Frequently Asked Questions

General Smoking Cessation Questions Nicotine Replacement Therapy (NRT) and Treatment Questions Specific Medication Questions

Why is it so hard to quit smoking?
Most smokers are physiologically addicted to nicotine, which is even more addictive than heroin! Nicotine binds to the brain receptors normally used by acetylcholine, an important neurotransmitter. In addition, it releases dopamine and increases endorphin levels, which often leads to a short-lasting feeling of euphoria. Over time, the brain reduces production of acetylcholine and becomes dependent on nicotine to perform the same tasks. So when you decide to quit smoking, your body is deprived of the nicotine it now needs to function. This is why you experience headaches, irritability, anxiety, difficulty in concentrating, depression, sleeping difficulty, weight gain, and of course an insatiable desire for another cigarette.

More than commitment and determination is required, for most smokers, to break this addiction. Fortunately, nicotine, while highly addictive, is not what harms you. The damage comes from the over 4000 chemicals, including cancer-causing substances, in the cigarette. The nicotine in tobacco is what keeps you buying more. One of the main reasons why the Smoke-Free Life program is so successful is our ability to personally customize a nicotine replacement strategy that allows you to stop smoking without the painful withdrawal experience.

Is there any age at which stopping smoking is no longer beneficial?
No! Regardless of how long someone has smoked, there are significant benefits to stopping smoking. Your body begins to heal the moment you quit, and you will quickly notice an improvement in your health, both mentally and physically.

Why is smoking harmful?
There are over 4000 chemicals in tobacco that cause cancer, emphysema, heart attacks and strokes. About 50% of all Americans who continue to smoke will die of smoking-related diseases! The average smoker will lose 14 years of life because of smoking. The life cost of smoking could be as much as $222 per pack for men and $94 per pack for woman. Fortunately, the body is amazing and begins to heal itself as soon as you quit.

Is chewing tobacco, snuff, or snus a safe alternative to cigarettes?
No. They contain many of the same harmful chemicals that are found in cigarettes. These chemicals are absorbed into the blood, leading to serious problems and death.

What are the benefits of stopping smoking?
  • Some of the immediate rewards of quitting:
    • Your breath smells better.
    • Stained teeth get whiter.
    • The tobacco smell in hair and clothes goes away.
    • Yellow stain on fingers and fingernails begins to disappear.
    • Food smells and tastes better.
    • Cough and shortness of breath start to improve.
    • Impotence and fertility improve.
    • Money is no longer wasted on tobacco products.
  • 20 minutes after quitting: Your heart rate and blood pressure drop.
  • 12 hours after quitting: The carbon monoxide level in your blood drops to normal, resulting in more oxygen available to your heart, brain, and other organs.
  • 2 weeks to 3 months after quitting: Your circulation improves and, often, lung function improves.
  • 1 to 9 months after quitting: Cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function, reducing the risk of infection.
  • 1 year after quitting: The risk of a heart attack is half that of a smoker's.
  • 5 years after quitting: Your stroke risk can be reduced back to that of a non-smoker.
  • 10 years after quitting: The risk of lung cancer is about half that of a continuing smoker.

Is nicotine harmful?
No. It can be highly addictive, but nicotine can actually be used for years, from medication, without any harm. Of course, one can get side-effects, most commonly a queasy or nauseous feeling, if too much nicotine is used. Many people associate the harmful effects of smoking with nicotine addiction, but this is not accurate. Because of this incorrect belief many feel that nicotine replacement medications are little better than smoking, so they rely on sheer determination to quit. Unfortunately, this very often results in failure and further discouragement. At Smoke-Free Life we create a personalized strategy, based on your own blood nicotine levels, that allows you to comfortably break the dependence on tobacco.

What are some of the advantages of a residential program?
You are able to get away from most of your usual "triggers", and, can learn all of the strategies for success, including which medications will work best for you, in the short period of one week. Since The Center for a Smoke-Free Life is located in the beautiful Napa Valley, you can also use this time to relax, enjoy the scenery and fine dining, and focus on living a healthy, smoke-free life.

Why do so many people relapse, even though they use nicotine medications?
This is a very important question, and the answer has been the key to our success. In a recent ground-breaking study, Dr. John E. Hodgkin, the Medical Director of The Center for a Smoke-Free Life, determined that "A medication program designed to assure that patients remain comfortable when they stop smoking is crucial to long-term success. Many individuals need to use medications for six months or more to remain off tobacco permanently." In the study, medications were tailored to suppress and eliminate nicotine withdrawal symptoms. The amount of nicotine needed to help people be comfortable off cigarettes varied from 5 mg to 90 mg per day.

