Help to stop smoking

Tag: quit smoking

  • Craving: the urge to smoke

    Craving: the urge to smoke

    Nicotinic receptors in the brain, hungry for their nicotine meal

    Craving, the irresistible and uncontrollable urge to light a cigarette is a major obstacle when trying to quit smoking. Understanding what a craving is, where it comes from, and how to deal with it is essential to successfully quitting smoking.

    What is a Craving and What Causes It?

    Simply put, a smoking craving is a powerful physical and psychological impulse to smoke or to use nicotine immediately.

    The Root Cause: Nicotine Addiction

    The core of the craving is your brain’s dependence on nicotine. When it is inhaled in tobacco smoke, nicotine is highly addictive (but the same nicotine in a nicotine patch is not addictive at all), and it alters the chemistry and the structure of your brain. Over time, your brain adapts: the number of nicotinic receptors increases and you start to need nicotine to feel “normal.” When you quit smoking, the nicotine level in your blood drops, and your brain sends out a distress signal, which we experience as a craving.

    The Triggers: Conditioning and Habit

    Smoking is heavily linked to daily routines and emotional states.5 Your brain has been conditioned to associate certain activities or feelings with smoking.6 These triggers fall into several categories:

    • Routine: Coffee, after a meal, driving, taking a break.7
    • Emotional: Stress, boredom, feeling happy or sad.8
    • Social: Being with friends who smoke, having a drink.9
    • Environmental: A specific armchair, a smoking spot outside work where you used to smoke.

    The 5-Minute Rule: a Powerful Tool

    Here’s the single most important fact to remember about a craving: It’s intense, but it’s short-lived.

    Research shows that the strongest part of a craving usually peaks and disappears after about five minutes.10

    Your job isn’t to make the craving vanish instantly; it’s to ride the wave for those few minutes until it naturally subsides. Remind yourself: “I just need to make it through the next five minutes.”

    The Role of Nicotine Replacement and Other Aids

    Don’t feel you have to fight this battle on willpower alone. Nicotine Replacement Therapy (NRT) and other aids are designed to give your brain the small, clean dose of nicotine it craves, without the thousands of toxins in cigarette smoke, helping you manage withdrawal symptoms.13

    • Nicotine Replacement Therapy (NRT): Patches provide a steady background dose, while gums, lozenges, inhalers, or sprays are “quick-response” aids you can use immediately when a craving strikes.14 They are excellent for helping you get past that critical 5-minute peak.
    • E-Cigarettes (Vaping): Vaping can serve as a transition tool.15 It mimics the hand-to-mouth action and provides nicotine in good flavors.
    • Oral Tobacco (Snus/Nicotine Pouches): These are sometimes used for harm reduction in places where they are legally available, offering a smoke-free nicotine source.16

    How to Deal with the Urge: Distraction is Key

    Since the urge is temporary, your strategy is simple: Distract yourself until the five minutes pass. You need quick, engaging activities that interrupt the thought process.

    Distraction Techniques

    • Move Your Body: Get up and walk around the house or office. Do 10 quick squats or push-ups.
    • Engage Your Hands: Play a quick game on your phone, doodle, chew gum, sip water slowly, or crunch on a carrot stick.11
    • Change Your Scenery: Step outside for a breath of fresh air (away from smoking areas), or move to a different room.12
    • Focus on Your Breath: Take five slow, deep breaths, counting to four on the inhale and four on the exhale.
    • Talk it Out: Send a text to a friend, or call a quitting support line.

    Specific Triggers and How to Control Them

    Triggers require a pre-planned response. Think of them as battle zones where you need a prepared counter-strategy.

    If the Urge Strikes…Try This Action Plan
    When you wake upDon’t leave the bedroom immediately. Drink a large glass of water, do a 2-minute stretch, chew a piece of nicotine gum, or brush your teeth.
    After a mealReplace the ritual. Immediately get up and clean the dishes, brush your teeth, chew a piece of nicotine gum, or call a friend for a quick chat.
    In the presence of smokersDistance yourself. Announce, “I’m going to grab a drink/fresh air,” and walk away for 5-10 minutes until they’ve finished their cigarette. Chew a piece of nicotine gum.
    In a stressful situationFocus on breathing. Use deep-breathing exercises. Take a 5-minute time-out to write down what’s stressing you, then crumple the paper.
    In a place you used to smokeChange the environment. Sit in a different chair, or physically block the usual smoking area (e.g., place a flowerpot there) to break the association.

