How To Quit Smoking – What Science Says Really Works

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for not only lung cancer but heart disease and stroke. But how risky is it, really? Current smokers are two to three times more likely to die from heart disease and two times more likely to die from stroke compared to people who don’t smoke. Yep, you’ve heard this already.

For those who want to quit or have loved ones who want to quit, here are some tidbits about smoking and the real deal on quitting. Should you quit smoking and if so, how?



Why exactly are cigarettes deadly?

Nicotine is the addictive component of cigarette smoke, but it’s actually other parts of cigarette smoke that affect heart disease risk. Cigarette smoke contains over 7,000 toxic chemicals that hurt you in multiple ways. They cause thrombosis (blood clots), inflammation, cholesterol abnormalities and heart arrhythmias. Good times.


Is any amount of smoking safe?

Surprisingly, smoking even a few cigarettes a day significantly increases heart disease risk. One scary study revealed that people who smoked just one cigarette daily had a higher risk of stroke. The take home message? There is no safe level of cigarette smoking.


How hard is it to quit?

If you’ve tried to quit and failed, you’re not alone. Most smokers make numerous attempts to quit before they are successful. In a 2015 National Health Interview Survey, almost 70% of smokers reported that they wanted to stop smoking and more than half of the smokers made an attempt to quit in the past year, but only 7% successfully quit. This doesn’t mean you should stop trying. Many smokers eventually succeed. Read on.  


Why is quitting so hard?

One reason why attempts to quit smoking have such a low success rate is that despite many effective treatments for smoking cessation, most smokers (69%) do not use them in their attempts to quit.  

On top of that, KNOW this. If you are living with someone who is still smoking, quitting won’t go well. People who live with other smokers are less successful at quitting, and those who place a ban on smoking in their home are more successful.

And peer pressure works. In one study, researchers found that smokers with a friend who quit smoking had a 36% lower chance of continuing smoking than smokers who had no friends who quit smoking. Having a spouse who quit smoking was even more powerful. It lowered the chances of continuing smoking by 67%.



What medications work for smoking cessation?

Medications that work and are approved by the FDA for smoking cessation include Chantix (varenicline), nicotine replacement therapies (NRTs) (five different products) and Zyban (bupropion).

If you’re worried about Chantix and bupropion causing depression, remember that the warnings given to them in 2009 about possible psychiatric side effects (like depression and suicidal thoughts) were removed in 2016 because there was no evidence to support the warnings.


What’s new?

Cytisine, a plant-like substance taken in tablets, acts similarly to nicotine—so it curbs symptoms related to nicotine withdrawal. Cytisine has been shown to be effective for smoking cessation in many studies, and in fact, it might be even more effective than NRTs. While clinical trials are underway in the United States, it is not yet available here. Also, it causes more side effects than NRTs, including nausea and vomiting.


What’s worked for you?


Dr O.


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