The main reasons why so many people relapse, in spite of using nicotine medication, is that they don't use enough nicotine and they don't use it for a long enough. For most, one large (Step 1) patch for a few weeks is simply not enough.

How long does one need to use medications, to successfully stop smoking?
Commonly, ex-smokers need to use medication for 6-9 months, and some need medications for a year or more. One of the most common reasons for relapse is stopping the use of medications too soon. Since nicotine causes a physiological change in the brain's neurotransmitter levels, it takes time for natural neurotransmitter production to return to normal.

How long do nicotine withdrawal symptoms last, when one stops smoking?
Because nicotine causes a physiological change in the brain's neurotransmitter levels, it takes time for natural neurotransmitter production to return to normal. Therefore, until the neurotransmitter balance is restored, you could experience varying degrees of nicotine withdrawal. This is why it is very important to create a nicotine replacement strategy that meets the physiological nicotine demand throughout the treatment period. For some, that time may be 3 to 4 months, for others it may take a year or more. Keep in mind, nicotine is not harmful, so regardless of the treatment time, your health starts to improve the day you quit smoking.

What are the nicotine withdrawal symptoms?
People experiencing nicotine withdrawal often complain of irritability, crankiness, anger, anxiety, fatigue, insomnia, headaches, mental confusion, depression, loneliness, restlessness, weight gain, and a craving for cigarettes.

How does a smoker know how much nicotine to use, or how to determine what combination of medications to use, when stopping smoking?
It is important to find a team that has experience in determining what medications will work best for a person who wants to stop smoking, and then titrating the medication regimen to meet the individual's needs. There are major differences in what will work best for smokers attempting to quit. Every person is unique. The medications that work for one person may cause adverse side-effects in another.

Is it safe to use more than one nicotine medication at the same time?
Yes, in fact, it is usually essential for success. For example, medications that significantly improve one's chances of stopping smoking permanently can be divided into Controller Medications and Rescue Medications. The Controller Medications (nicotine patch, varenicline, and bupropion) are longer acting, and designed to reduce or prevent nicotine withdrawal symptoms. The Rescue Medications, all nicotine products (gum, lozenge, oral inhaler, and nasal spray), help alleviate nicotine withdrawal symptoms that occur in spite of using a Controller Medication.

Are there side-effects from nicotine medications?
Excess nicotine most commonly leads to a queasy, nauseous feeling. Other possible side-effects include difficulty sleeping, nervousness, sweating, and skin irritation at the patch application site.

How about stopping smoking, without the use of medications or counseling, i.e. "cold turkey"?
The "cold turkey" success rate at one year is very poor, with only about 5% not smoking or using any tobacco product. The strategies in the Smoke-Free Life program include behavioral modification, the proper use of medications to insure comfort off of cigarettes, exercise, spirituality, and good nutrition.

What role does Behavior Modification play in stopping smoking?
One needs to learn to substitute something safe for a cigarette, when a "trigger" occurs that is associated with smoking, e.g. if one smokes a cigarette when drinking a cup of coffee, substitute a carrot or a cinnamon stick instead of a cigarette, when drinking coffee, or switch from drinking coffee to tea. Triggers have been the downfall of many that have attempted to quit. Before they know it, a lit cigarette is in their mouth and they are hooked again. A personalized nicotine replacement strategy will help neutralize the physical craving, but the person must also change their behavior.

Do tranquilizers help people quit smoking?
None have been shown to make a significant difference.

Does bupropion (also known as Zyban and Wellbutrin) help?
Yes, but it is most helpful when used in conjunction with nicotine medications. Though it is an antidepressant, in the context of smoking cessation it can help those who have never been depressed.

Can bupropion be used when a person is on another antidepressant?
Yes, and most commonly at the usual dose of both antidepressants. However, significant side-effects can occur, so your physician needs to monitor the use of these drugs carefully.

Are there side-effects from bupropion?
Yes, some people become agitated, while others can experience feelings of depression. Difficulty sleeping is particularly common, if this medication is taken in the evening.

Is Chantix helpful?
It can definitely help many to stop smoking, however the one year success rate, when used daily for 3 months, is less than 30%.

Are there side-effects from Chantix (Varenicline)?
Nausea is common, occurring in up to 30% of people. It does not suppress the weight gain associated with stopping smoking, and changes in emotional state (including agitation and severe depression) have been reported. Since Chantix blocks the nicotine receptors in the brain, the Rescue Nicotine Medications, such as gum, lozenge, and nasal spray, may not effectively relieve nicotine withdrawal symptoms that occur while using Chantix.