Frequently asked questions

Coughing

“Is it normal to still cough in the morning after 12 days without smoking?”
Your coughing is caused by the restarting of your body’s natural lung cleansing mechanism. The irritating substances found in cigarette smoke paralyse the tiny hairs lining the throat and nose reducing your defences against pollution and infection. Your coughing should gradually subside as your lungs become clearer but, if you are at all concerned about it, don’t hesitate to speak to your doctor or pharmacist.

Nicotine Replacement Therapy

“I’ve developed an allergy to my NRT patch. What can I do?”
Allergies to adhesive substances are rare – it is more likely that the nicotine within the patch has caused a local irritation. Try sticking the patch on another part of the body. If the problem persists, consult your doctor or pharmacist.

“Can I cut the patch in half to reduce my dose?”
No. Cutting the patch in half does not mean that each half will contain exactly the same dose, so you could not be certain how much nicotine you would be receiving. Cutting the patch may also affect the delivery mechanism, causing too much or too little nicotine to be released at any one time.

“Can I swim whilst I’m wearing my patch?”
Yes, but don’t stay in the water too long. To make sure your patch doesn’t come off, stick it on an area where it will be protected by your swimsuit. If this doesn’t work, try covering it with a waterproof plaster.

“Where should I stick my patch?”
Your patch can be applied to any non-hairy area of skin such as the arms, shoulder blades or buttocks. To ensure a complete seal make sure the skin is dry before application and avoid areas which may become sweaty.

“Can I take my patch off at night?”
No. If you remove the patch before going to sleep you may experience strong cravings when you wake up. Your patch must be kept on for 24 hours for it to be fully effective.

Different forms of tobacco

“I stopped smoking cigarettes and now only smoke cigars. Are they as dangerous?”
Yes. If you inhale the smoke, a cigarillo is equivalent to 2 cigarettes and a cigar is the equivalent of 3–5 cigarettes. Even if you don’t inhale the smoke, you still absorb the nicotine, which enters your bloodstream through the lining of the mouth . The effects on your heart and arteries are therefore as high as if you were smoking cigarettes. The only difference with cigars is that cancer localisation tends to be around the mouth, cheeks, tongue or throat.

“Is rolling my own cigarettes more natural and therefore less harmful?”
No. Rolled cigarettes are more harmful as their smoke contains four times more toxic substances than a commercially produced cigarette of the same weight.

“I’ve been smoking light cigarettes for years. Does that make me less at risk?”
No. The level of nicotine and tars indicated on cigarette packets is determined by a smoking machine. You are not a machine and you will naturally adapt the way you smoke to meet your nicotine needs, so the quantities you absorb will not necessarily correspond to those indicated on the packet. Although you are smoking “light” cigarettes you may be changing the way you smoke and dragging on your cigarette to absorb a greater quantity of nicotine. “Light” cigarettes are therefore just as dangerous as regular ones.

“What about chewing tobacco? That must be a good way to get around the problem?”
Tobacco that is not smoked, i.e. is chewed or snuffed, still causes nicotine to pass through the lining of the mouth and means that carcinogenic and irritating substances are still absorbed.

“If I smoke tobacco free cigarettes will I be exposed to the same risks?”
Tobacco free cigarettes do not contain nicotine but, upon combustion, they do release the same toxic substances as a regular cigarette (tar, carbon monoxide, irritating substances etc.).

“And what about smoking a pipe?”
With pipe smoking the risks vary, depending on factors such as how it is smoked and the shape of the pipe. Tars from pipe smoking enter the mouth where their direct toxicity to the lip and tongue increases the risks of mouth and tongue cancers.

Depression

“I have already suffered from severe depression. Will stopping smoking increase the risk of it happening again?”
Even though you have been through depression, you can still stop smoking. Withdrawal symptoms can be more intense for people who have suffered from depression so it would be a good idea to consult your doctor who can adapt your treatment. Make sure you look out for and report any signs such as sleep problems and persistent gloomy thoughts that could indicate your depression is returning.

