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lthough most smokers know that cigarettes are bad for their health, many still find it very hard to give them up.

Tobacco addiction is the most common addiction in Canada. It is the leading preventable cause of heart disease, lung disease, cancer and other health problems. More than 40,000 Canadians will die of smoking related diseases this year.

Some smokers are not thinking of quitting, but many are and would like to be smoke-free. Some have tried numerous times and have found it impossible. It can be very difficult to stop smoking. The reasons why are complex, and depend very much on each individual.

Generally, there are two main factors that make people keep smoking.

1. Physical effects of nicotine
   Tobacco contains nicotine, a psychoactive substance that affects how the brain functions. It is a stimulant that speeds up the brain and central nervous system. Nicotine also triggers the release of a chemical in the brain (dopamine) that is associated with feelings of pleasure. After smoking a cigarette, a person can feel either more awake or more relaxed.
   
   Over time, your brain adjusts to the all this stimulation (the "buzz") from nicotine by lowering your natural energy level or mood. This is one reason why you believe that you need a cigarette for a "boost" physically and emotionally.
   
   Once this pattern in the brain is established the body gets used to having nicotine to feel normal. Being without tobacco for even a few hours can cause you to experience withdrawal symptoms like headaches, depression, anger, anxiety, and problems sleeping.
   
   The good news is that withdrawal symptoms only last about a week for most people. You can manage them by knowing what to expect and preparing for it. Remember that withdrawal symptoms are a sign that your body is healing itself. They are only temporary and soon you will regain your natural energy level.
   
   
2. Psychological effects of smoking
   There is more to smoking than the physical reaction to nicotine. Smoking is a ritual that can itself be a source of pleasure. Many people find that the emotional attachment to handling a cigarette and lighting up is calming, enjoyable, or comforting. It becomes a first response to stress, anxiety, anger, sadness, and even happiness.
   
   For some people, the act of smoking becomes a familiar source of comfort and part of daily life. It helps you relax and enjoy time with friends. It helps you to concentrate and gives you relief or a boost when you need it. Cigarettes become like a reliable friend who is always there for you.
   
   Learning to live without tobacco is a process which takes time, commitment and effort. It is never too late to try!

There are many good reasons, but you need to find the ones that will motivate you.

Good for your health

• Within 20 minutes after finishing a cigarette, your blood pressure and pulse rate return to pre-cigarette level.
• After 8 hours, the oxygen levels in your blood will return to normal.
• Within a day, your risk of having a heart attack decreases.
• After 3 months, your circulation will improve and your lung function will increase.
• After one year, your risk of having a heart attack will be about half of what it would have been if you had continued to smoke.
• After 5 years, your risk of stroke will be greatly reduced.
• After 15 years, your risk of coronary heart disease will be the same as a non-smoker's.

Good for your life

• Your smoking will no longer affect the health of people around you.
• You will have more money to spend on other things, or to save.
• You will set a good example for your children or friends.
• You can be free of a drug that has been controlling you.
• You can feel proud of what you have done.

Can you think of other good reasons to stop? Make a list of all the reasons why stopping smoking would improve your life.

It took time for you to become dependent on cigarettes. It also takes time to learn how to live without them. If you are thinking of quitting, it is important to understand your relationship to tobacco. When did you start smoking and why? What does it do for you now? Does it give you pleasure, comfort, relief, or something else?

What are you thinking, feeling, and doing when you reach for a cigarette?

Answering these questions and learning about tobacco addiction can show you the role that smoking has played in your life and what has kept you smoking. This understanding can help you find new ways to meet your needs. For example, you could learn a breathing technique for relaxation or take up a new form of exercise to relieve anxiety or stress.

			Stop smoking in 2005! Here are some resources to help
			There are many supports available to help you quit smoking. Browse through them to find one that appeals to you: On the Road to Quitting A self-help guide from Health Canada that helps you learn more about your relationship to smoking and explore options for quitting. To Quit or Not to Quit A free online program for people who are ready to quit as well as those who are not. Forever Free A series of eight booklets for recent ex-smokers that were shown in a study to reduce relapse rates significantly. Topics include how to handle urges, what to do if you have a cigarette, and making lifestyle changes to replace smoking in your life. Telephone Help-Lines For a list of telephone help-lines, please visit the Canadian Cancer Society web site. Do you want to help a friend? Helping Someone Quit Helping Others Quit I'm a Friend of a Smoker

• Seek self-help: Studies have shown that self-help materials reduce the chances of having a relapse.
  
  
• Find support: The encouragement of people around you can help. It is good to have someone to talk to when you are finding it tough. If there is no one you are comfortable talking to, consider joining an online discussion group like QuitNet or a support group in your community.
  
  
• Focus on what smoking means to you : Research has found that focusing on the role of smoking in your life and the costs of quitting can be helpful. This makes it easier to compare the costs and benefits of smoking to those of quitting. It also helps you to find other ways to meet the needs that smoking fulfilled. (Source: Prochaska J. (1999) The Heart and Soul of Change. Mark Hubble et. Al. (Ed.). American Psychological Association.
  
  
• Try nicotine replacement: Nicotine replacement therapies (such as patches, gum, or nasal spray) can be useful to help you deal with cravings. Some forms are available over the counter at your pharmacist; others require a prescription from your doctor.
  
  
• Consider other medications: Some people benefit from the use of certain antidepressants. It can sometimes help the process of learning to live without smoking. (Source: World Health Organization. (2001). Women and the Tobacco Epidemic: Challenges for the 21st Century. Geneva, Switzerland.)
  
  
• Combine many supports: Research shows that it helps to combine different kinds of support. For example, look for support from friends and family, use a self-help workbook, call a 1-800 counselling line or join a support group, and also have some gum or patches on hand for when you have cravings. You will need to find the combination of supports that works best for you. (Source: Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Public Health and Human Services. Public Health Service. June 2000.)
  
  
• Look after yourself: Healthy eating, regular exercise, and thinking and saying positive things to yourself can all increase your confidence. This will help you to make lasting changes. The Canadian Health Network has many resources you need to help you quit and to stay healthy.

It takes time to deal with the physical and psychological challenges of quitting smoking. Learning to live without smoking is a process, not an instant change. Many smokers make four to five attempts to stop before quitting for good.

Even though relapse rates for people trying to quit smoking are high: 60% of people start smoking again in three months and 75% do so in six months, don't be discouraged. Expect setbacks along the way but do not think of them as failures! Each "slip" is a learning opportunity on the way to freedom from smoking.

If you do start smoking again, it may help you identify a challenge and to deal with it. Think about the circumstances of your relapse. Did it happen because you were in a particular situation that you found difficult? Were you hungry, angry, lonely or tired? Plan how you might deal with this situation if it arises again.

Remember: take the time you need to get ready to quit, learn new ways to cope with stress, get help, be prepared for difficult feelings and situations, learn from setbacks, take care of yourself and keep trying.