Smoking cessation medications such as Zyban and Champix are taken in staged doses.

It is common for these treatments to begin on a low dose, then for the dose to be increased shortly afterwards when the user quits smoking, then subsequently reduced again after a period of weeks before eventually being stopped altogether.

This greatly improves the chances of treatment being successful.

The adjustments help the body to make the transition and reduce the effects of nicotine withdrawal.

It’s important to wean the dose down as opposed to stopping it suddenly, to reduce the likelihood of cravings returning.

Champix

The initial course of Champix lasts for three months, starting at least one week before the date a user has designated to stop smoking. This date should be set for the second week of treatment.

  • You will have been issued with a starter pack if taking it for the first time; for the first week you should take the white tablets, which contain 0.5 mg of the active agent Varenicline.
  • For the first three days, take one white tablet a day.
  • For the following four days, take two white tablets a day.
  • After the first week, you will move on to the blue tablets, which contain 1 mg of Varenicline.
  • From the second week, before and after your stop date, take two blue tablets a day.
  • If this course is successful, your doctor may prescribe a second course of the same or reduced dosage, this time with a full pack of 1 mg tablets.
  • Do not stop taking Champix unless told to do so by your doctor.

Zyban

A course of Zyban treatment also typically begins in the week before your stop smoking date.

  • For the first six days you will need to take one tablet once a day.
  • As of the seventh day of your course, take one tablet twice a day.
  • Your stop smoking date should fall within the second week of your treatment.
  • If Zyban has not helped you to quit smoking within seven weeks, your doctor might tell you to stop taking it.
  • If the treatment is a success, after nine weeks you might continue the medication on a reduced dose.

Nicotine Replacement Therapy

Over the counter products such as transdermal patches, gum, inhalers and e-cigarettes can be used from the day you decide to quit smoking, though there are some patches and gums that might need to be started slightly beforehand.

It is still vital to be careful about stopping treatment suddenly or reducing the amount you use too early in case the temptation to resume smoking comes back.

A course of over the counter treatment generally lasts between two to three months, and long term use is not advised.

If you are having difficulties with NRT products or need guidance on their use, your doctor or local stop smoking service will be able to assist you.

What are the symptoms of nicotine withdrawal?

Smoking is an incredibly hard habit to break, and often takes several attempts.

About half of all smokers try to give up at least once every year; only around five per cent of those people manage to give up for good.

An overarching factor of this is the symptoms of nicotine withdrawal, which manifest themselves within hours of your last cigarette, and can be extremely difficult to deal with.

Initially they include:

  • Nicotine cravings
  • Irritability
  • Anxiety
  • Depression
  • Fatigue
  • Problems sleeping
  • Headache
  • Feeling sick
  • Hunger

These symptoms are at their most severe after the first few days, and usually start to improve after around two weeks.

Many smokers who try to quit often find that they gain weight. One study found that smokers put on an average of seven kilograms in the long term.

There are a number of reasons for this:

  • Firstly, nicotine is an appetite suppressant, and raises the metabolism.
  • Furthermore, as your sense of taste gradually returns you can find yourself craving certain foods, and you are also more likely to snack if you are longing for a cigarette.
  • It’s easy to mistake nicotine cravings for hunger, too.

Obviously gaining weight can be detrimental to health. But possible weight gain should never be considered a valid health reason for someone to continue to smoke.

It’s important to maintain a sense of perspective. There are several very serious health risks closely associated with smoking. Gaining a handful of extra pounds isn’t ideal; but doing so in order to give up smoking will help to offset these health risks.

Once someone has successfully given up smoking, they may find the process of losing a few pounds through healthy eating and exercise comparatively easy.

How to deal with cravings

Cravings are most often at the root of failed quit attempts.

They can either linger in the back of the mind continually, and they can emerge suddenly during times of stress or anxiety. These acute cravings usually pass after a few minutes.

Treatments can help to reduce cravings, but quitting successfully also requires will power and often support from those around you.

There are numerous ways you can help to reduce cravings when you are desperate to have a cigarette and are in danger of undoing the good work you’ve already done:

Change your routine

We often associate smoking with certain aspects of our day, such as a cigarette after a meal or with a morning coffee, turning it into a ritual we become attached to.

Trying something different at those times of day, such as housework, reading to a book or walking the dog, will help you to adjust that association and forget about smoking.

Let yourself be distracted

Concentrating on something other than a cigarette when you’re overcome with cravings is an effective coping strategy. Reading and doing crosswords or sudoku are great ways of occupying the brain, as is catching up with friends over he phone.

Treat yourself

Give yourself a reward when you reach a milestone for being smoke-free. It can be for every successful week, month, or whatever you think appropriate.

This will give you something to look forward to and focus on until the cravings pass.

It can be as simple as a relaxing bath, or something more special like a meal out or a small gift to yourself.

Remind yourself why you are doing it

You might be giving up just for the sake of your health, or your children or grandchildren. Finances might be the driving force behind giving up, and you might want to save for a car or a holiday.

When you have a craving, focus on those reasons. Try writing them down on a piece of paper to remind you when you need it.

Change your diet

You should always consult your doctor before making any drastic changes to your diet.

But it might be worth keeping in mind that meat, alcohol, tea and coffee all help cigarettes to taste better, while dairy products, fruit and vegetables, water and juices make them taste worse.

Having more vegetarian meals, and replacing a glass of wine with a fruit juice might help you avoid your after dinner cravings.

Have a healthy snack

Snacking will allow you to do something to occupy your hands and your mouth while you experience cravings; but it’s important that you stick to healthy snacks, so that you aren’t replacing one bad habit with another.

Dried and fresh fruit, unsalted nuts and carrot or celery sticks are ideal.

Exercise

As well as occupying your mind and body and assisting in easing stress, exercise is also thought to reduce tobacco cravings and withdrawal symptoms. It can also help to offset the weight gain associated with quitting smoking.

It doesn’t necessarily have to involve intense activities, such as going to the gym or playing sport; a brisk walk, a spot of gardening or dancing can be enough.

Keep your hands busy

Give your hands something to do rather than hold a cigarette; for example, you can try stress toys, drawing or sewing. this will also allow you to focus your mind on something else.

Relax

Breathing exercises and mindfulness can help you relax wherever you are, and just require a few moments of contemplation.

You might also find it beneficial to focus on your goal of being smoke-free and visualise how your life will be improved if you succeed.

How long will it take me to give up smoking?

There’s no definitive length of time it should take someone to quit.

The time it takes to stop smoking and for cravings to subside is different for everyone, and can be dependent on how heavy a smoker you were and how long you smoked for.

You must also be aware that you might have to try giving up several times.

If they work for you, the various forms of stop smoking treatment are generally used for around two to three months before they are gradually stopped.

By then, nicotine receptors in the brain should have returned to the same state in which they were before you started smoking.

You can still experience cravings even after this period but they will become less and less frequent with time and will be easier to resist.