Help Me Stop Smoking

Dear Dr. Mahler:
I am 65 years old and was diagnosed with COPD about four years ago.  My doctor prescribed Combivent Respimat which I take 3 – 4 times a day which helps my breathing. I am writing to you because I smoke a pack of cigarettes each day and want to quit. I really enjoy smoking when my younger brother and I go fishing  and hunting.  What do you suggest that I do? Paul from Chicago Heights, IL
Answer from Dr. Mahler
Dear Paul, The most important thing is that you want to stop smoking!  You may wish to write down all the things that you like and do not like about smoking on a piece of paper. Then, you should set a quit date and tell family and friends that you plan to quit.  Next, remove cigarettes from your home, car, and work.  You need to be aware of nicotine withdrawal which happens to most people who quit smoking.  These symptoms may include: feeling bad, irritability, anxiety, difficulty concentrating, eating more, and difficulty sleeping. Many smokers light up a cigarette with their morning coffee, after a meal, and when drinking alcohol.  These triggers may make it difficult to quit because you may associate one activity (smoking) with another (drinking coffee).  You should have a plan to deal with these, and you may wish to avoid such triggers by going for a walk, talking to a friend, or calling a telephone quit smoking helpline. There are nicotine replacement therapies available over the counter that can help reduce your body’s craving for nicotine.  These include nicotine gum, lozenges, and patches.  Also, prescription medications (bupropion and varenicline) can help you quit smoking by reducing the desire in the brain to smoke.  You should discuss these with your doctor. Although it may not be easy to quit smoking, and it may take a few tries before you are successful, you are in control of what you do.  You may wish to check with your local hospital to find out about services to help you quit.  Here are some free resources.
American Lung Association 800 586-4672
Freedom from Smoking® 866 316-2673
COPD Foundation
Tobacco Quit Line 800 QUIT NOW
American Cancer Society
  Good luck and let me know how you do.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.