or dentist. Your physician or dentist can:

• Do an oral exam to identify lesions caused by smokeless tobacco
• Give you advice and help you develop a quit plan
• Provide encouragement
• Provide information on how to learn skills to deal with quitting and staying off smokeless tobacco
• Discuss nicotine replacement therapy or other therapies (see explanation in the paragraph below)
• Schedule follow-up contact to see how you're doing

Quit on your own. Once you decide to quit, you need to:

• Pick a quit date - pick a date a least a week away so you can prepare to quit
• Cut back on smokeless tobacco before you quit - keep lowering the amount of smokeless tobacco you use each day, and cut back on the number of times you use smokeless tobacco each day
• Build support before you quit - talk to other people who have quit or who want you to quit and tell your friends you are quitting
• Get ready to quit - get rid of the rest of your smokeless tobacco, get substitutes for smokeless tobacco like gum or sunflower seeds
• Quit on your quit day - do something special for yourself and stay busy

Thinking about using a medication to help you quit?

Nicotine replacement products. Nicotine replacement products such as gum, patches, nasal spray, nasal inhaler, and lozenge have been approved by the Food and Drug Administration (FDA) as effective aids for helping people to quit smoking cigarettes. Even though their effectiveness has not yet been proven for helping smokeless tobacco users quit, they may be useful in helping you quit or at least helping to reduce your craving for smokeless tobacco.

Nicotine replacement products are best used in combination with other help such as group sessions or counseling. About twice as many smokers who have used these products were able to quit smoking cigarettes than those people who did not use the products. Nicotine replacement products help by allowing the gradual lowering of the amount of nicotine your body needs.

Nicotine gum, patches, and lozenges can be bought without a prescription in drug stores. Make sure to follow the instructions and don't use any tobacco, including smokeless tobacco, when using nicotine gum, patches, or lozenges. You may want to talk with your physician, dentist, or pharmacist before using nicotine gum, patches, or lozenges.

Nicotine nasal spray and nasal inhaler are prescription nicotine replacement products that have not been evaluated in research studies for effectiveness with smokeless tobacco users. The inhaler may not be very useful for smokeless tobacco users since it is shaped like a cigarette filter tip to provide smokers the hand-to-mouth movements like in smoking.

Buproprion (brand name Zyban). The Food and Drug Administration gave its approval in March 1998 for a non-nicotine prescription drug, buproprion, to be used by smokers to help them quit. Like nicotine replacement therapies, buproprion has not demonstrated effectiveness for helping smokeless tobacco users to quit. Buproprion helps stimulate the two brain chemicals that nicotine affects, dopamine and norepinephrine. These two brain chemicals give you energy and a sense of well-being. Since buproprion is a prescription drug, you will need to talk with your physician or dentist about whether you should use it and how to use it. As is the case with nicotine replacement therapies, buproprion is best used in combination with other help such as group sessions or counseling.

Programs and written materials. Programs and materials are available to help you quit. Group and individual counseling sessions to deal with quitting have been found helpful. NCI offers a telephone quitline, 1-877-44-U-QUIT, and an instant messaging service, "LiveHelp," to help people quit using tobacco. These services connect you directly by phone or the Internet with an information specialist that can speak with you about quitting tobacco. There are also printed materials that give you information and can help you quit. You can call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER for ordering information or visit the Web site: https://cissecure.nci.nih.gov/ncipubs/. NCI also has a Web site dedicated to quitting smoking called www.smokefree.gov where you can connect with all of the services mentioned above.

If you can stay off smokeless tobacco for two weeks, your body is rid of the addicting nicotine.

Side effects of quitting -- There are side effects to quitting and you need to know about them in order to deal with them.

• Craving smokeless tobacco - Since nicotine is addictive, you'll have cravings for smokeless tobacco. Try waiting it out. Each urge to use will usually last only 3 to 5 minutes. Deep breathing and exercise help you feel better right away.
• Feeling tense or edgy - You're going through nicotine withdrawal. Try some form of exercise; even walking can help.
• Feeling hungry - Yes, people can gain weight once they have stopped using tobacco products. If you get hungry, drink fruit juices or eat a low calorie snack. Drink a lot of water.

What if you slip up? -- If you start using smokeless tobacco again, it does not mean you can't quit. You need to think about why you started again, so you can avoid the urge the next time. Learn from your quit attempt and try again! Each time it will be easier. Most people try to quit more than once before they quit for good. Don't give up!

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