Smoking cessation is the process of quitting smoking. Because smoking causes both chemical and psychological dependency, strategies for smoking cessation typically aim to help alleviate physical symptoms and develop tactics to help control the desire to smoke in situations where one might typically smoke. Those who wish to quit smoking but find it difficult to do so may find it helpful to speak to a therapist.

Smoking Statistics

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Approximately 18% of adults in the United States, or 42.1 million adults, currently smoke cigarettes, and 16 million Americans have some type of smoking-related disease. The leading cause of preventable disease and death in the United States is smoking: Over 480,000 Americans die each year from smoking-related complications, such as heart disease and lung cancer, and over 41,000 of these deaths result from exposure to secondhand smoke.

Smoking Cessation Methods

In the United States, about 7 out of 10 adults who smoke wish to quit completely. Typically, smoking cessation can be achieved in one of two ways: by stopping altogether, known as going “cold turkey," or by gradually decreasing the number of cigarettes smoked, thus decreasing the amount of nicotine the body craves. This process can be a tedious and stressful one, and most people who smoke have to quit several times before they are successful. However, there are newer methods available, many of which increase the success rate or decrease the number of attempts needed before quitting is successfully achieved. These methods include:

  • Support groups. These may be attended regularly or when the urge to smoke arises. There are also telephone support lines available.
  • Nicotine patches and gum provide nicotine to reduce physical cravings. Nicotine supplements typically provide progressively smaller quantities of nicotine until the body is no longer dependent on nicotine.
  • Biofeedback methods demonstrate the effects that smoking has on the lungs and overall health, thus increasing motivation to quit.
  • Hypnotherapy uses the power of suggestibility to encourage smoking cessation. Using this method may also result in fewer cravings.
  • Medications that block the receptors for nicotine decrease the satisfaction received from smoking and can reduce cravings. The antidepressant medication bupropion, marketed as Zyban, can also enable smoking cessation by decreasing the psychological effects of quitting and reducing cravings.
  • Incentives, competitions, and challenges such as the Great American Smokeout can encourage smoking cessation by establishing a sense of community between those who wish to quit smoking and creating a base for social support.
  • Support from family or friends. Attempts to quit smoking have been shown to be more successful when parents or partners insist on a smoke-free home, for example.
  • Counseling or help from a medical doctor or therapist. This type of counseling may include information about the effects of smoking on the body, advice on ways to quit, and other assistance that may improve chances of quitting.

Cessation Success Rates

Developing a smoking habit often leads to a nicotine addiction. According to research, nicotine may be as addictive as heroin or cocaine. Due to this addiction, it is often very difficult to quit smoking. Those who wish to quit may attempt to quit but begin again after experiencing stress, symptoms of withdrawal, or the weight gain that can occur after quitting smoking. However, quitting is possible. In the United States, about 7 out of 10 adults who smoke wish to quit completely, and the number of people who have successfully quit smoking is greater than the number of people who currently smoke.

A person may make several attempts to quit before finally stopping smoking for good. Forty-two percent of all adults who smoke attempted to quit in 2010, but 40% of those who attempted quitting did not succeed on that attempt. Aids such as counseling, medication, or other support are also considered to be helpful: According to research, less than 7% of people are able to quit smoking without some sort of assistance. However, studies show that 25% of those who used medication to help them quit were able to stop smoking for six months or more.

Therapy for Smoking Cessation

Because it is often difficult to stop smoking, those who wish to quit, especially those who have attempted to quit in the past and experienced difficulty doing so, may find therapy can provide them with extra support. There is no one way to succeed at quitting, but studies have shown that even one meeting with a therapist or a group of people who are also attempting to quit can increase the likelihood of success. Lengthier time in treatment will generally improve the likelihood of being able to quit completely.

Therapy can be helpful at addressing and treating the causes of a smoking habit. If stress creates the urge to smoke, therapy that encourages the exploration of coping methods can reduce the desire to smoke in challenging and overwhelming situations. If smoking is a coping method to deal with the symptoms of a mental health condition such as depression or anxiety, alternative coping methods may be developed through therapy, and treatment can also focus on the underlying cause of the mental health issue. If symptoms of depression, anxiety, or another condition recede, so might the desire to smoke. An awareness of triggers for smoking can be gained in therapy and alternative behaviors can be explored, both of which may help break the habit of smoking.

Cognitive behavioral therapy (CBT) can also be helpful to smoking cessation. In CBT, methods to reframe negative or self-defeating thoughts can be explored, which may make it easier to cope with nicotine cravings and any unpleasant emotions or feelings associated with quitting, such as symptoms of withdrawal. CBT treatments may increase the likelihood that an attempt to quit is successful. Residential treatment has also demonstrated effectiveness for helping people successfully quite smoking, perhaps due in part to the fact that the treatment involves being removed from one's daily routine and stressors that might dictate a person's smoking habits.

Case Example

  • Anxiety and nicotine dependence: Jana, 33, enters therapy because she wishes to quit smoking but cannot seem to do so on her own. She has attempted to quit smoking several times over the last five years, but each time she begins again. This latest attempt was her longest time without smoking: four months. She tells the therapist that she is frustrated with herself for being unable to quit on her own but expresses a reluctance to try medication. The therapist asks Jana some questions to determine any reasons why her attempts to quit may have failed, and Jana admits that although she feels physically better when she does not smoke, she also begins to gain weight, a side effect that she does not like, and that she begins to feel anxious about her weight and other issues after several weeks not smoking, and that she begins smoking again to help resolve this anxiety. Jana also tells the therapist that she began smoking in college in order to help control her weight. Together, the therapist and Jana discuss her concerns about weight gain and some body image issues that Jana expresses, and the therapist encourages Jana to pursue options other than medication that might help her quit smoking.


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