Stop smoking · 2013. 5. 8. · Stopping smoking. It may not be easy – but it is possible! People who plan and prepare to stop smoking are much more likely to be successful. The

Stop smokingHow to quit for a healthy heart

Stopping smoking. It may not be easy – but it is possible!People who plan and prepare to stop smoking are much more likely to be successful. The information, practical tips and questions in this guide will help you understand more about why you smoke and how you can stop smoking for good.

At the British Heart Foundation (BHF) we understand that changing a long-standing habit may not be easy and have produced this interactive guide to help you succeed in stopping smoking for good. Fill in the sections as you go along.

If you’re a smoker, stopping smoking is the single most important step you can take to protect the health of your heart.

In this guide we talk mostly about cigarettes, but the same advice applies to all forms of tobacco and smoking – roll-ups, chewing tobacco, pipes or cigars, or shisha smoking (also known as hookahs, narghiles, hubble-bubble pipes or water pipes).

This guide does not replace the advice your health professionals may give you based on their knowledge of your condition.

1Contents

ContentsTen top tips 3

What makes smoking so dangerous? 5

Why it is worth stopping smoking 9

Understanding why you smoke 13

Decision time. Are you ready to stop? 16

Stop-smoking services – helping you to quit 20

Preparing to become smoke-free 23

Methods people use to stop smoking 41

Preparing for your quit date 51

Tips on managing the first week 59

What if I get tempted to smoke? 63

Achieving lasting success 71

How the British Heart Foundation can help you 74

Index 79

3Ten top tips

Ten top tips● Think positive. Tell yourself – you can stop smoking.● Contact your local NHS Stop Smoking Service for

practical help and advice from trained specialists.● Using nicotine replacement therapy (NRT), or

a medication such as bupropion (Zyban) or varenicline (Champix), can more than double your chance of stopping smoking successfully. If you take medication or NRT and also get professional support, you are four times more likely to stay smoke-free. (We explain more about all these things on pages 41–49.)

● Pick a quit date that will be stress-free and stick to it.● Avoid situations and people that might tempt you

to smoke.● Avoid temptation. There’s no such thing as having

‘just one’ cigarette.● Plan ahead to help you cope with stressful situations.● Pair up with someone else who wants to stop

smoking, and support each other.● Spend some of the money you’re saving on a well

deserved treat.● Take it one day at a time and congratulate yourself

every day.

5What makes smoking so dangerous?

What makes smoking so dangerous?Tobacco smoke contains tar, carbon monoxide, nicotine and over 4,000 chemicals. Every time you inhale, this deadly cocktail enters your lungs and goes straight into your bloodstream and body tissues.

ChemicalsThe chemicals in tobacco smoke are known to damage the lining of the coronary arteries (the arteries that supply the heart muscle with oxygen-rich blood). This damage leads to atheroma – the build-up of fatty material within the arteries, which in turn causes coronary heart disease. Tobacco smoke also makes the small particles in the blood – called platelets – more sticky, which means that the blood is more likely to form clots.

Cigarette smoke contains over 60 chemicals that are known to cause various cancers.

Shisha smoking (a custom of some South Asian people) is also harmful. Recent research has shown that shisha smoke contains large quantities of the chemicals that can lead to heart disease, cancer, and addiction in cigarette smokers. A shisha smoker may typically inhale as much smoke during one session as a cigarette smoker would inhale by smoking 100 or more cigarettes. Even after it has been passed through water, the smoke from a water pipe contains high levels of toxic compounds including carbon monoxide, heavy metals, and cancer-causing chemicals.

Carbon monoxideCarbon monoxide is a poisonous gas and is fatal in high concentrations. It binds onto the red blood cells, reducing their ability to carry oxygen around the body and depriving the heart and body tissues of vital oxygen. Having carbon monoxide in your blood greatly increases the risk of heart disease.