    Every time you beat a craving, you weaken the addiction and strengthen your resolve. You are retraining your brain, one five-minute victory at a time. Keep going !

    Rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (1 votes, average: 5.00 out of 5)
    Loading...

    Please use the “Comments” field below to share your experience or suggest improvements to this article.

  • Weight gain

    Weight gain

    After quitting smoking, most people gain weight. Here we explain why this happens, how much weight people usually gain after quitting, the possibility of using nicotine medications to delay weight gain, and how to limit weight gain

    Why people gain weight after they quit

    There are three main reasons why your body tends to put on a few pounds when you stop smoking, linked to the effects of nicotine on your appetite and metabolism. Together, these three factors influence your calorie balance (intake/expenditure) and storage in the form of body fat.

    Increased appetite and cravings:

    Nicotine acts as a mild appetite suppressant. When you remove it, you may feel hungrier more often. Increased appetite is a well-documented nicotine withdrawal symptom.

    Many people also mistake the craving for a cigarette for a craving for food. Reaching for a snack is often an unconscious way to deal with the urge to put something in your mouth (the “hand-to-mouth” habit).

    Food, especially sugary or fatty treats, releases brain chemicals that feel good, temporarily replacing the pleasure you got from nicotine.

    Slower metabolism:

    Smoking actually speeds up your metabolism (the rate your body burns calories). A smoker’s body burns about 150 to 200 more calories per day than a non-smoker’s.

    When you quit smoking, your metabolism slows down to a normal, healthy rate, meaning you burn fewer calories at rest. If you don’t adjust your eating, those unburned calories can lead to weight gain.

    Changes in how your body handles fat:

    Nicotine affects how your body processes and stores fat. Quitting can lead to a shift in your body’s fat storage that contributes to weight gain.

    How much weight can you expect to gain?

    The good news is that the weight gain is usually modest. On average, most people who quit smoking gain about 10 pounds (4-5 kg). About one in ten people may gain more than 30 pounds, but this is the exception, not the rule. Most of this weight gain occurs within the first three months after quitting, and weight usually stabilises after about a year.

    Remember, even with a 10-pound gain, your risk of heart disease and cancer is still significantly lower than if you continued to smoke.

    How to use nicotine medications to delay and limit weight gain

    Increased appetite and weight gain are nicotine withdrawal symptoms, and you can delay them as long as you take a sufficient dose of nicotine. Of course, it is preferable to use nicotine medications (patches, gum, lozenges, sprays or inhalers) which are harmless. By ‘delay’, we mean that you first stop smoking, then after 3 months of using nicotine medications, you can stop the nicotine treatment and only then will you gain weight. This two-step strategy allows you to deal with one problem at a time, first quitting smoking and managing withdrawal symptoms, then managing your weight.

    Nicotine medications also make it easier to quit smoking by attenuating the other nicotine withdrawal symptoms: craving, iritability, depressed mood, anxiety, difficulty concentrating, difficulty sleeping.

    But you have to accept the fact that, for most former smokers, weight gain is permanent. On average however, former smokers weigh the same as people who have never smoked, and current smokers weigh less than non-smokers. This means that, on average, former smokers simply return to the normal weight of non-smokers of the same age and gender. However, some former smokers gain a lot of weight and end up weighing more than is normal for their age.

    We have created an entire website (Stop-Kilos.org) dedicated to helping people lose weight, so we invite you to visit the Stop-Kilos website for more information.

    Is weight gain always a health problem?

    Weight gain can lead to health problems mostly if you are overweight (body mass index, BMI>25 kg/m2) or obese (BMI >30 kg/m2) or if your waist circumference is >80 cm or >31.8 in (women) or >94 cm or 37 in (men). See our articles on how to measure your waist circumference and your body mass index.

