Just this past Sunday, I decided it was time to? quit smoking.? I? am getting married? and would eventually like to have children.? My fiance? does not smoke? and would like to see me live a long, healthy life.? I have smoked since I was 16 and am VERY addicted to the habitual and mental part of smoking.? I am using the Nicotrol Inhalers but they are not working at all.? I think this is due to the fact that I am craving the actual act of the cigarette rather than the nicotine.? The inhalers just anger me because they simulate smoking but, obviously, you are really not.? I am EXTREMELY irritable and VERY emotional.? I have cried at least a handful of times every day since I have quit.? I am not really sure why I am so sad and upset.? It’s like I’m? mourning the loss of my cigarettes!? Isn’t that silly?? I don’t know what to do.? I need to know if there is some type of medicine that will help me quit smoking or if there is only the gum or the patch or the inhaler.? These products are probably effective for other people, but they are not working for me.? I am a wreck and I need to get my emotions back under control.? Please help!!!!!!!

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Dr. Joshua’s answer

Congratulations on your decision to quit smoking! That’s the first and most important step. Smoking has been proven beyond any doubt to be extremely harmful. Smoking kills, simple as that, and before it kills, it enslaves you, reduces your social status, and eventually destroys your health. If you smoke during pregnancy, you will seriously harm your child.

In my opinion, the best way to stop smoking is cold turkey. This takes a lot of guts, and can be really hard. The decision has to be final, and you have to be prepared for war. There’s no easy way. If you are familiar with Tolkien’s The Lord of the Rings, think of yourself as Aragorn on your way to Mordor. The enemy is powerful, and there is little hope, but much is at stake, and the journey must be made. And the battle can be won.

There are support groups and behavioral therapies available, these have been shown to be of benefit in quitting smoking. Nicotine patches and gum have also been shown to increase your chances of quitting.

There are a couple of drugs, which double your chances of quitting. One is bupropion (Zyban) and the other is nortriptyline (Pamelor, Aventyl). They are antidepressants, but their effect is the same whether you are depressed or not. In clinical trials, about 10% of subjects who took placebo (fake drug) managed to quit. About 20% of those who took the real drug managed to quit. However, there is no evidence that the drugs are beneficial in the long term. Plus, the drugs have not been proven to be more effective than nicotine patches.

Ask your doctor about these drugs, and ask about support groups and behavioral therapy. You might benefit from them. However, the most important factor is you - and your decision. Like I said, there is no easy way. You just have to do it.

Good luck,

Dr. Joshua