“I’m unemployed and going through a nervous breakdown. Will I be able to stop smoking?”
Your current situation, although very difficult, is also temporary. This may not be the most appropriate time for you to quit but this doesn’t mean that you cannot stop eventually. Your doctor will be able to help you decide when would be a good time to stop.

Moods and behaviour

“Will I be an unbearable pain to everyone around me if I stop smoking?”
Irritability and nervousness may occur, but are only temporary withdrawal symptoms which indicate your body is getting rid of nicotine. If you use nicotine replacement therapy when you stop smoking these symptoms will be less obvious. As for the people around you, talk to them and explain that you’ve just quit smoking – many of them will be happy to give you their support.

“How will I cope at work if I become nervous or irritable?”
Nervousness and irritability caused by stopping smoking can be managed. Nicotine replacement therapy can help to reduce or prevent these symptoms as can the development of some new habits to help you cope with any difficulties. If you feel you are “losing it” try taking a short break, walk around the office, wash your hands, take some deep breaths or drink a glass of water.

Weight

“Why do some people put on weight when they quit?”
Although weight gain is not automatic, it is true that some smokers do put on a little weight when they quit. This is due to several factors:

• Nicotine increases metabolism so your body burns more calories. When you stop smoking your calorie requirements are reduced by about 200kcal per day
• Smoking also suppresses your appetite – when you stop smoking, food smells and tastes better so you naturally want to eat more of it
• A lot of people replace the physical act of smoking a cigarette with snacking. Replacing cigarettes with biscuits is bound to make you put on weight

“What are the basic rules to avoid putting on weight?”
These are very simple:

• Do not skip meals
• Have a substantial breakfast to help you avoid the 11am “appetite suppressant” cigarette
• Adjust your diet to ensue that you are reducing your calorie intake by 200 kcal per day
• Try not to snack between meals – if you must, choose raw vegetables or fruit rather than crisps and biscuits
• Drink lots of water (preferably between meals)
• Increase your level of physical activity – even if it’s just by taking a brisk ½ hour walk every day

“How much weight am I at risk of putting on?”
Firstly, you need to realise that weight gain is neither inevitable nor irreversible. Everybody is different but, on average, you can expect to put on about 3-4 kilos (6-9lbs) in the months following smoking cessation. Weight gain is usually only temporary and can be minimised by following the tips on this website.

“How can I avoid putting on weight?”
To prevent weight gain you need to think about stabilising your weight from the very first day of cessation. The 3 main things you can do are:

• Exercise daily – this doesn’t mean taking up an extreme sport but simply using the stairs instead of the lift, walking wherever you can etc.
• Reduce your calorie intake – you don’t have to eat less, just check the calorie content of foods and try to make healthier choices
• Find compensations for your psychological dependency and reward yourself, rather than replacing cigarettes with an unbalanced diet

Sleeping

“Why don’t I sleep as well as I used to?”
Quitting smoking can temporarily disturb the wake/sleep cycle. It is another symptom of nicotine withdrawal as your body starts to function normally again. Nicotine replacement patches can often help with this problem. If you are using patches and are still having difficulty sleeping then you may be under-dosed – speak to your doctor or pharmacist for advice.

“Is there anything I can do to improve my sleeping?”
The following simple measures can help to improve your sleep:

• Go to bed at a regular hour, especially during the first two weeks of stopping smoking
• Make sure you are getting enough sleep – 6-8 hours are necessary to ensure that you wake up feeling refreshed
• Observe your waking rhythm (how long it takes you to get up after your alarm goes off) and try to reduce this period

“I’m hardly sleeping at all and I feel on top form. Is this normal?”
If you can’t sleep but still feel fine during the day and/or if you are dreaming a lot, your dose of nicotine replacement therapy may be too high. This is quite unusual so please speak to your doctor or pharmacist for advice.

“I had trouble sleeping before but now it’s even worse. What can I do?”
Avoid stimulating substances such as tea or coffee in the evenings and have some herbal tea or warm milk before going to bed. In addition to the physical withdrawal symptoms triggered by stopping smoking you may also be missing certain rituals such as smoking a cigarette just before bed. If this is the case, create yourself a new bedtime ritual e.g. listening to some relaxing music or taking a warm bath to help you unwind.