    Stop-Kilos

    Please rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (1 votes, average: 5.00 out of 5)
    Loading...

    Please use the Comments field below to share your experience and to suggest improvments to this page.

  • Cytisine

    Cytisine

    If you are looking for an effective nicotine-free treatment to help you quit smoking, you may have heard about cytisine. Although it has only recently been recognized in countries such as the United Kingdom and North America, this plant-derived substance has been used successfully for decades by millions of people in Central and Eastern Europe, making it one of the oldest and most reliable ways to quit smoking

    What Is Cytisine?

    Cytisine is a naturally occurring plant alkaloid, a chemical substance extracted primarily from the seeds of plants in the Cytisus and Laburnum genera (like the Golden Rain acacia, which gets its name from its beautiful yellow flowers). It is usually referred to by its generic names cytisine or cytisinicline.

    Like nicotine, cytisine is a natural insecticide: it kills insects by acting on their nervous system, and it also acts on the human nervous system. Its mechanism of action is similar to that of the prescription medication varenicline (Chantix/Champix). Cytisine works by acting as a partial agonist at the nicotinic acetylcholine receptors in the brain—the same receptors that nicotine targets. Its action serves two critical purposes: it reduces nicotine cravings and withdrawal symptoms by partially activating these receptors, and it blunts the rewarding effect of smoking by blocking nicotine from fully binding to nicotinic receptors. Essentially, it “tricks” your brain into feeling like you’ve had some nicotine, making the experience of smoking less satisfying.

    A Long History of Use

    Cytisine is not a new discovery. It was first isolated in 1865, and during World War II, it was smoked by German and Russian soldiers as an accessible, cheap substitute for tobacco. However, its formal use as a pharmaceutical smoking cessation aid began in 1964, when the Bulgarian company Sopharma first marketed it under the brand name Tabex. Since the 1970s, it has been widely available and highly popular across many Central and Eastern European countries. Its extensive and long-term use has provided substantial data on its safety and effectiveness.

    How Effective Is Cytisine?

    The evidence supporting cytisine’s efficacy is strong and growing. Rigorous modern studies and meta-analyses have consistently demonstrated that smokers who use cytisine are about 1.3 times to 1.75 times more likely to achieve long-term abstinence compared to those using a placebo. Even with its short treatment course, cytisine has been found to be as effective as varenicline, and more effective than NRT (nicotine replacement therapy). Also, cytisine leads to a decrease in the number of people reporting serious adverse effects compared to varenicline.

    Given its efficacy and low cost, cytisine is often cited by public health experts as a medicine with the potential to have a major global impact on smoking rates. Cytisine was recently (2025) added to the World Health Organization (WHO) list of essential medicines, which could facilitate its adoption in more countries.

    Side Effects and Withdrawal

    The most commonly reported side effects of cytisine are mild to moderate and tend to occur mainly at the beginning of the treatment course before resolving. These may include gastrointestinal issues such as nausea, vomiting, dry mouth, or constipation, as well as sleep disturbances (insomnia or drowsiness), headache, dizziness, increased appetite, and irritability.

    It is important to remember that many of these symptoms—such as irritability, sleep problems, increased appetite and mood changes—are also classical symptoms of nicotine withdrawal. It is important to distinguish between the two.

    Dosage and Treatment Duration

    Cytisine is typically taken as a 1.5 mg tablet or capsule and is prescribed as a 25-day course of treatment with a gradually reducing dose.

    The treatment schedule is as follows:

    • Days 1–3: One tablet every 2 hours (Maximum 6 tablets per day)
    • Days 4–12: One tablet every 2.5 hours (Maximum 5 tablets per day)
    • Days 13–16: One tablet every 3 hours (Maximum 4 tablets per day)
    • Days 17–20: One tablet every 5 hours (Maximum 3 tablets per day)
    • Days 21–25: One to two tablets per day (Maximum 2 tablets per day)

    You must stop smoking no later than the fifth day of treatment. Although the standard course is 25 days, some clinical evidence suggests that a longer treatment, up to 12 weeks, may be more effective, but this is not the typical licensed duration.

