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Kicking smoking to the curb: 3 evidence-based ways to aid you on your journey to becoming smoke-free

The Bottom Line

  • Over one billion people smoke tobacco worldwide. Smoking is a risk factor for cancer, heart disease, respiratory infections and illnesses, stroke, and a reduced lifespan. 
  • The World Health Organization lists smoking as a potential risk factor for increasing the severity of complications in those who contract COVID-19. More research is needed.  
  • The current time is as good as ever to try your hand at quitting! Nicotine replacement therapy, group smoking cessation programs, and telephone support can all increase your chances of successfully quitting.  
 

It is not too late to revisit the goals we had set for ourselves at the start of the year or to identify and commit to new ones. In fact, as we slow down and take a break from our “normal” routines, we’re presented with the opportunity to think about the things we may have been meaning to get to for a while. Not only can we use this time to lay out how we plan to accomplish our goals, but we can even start taking action towards making them a reality.


If you are one of the over one billion people worldwide who smoke tobacco, quitting may be on the top of your wish list (1;2). There are a variety of reasons that can motivate you to put down your cigarettes for good. Premature death and the increased risk of developing heart disease, cancer, stroke, pneumonia, and chronic obstructive pulmonary disease (COPD), as well as the immense health benefits of stopping, are just a few (1;3-7). Now, COVID-19 may be another addition to the ever-growing list of reasons to quit.


You may be wondering why that is. It seems that people who smoke may be at an increased risk of developing severe symptoms and complications from COVID-19—such as the need to be in an intensive care unit or on a ventilator. People who smoke could be more vulnerable to COVID-19 because smoking is already known to increase the risk of respiratory infections such as pneumonia and the flu. Additionally, these folks may also have underlying health conditions, due to smoking, that impact their lung or cardiovascular function (e.g., COPD or heart disease) (8;9).


Be it COVID-19 or some other motivation, quitting smoking is a positive step towards better health. Click the links below to learn more about different strategies that can help you on your path to becoming smoke-free!


1. Consider nicotine replacement therapy (NRT)

This over-the-counter treatment comes in a variety of forms including patches, tablets, gums, lozenges, sprays, and inhalers. If you’re motivated to achieve long-term quitting, NRT can improve the chances of successfully doing so by 50%-60%, and is generally associated with just minor side effects (10). In terms of how different NRTs stack up, the fast-acting options (e.g., gums or lozenges) are just as likely as the long-acting ones (e.g., patches) to help people who smoke at least 15 cigarettes/day and want to quit, to stop smoking. On the other hand, combining fast and long-acting NRTs is even more beneficial than using just one form alone (11).


Tips for purchasing NRT:

  • Support! Before starting NRT or if you have more specific questions about its use, seek guidance from a pharmacist or your health care provider. Financial support may also be available for NRT, with some provincial drug plans covering or reimbursing a certain amount of NRT. Some smoking cessation programs may also offer NRT for free.
  • Online! Consider online shopping and delivery options to minimize trips to the pharmacy or store.
  • In-person! If in-store purchasing is preferred or the only option available, check to see if your local pharmacy or store is offering specific shopping times for older adults and people living with disabilities. Sometimes these hours also come with a “senior’s discount”.  Be sure to follow public health safety guidelines when out.

2. Lean on your peers for support

Don’t want to go it alone? You don’t have to! Group smoking cessation programs, which allow you to learn and gain strength from those on a similar journey, can increase your chances of quitting by 50%-130% compared to “self-help” (12). They can even be done on their own or coupled with NRT (13). What’s more, in times when in-person group supports are unavailable, you can turn to a wide variety of online group programs to get that at-home support.


3. Seek telephone support from a counsellor

In-depth telephone counselling, which involves receiving multiple calls from counsellors via a smoker’s helpline or health care provider within different settings, is another strategy that can be accessed at home. In fact, receiving in-depth telephone support after reaching out to a smokers’ helpline may increase your chances of quitting by 20%-60%, versus calling into a helpline and only receiving self-help materials and/or one-time counselling. Similarly, if you were/are receiving quitting services within a non-helpline setting, in-depth telephone support provided by a health care provider may increase your chances of success by 15%-35% (14-16).


Like the saying goes, when it comes to making healthy changes in our lives, “there is no time like the present”! If you’re motivated to quit smoking, there are an arsenal of strategies that you can use to help you get started and succeed.

Featured Resources

 
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References

  1. Tzelepis F, Paul CL, Williams CM, et al. Real-time video counselling for smoking cessation. Cochrane Database Syst Rev. 2019; 10:CD012659. doi: 10.1002/14651858.CD012659.pub2.
  2. World Health Organization. WHO report on the global tobacco epidemic, 2019: Offer help to quit tobacco use. Geneva (CH): World Health Organization; 2019.
  3. Banks E, Joshy G, Weber MF, et al. Tobacco smoking and all‐cause mortality in a large Australian cohort study: Findings from a mature epidemic with current low smoking prevalence. BMC Medicine. 2015; 13:38. doi: 10.1186/s12916-015-0281-z.
  4. Jha P, Ramasundarahettige C, Landsman V, et al. 21st‐century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013; 368(4):341‐50. doi: 10.1056/NEJMsa1211128. 
  5. U.S. Department of Health and Human Services. The health consequences of smoking: 50 years of progress. A report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
  6. Cahill K, Lindson‐Hawley N, Thomas KH, et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2016; 5:CD006103. doi: 10.1002/14651858.CD006103.pub7. 
  7. US Surgeon General. The health consequences of smoking: A report of the Surgeon General. 2004. [cited April 2020]. Available from https://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm
  8. World Health Organization. Q&A on smoking and COVID-19. 2020. [cited April 2020]. Available from https://www.who.int/news-room/q-a-detail/q-a-on-smoking-and-covid-19
  9. World Health Organization. Tobacco and waterpipe use increases the risk of suffering from COVID-19. 2020. [cited April 2020]. Available from http://www.emro.who.int/tfi/know-the-truth/tobacco-and-waterpipe-users-are-at-increased-risk-of-covid-19-infection.html
  10. Lindson-Hawley N, Hartmann-Boyce J, Fanshawe TR, et al. Interventions to reduce harm from continued tobacco use. Cochrane Database Syst Rev. 2016; 10:CD005231. doi: 10.1002/14651858.CD005231.pub3.
  11. Lindson N, Chepkin SC, Ye W, et al. Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2019; 4:CD013308. doi: 10.1002/14651858.CD013308.
  12. Stead LF, Carroll AJ, Lancaster T. Group behaviour therapy sessions for smoking cessation. Cochrane Database of Syst Rev. 2017; 3: CD001007. doi: 10.1002/14651858.CD001007.pub3.
  13. Hajek P. Current issues in behavioral and pharmacological approaches to smoking cessation. Addict Behav. 1996; 21(6):699-707.
  14. Matkin W, Ordóñez-Mena JM, Hartmann-Boyce J. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2019; 5:CD002850. doi: 10.1002/14651858.CD002850.pub4. 
  15. Rigotti NA, Kruse GR, Livingstone-Banks J, et al. Treatment of tobacco smoking: A review. JAMA. 2022; 327(6):566-577. doi: 10.1001/jama.2022.0395.
  16. Hartmann-Boyce J, Livingstone-Banks J, Ordonez-Mena JM, et al. Behavioural interventions for smoking cessation: An overview and network meta-analysis. Cochrane Database Syst Rev. 2021; 1:CD013229. doi: 10.1002/14651858.CD013229.pub2.

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