The good news is that, as soon as you quit smoking, your carbon monoxide level should drop dramatically. If you see an NHS Stop Smoking adviser to help you stop smoking, they will probably measure your carbon monoxide level both before and after you stop smoking, so you’ll be able to see the benefits of stopping smoking. (To find out how to contact an adviser, see pages 20 and 21.)

7What makes smoking so dangerous?

TarThe tar in cigarette smoke can cause cancer (most commonly lung cancer), and other serious diseases related to the lungs and airways. When you inhale, about 70 per cent of the tar stays in your lungs. Low-tar cigarettes are not safer. People who smoke ‘light’ or ‘mild’ brands are likely to inhale as much tar as smokers of regular brands. Misleading descriptions like these are now banned on cigarette packaging across Europe. There is no such thing as a ‘safe cigarette’.

NicotineMost people who smoke become dependent on the nicotine they get from cigarettes. Nicotine can raise the heart rate and blood pressure and speed up the smoker’s metabolism.

Second-hand smokeSecond-hand smoke – or ‘passive smoking’ – is when someone inhales other people’s smoke. Medical research shows that people who are exposed to second-hand smoke can experience:

● irritation of the eyes, nose and throat● headaches, dizziness and sickness, and● worsening of their asthma and allergies.

Long-term exposure to second-hand smoke can also increase the risk of getting lung cancer, coronary heart disease, and problems with the lungs and airways.

If you want to live a longer and healthier life, stopping smoking is the single most important thing you can do.

9Why it is worth stopping smoking

Why it is worth stopping smokingFacts● Smoking is one of the major risk factors for coronary heart

disease. (A risk factor is something that increases your risk of getting a disease.)

● 30,000 smokers die from coronary heart disease each year in the UK.

● Smokers who have coronary heart disease have nearly twice the risk of having a heart attack compared with people who have never smoked.

● Stopping smoking after a heart attack reduces the risk of having another heart attack and improves the chances of surviving a heart attack.

● Stopping smoking before surgery, especially before heart surgery, reduces the risk of serious complications.

● More than eight in every ten cases of lung cancer and more than 50 different serious diseases and disorders are caused by smoking.

● Smokers die, on average, about ten years younger than non-smokers.

● Among women who take the contraceptive pill, those who smoke are more at risk of getting diseases of the heart and circulation than those who don’t smoke.

● Pregnant women who smoke are more likely to have underweight or premature babies, or stillbirths. Their children are also more likely to suffer mental and physical developmental delays up to the age of 11.

● Smoking has been associated with increased sperm abnormalities and is a cause of impotence.

● Smokers are more likely to develop facial wrinkles at a younger age and to have dental hygiene problems.

The heart attack really scared me. It was my kids who really gave me the motivation to quit, especially as we’d had another baby after I thought the medication I was on had made me infertile. My wife Nicola and I both realised it was really important not to set the kids a bad example by smoking, so she stopped too. I feel so much better now – I can taste food and smell things properly. It’s not always been easy, but I owe it to my kids to be around to see them grow up. We’ll never go back.

11Why it is worth stopping smoking

The health benefits of stopping smokingGood news. The box below shows how your body will benefit from stopping smoking, even if some damage has already been done.

Time stopped Benefits

8 hours Nicotine and carbon monoxide levels in the blood reduce by half and oxygen levels return to normal. The circulation improves.

24 hours Carbon monoxide and nicotine leave the body.

48 hours The ability to taste and smell improves.

3 to 9 months Coughing and wheezing decline.

1 year The risk of having a heart attack reduces by half compared to that of a smoker.

10 years The risk of lung cancer falls to about half that of a smoker.

15 years The risk of having a heart attack falls to the same as someone who has never smoked.

13Understanding why you smoke

Understanding why you smokeThink about why you first started smoking. Fill in the box below.

Tick the reasons why you first started smoking

Tick those reasons that still apply

Peer pressure

To look ‘cool’ or sophisticated

To rebel

To be accepted

To show my independence

It made me feel confident

Curiosity

Family or friends all smoke

Other reasons


List any times when the need to smoke has been inconvenient for you.