    Contraindications

    Cytisine is generally not recommended and is contraindicated (should not be used) if you have:

    • A known hypersensitivity (allergy) to cytisine or to any of the excipients in the product.
    • Unstable angina, a recent history of heart attack, or clinically significant heart rhythm issues.
    • A history of recent stroke.
    • Are pregnant or breastfeeding.

    It is also generally not recommended for people under 18 or over 65, or those with severe kidney or liver impairment, due to limited clinical data in these groups. Use with caution is advised for individuals with ischemic heart disease, heart failure, high blood pressure, ulcers, and certain other chronic conditions.

    Main Brands

    Cytisine is authorized for smoking cessation in 34 countries, and is included in the WHO’s list of essential medicines. It is manufactured and distributed by relatively small pharmaceutical companies rather than by “big pharma”:

    • It is sold under the brand name Tabex since the 1960s (manufacturer: Sopharma in Bulgaria),
    • and more recently Desmoxan (manufacturer: Aflofarm in Poland), and the same product by Aflofarm is sold under different brand names in different countries:
      – Defumoxan in Romania,
      – Liberisan in Hungary,
      – Tadocitan in Spain,
      – Asmoken in Austria and Germany,
      – Decigatan in Belgium and the Netherlands,
      – Dextazin in Portugal, and
      – generic Cytisine in the UK.
    • Other brands include Cravv in Canada by Zpharm,
    • and Tactizen in the UK.
    • The Polish firm Adamed Pharma produces cytisine tablets under the brand names Recigar (sold in also in Russia and Ukraine), and Cytisinicline Adamed, Glavrinxa and Belnifrem in the UK, distributed by Viatris.
    • In Thailand, the Government Pharmaceutical Organization produces tablets under the brand name Cytisine GPO.
    • In Australia, Quit4Good sells cytisine tablets that dissolve under the tongue, Nicoiq sells oral strips, and QSN sells cytisine tablets under the name NaturQuit.
    • In the USA, the company Achieve Life Sciences conducted several randomized trials with the objective of obtaining FDA approval for its cytisinicline product.
    • In some other countries, cytisine is not available as a commercial product, but is available as a compounded magistral preparation dispensed by pharmacists on medical prescription.
    • There are probably other brands and manufacturers, so please tell us if you know of any, using the “Comments” field below.

    Important: If you are considering using cytisine to quit smoking, it is essential to discuss this with your doctor beforehand to ensure that it is an appropriate and safe choice for you. Only use cytisine if prescribed by a doctor; do not purchase it online without a prescription.

    The Stop2smoke website provides information on other smoking cessation medications, such as varenicline or Nicotine Replacement Therapy (NRT)

    References:

    Read an comprehensive summary on cytisine here.

    Cytisine. By Robert West, Magdalena Cedzyńska and Andy McEwen, with contributions from Julia Robson, Lou Ross. Editor: Andy McEwen. UK National Centre for Smoking Cessation and Training (NCSCT): March 2025 (PDF).

    Etter JF. Cytisine for smoking cessation: a literature review and a meta-analysis. Arch Intern Med. 2006 Aug 14-28;166(15):1553-9. doi: 10.1001/archinte.166.15.1553. PMID: 16908787.

    Etter JF, Lukas RJ, Benowitz NL, West R, Dresler CM. Cytisine for smoking cessation: a research agenda. Drug Alcohol Depend. 2008 Jan 1;92(1-3):3-8. doi: 10.1016/j.drugalcdep.2007.06.017. Epub 2007 Sep 6. PMID: 17825502.

    Livingstone-Banks J, Fanshawe TR, Thomas KH, Theodoulou A, Hajizadeh A, Hartman L, Lindson N. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2023, Issue 6. Art. No.: CD006103. DOI: 10.1002/14651858.CD006103.pub9. Accessed 14 December 2025.

    Tutka, P., Vinnikov, D., Courtney, R. J., and Benowitz, N. L. (2019) Cytisine for nicotine addiction treatment: a review of pharmacology, therapeutics and an update of clinical trial evidence for smoking cessation. Addiction, 114: 1951–1969. https://doi.org/10.1111/add.14721.

    Walker N et al. Cytisine versus nicotine for smoking cessation. New England Journal of Medicine. 2014; 371(25): 2353–2362

    Walker N, Bullen C, Barnes J, McRobbie H, Tutka P, Raw M, Etter JF, Siddiqi K, Courtney RJ, Castaldelli-Maia JM, Selby P, Sheridan J, Rigotti NA. Getting cytisine licensed for use world-wide: a call to action. Addiction. 2016 Nov;111(11):1895-1898. https://doi.org/10.1111/add.13464. Epub 2016 Jul 17. PMID: 27426482.

    Please rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)
    Loading...

    Please use the ‘Comments’ field below to share your experience and to suggest improvments to this article.

  • 10 rules to stop smoking

    Here are the 10 rules for quitting smoking (PDF):

    1. Make a firm commitment in writing, set a date to stop smoking in the next few days, and stick to it.
    2. Once you quit, do not touch a cigarette, not even one puff.
    3. Throw away all your tobacco, ashtrays, and lighters.
    4. Ask your family, friends, a doctor or a specialist clinic for help and support, or call a helpline.
    5. Follow a treatment programme: nicotine replacement therapy, bupropion, varenicline or cytisine, and use these medicines in conjunction with medical supervision.
    6. Or switch to another source of nicotine (e-cigarettes, nicotine pouches) or a tobacco product that is not burned (snus, heated tobacco for a few weeks).
    7. Avoid smokers and places where you used to smoke.
    8. If you have a strong urge to smoke, wait a few minutes—it will pass after 5 minutes—and take nicotine to relieve the urge (e.g., a patch or e-cigarette).
    9. Ask people to avoid smoking in your presence.
    10. Persevere, try again if you fail. You may need several attempts to succeed, but you will eventually get there.
  • Doctors and clinical services

    Doctors and clinical services

    Here is a list of smoking cessation clinics and programs:

    🇺🇸 United States

    🇬🇧 United Kingdom

    ✅ NHS Stop Smoking Services

    Other UK Resource

    • National Centre for Smoking Cessation and Training (NCSCT) – Provides training, resources, and links for evidence-based cessation support (useful for providers and pathways to services). NCSCT smoking cessation support📍

    🇦🇺 Australia

    📍 Government Support & Quitline

    • Australian Government Smoking & Tobacco Info – Lists the Quitline contact and national cessation support resources for people trying to quit. Health.gov.au smoking cessation contacts📍
      • Includes Quitline phone support and links to local services.

    🇨🇦 Canada

    📍 Provincial and territorial services: list of resources by province.

    🇳🇿 New Zealand

    📍 Smokefree NZ – Stop Smoking Services

    Use the ‘Comments’ field below to share your experiences with the services listed above, or to suggest additions to this list.

  • Forums

    Forums

    Get support and encouragement from online discussion forums, join the conversation and help others quit smoking.

    Here is a list of forums you may want to join :

    Use the “Comments” field below to suggest additions to this list and share your experience with the forums mentioned above.

  • Testimonials

    Testimonials

    Share your own story, and encourage others to quit smoking.

    Write a testimonial or personal story:

  • Nicotine medications

    Nicotine medications

    Nicotine replacement therapies (NRT) are safe and effective, they include :

  • Relapse

    Relapse

    Quitting smoking is often a difficult break from a powerful addiction. However, the real test of resilience often begins after the initial withdrawal phase. A relapse is not a failure, but a common obstacle—a sign that the addiction pathways in the brain are still active. To remain abstinent in the long term, you must not only stay away from smoking, but actively build a life in which smoking no longer plays a role. This transition requires practical strategies and an unwavering commitment.

    Identifying the Enemy: High-Risk Triggers

    The majority of relapses occur in predictable situations that act as powerful psychological cues. Understanding these personal triggers is the first line of defense. They fall broadly into four categories:

    1. Social Triggers: Being around other smokers is perhaps the most immediate danger. Attending a party where everyone steps outside for a smoke break or going to a bar where smoking is allowed can easily compromise resolve.
    2. Emotional Triggers: Stress, anxiety, boredom, anger, sadness, or even a celebration can all signal the brain that it needs the soothing or stimulating effect of nicotine. For example, the former smoker who always reached for a cigarette after a heated argument with a spouse must have a replacement plan ready before the next disagreement even begins.
    3. Routine Triggers: These are the habitual pairings—the ritualistic moments in the day tied to a cigarette. The first cup of coffee in the morning, the end of a meal, or getting into the car are all prime examples. These triggers are the most ingrained and require consistent, active substitution.
    4. Craving and other nicotine withdrawal symptoms: a very strong urge to smoke (craving), being in a bad mood (sad or depressed, angry, irritable, impatient or agitated, anxious or nervous, rapid mood swings), poor sleep (insomnia), difficulty concentrating, increased hunger and weight gain. But quitting smoking also brings about a rapid improvement in smell and taste. These symptoms are alleviated by nicotine replacement therapy.

    The Escape Plan: Avoidance and Substitution

    To successfully navigate these high-risk moments, preparation is key. Avoidance is the simplest tactic for the immediate term. For instance, if a specific coffee shop was the regular smoking spot, the former smoker should temporarily change their morning routine, perhaps opting for tea at home or taking a different route to work.

    When avoidance is impossible, substitution becomes the main tool. This is where the commitment to a new behavior must override the old habit. If stress is the trigger, a five-minute substitution could involve deep-breathing exercises, a quick walk around the block, or texting a supportive friend. If the trigger is the end of a meal, the former smoker needs to immediately engage the mouth and hands with something else—brushing teeth right away, chewing nicotine gum, or eating a piece of hard candy. The crucial action is disrupting the old routine instantly.

    Navigating Cravings: The Four D’s

    Cravings, even months after quitting, are intense but short-lived. They typically peak within three to five minutes. Former smokers need a repertoire of rapid response mechanisms to survive this brief window of desire. In addition to taking a nicotine gum of lozenge, experts recommend the “Four D’s” strategy:

    • Delay: Wait it out. Tell oneself, “I will wait five minutes and see how I feel then.” By delaying, the intensity often subsides before the person gives in.
    • Deep Breathe: Take ten slow, deep breaths. This not only distracts but also helps manage the anxiety often associated with the craving.
    • Drink Water: Sip a glass of water slowly. The physical act engages the mouth and provides a minor distraction.
    • Do Something Else: Immediately change activities. If one is sitting, they should stand up and move. If they are talking, they should shift the topic. A quick distraction breaks the mental focus on the craving.

    Weight Gain

    Many former smokers gain a few pounds after quitting smoking. Weight gain can be delayed by using nicotine replacement products (patches, gum, tablet). This way, you can tackle one difficulty at a time: first, you quit smoking, then you use nicotine replacement products for a few months, and only when you stop using these products will you possibly gain weight.

    The Relapse Management Protocol

    The ultimate mistake is to treat a single slip as a total failure. A single cigarette is a slip, not a surrender. The danger lies in the self-defeating mindset that follows, leading to the full return to regular smoking.

    A successful relapse management protocol requires compassion and immediate action. If a former smoker has a cigarette, the focus must be on what happened just before that moment, identifying the trigger (Was it alcohol? Stress? A specific person?) and analyzing what defensive measure was skipped. The goal is to learn from the mistake and immediately recommit to the quit effort, disposing of any remaining cigarettes and reinforcing the substitution tactics for the next high-risk situation.

    Long-term success is built on the realization that abstinence is a continuous, conscious effort. It requires maintaining motivation, celebrating every smoke-free day, and understanding that managing the urge to smoke is a skill that improves, but never entirely disappears. Staying vigilant against the triggers is the true path to a permanently smoke-free life.

    Use the ‘Comments’ field below to share your experience or to suggest improvements to this article.

  • Quitting smoking

    Quitting smoking

    In this section, you will find everything you need to know to stop smoking for good:
    – 10 rules to stop smoking,
    – post cessation weight gain,
    – addiction and withdrawal symptoms,
    – effective methods and treatments,
    – avoiding relapses,
    – the health benefits of quitting smoking
    – Addresses: helplines, doctors and clinics, discussion forums