For example: when having a meal out, or at the cinema, or when visiting non-smokers.

Next, find out how much you have spent supporting your smoking habit. You might be in for a big surprise.

How much does one week’s supply of tobacco cost? £

Multiply this weekly amount by 52 to get the cost for a year.

In a year I will spend this amount on tobacco: £

The total amount of money I’ve spent on tobacco in my lifetime is probably £

If you stop smoking now, what else could you spend this money on?

For example: a family holiday, a car, or the mortgage.

Decision time. Are you ready to stop?Think about the advantages and disadvantages of stopping smoking. Fill in your answers on pages 17 and 19.


What I enjoy about smoking

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Why I want to stop smoking

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Read through your answers.Are you ready to make a serious attempt to stop smoking?

Yes No Maybe

I started smoking in my teens, when no-one knew it was bad for your health. When I tried to quit, nothing seemed to work, even though I felt guilty about exposing my family to my smoke and being a bad role model to the youngsters I worked with. About a year ago I signed up for NHS Smokefree, and with the support of my family and fellow quitters, I finally succeeded. I’m a changed man – and I’ve put the money I’ve saved towards founding an orphanage in Bangladesh. A lot of our community have died from smoking. I chose not to be one of them.


If your answer is ‘Yes’Congratulations and good luck!

If your answer is ‘No’Try to answer this question honestly:

What would have to happen, to make me want to stop smoking?

For example: having a heart attack, cancer, no money saved, clothes smelling.

If your answer is ‘Maybe’It would be a good idea to talk through your specific situation with a professional stop-smoking adviser. See pages 20 and 21 for how to contact one.

Stop-smoking services – helping you to quitNHS Stop Smoking ServicesStop-smoking groups and one-to-one supportResearch shows that getting professional help (for example, in a stop-smoking group or one-to-one with a stop-smoking adviser) doubles your chance of quitting.

There is a comprehensive network of free NHS Stop Smoking Services providing counselling and support to anyone who wants to quit smoking. To find your nearest service, call the free NHS Smoking Helpline on 0800 022 4 332 or visit www.smokefree.nhs.uk

You can go to group support sessions or, in some areas of the UK, you can have one-to-one support. Going to a group can help you to feel less alone in your attempt to quit. Being with other people who are also stopping can provide you with all-important support, a sense of being understood, and some friendly competition! Groups are usually run over a period of about six weeks and take you through the different stages of stopping. To find out more, call 0800 022 4 332 or visit www.smokefree.nhs.uk

National stop-smoking helplines and websitesCalls to these helplines are free from a land line, but not from a mobile phone.

England 0800 022 4 332Lines are open daily, from 7am to 11pm, with specialist advisers available from 10am to 1pm. www.smokefree.nhs.uk

Northern Ireland 0800 85 85 85Lines are open daily, from 12 midday to 7pm. www.spacetobreathe.org.uk

Scotland 0800 84 84 84 Lines are open daily, from 12 midday to 12 midnight. www.canstopsmoking.com

Wales 0800 085 2219Lines are open daily, from 12 midday to 12 midnight. www.stopsmokingwales.com

21Stop-smoking services – helping you to quit

Stop-smoking services – helping you to quitNHS Stop Smoking ServicesStop-smoking groups and one-to-one supportResearch shows that getting professional help (for example, in a stop-smoking group or one-to-one with a stop-smoking adviser) doubles your chance of quitting.

There is a comprehensive network of free NHS Stop Smoking Services providing counselling and support to anyone who wants to quit smoking. To find your nearest service, call the free NHS Smoking Helpline on 0800 022 4 332 or visit www.smokefree.nhs.uk

You can go to group support sessions or, in some areas of the UK, you can have one-to-one support. Going to a group can help you to feel less alone in your attempt to quit. Being with other people who are also stopping can provide you with all-important support, a sense of being understood, and some friendly competition! Groups are usually run over a period of about six weeks and take you through the different stages of stopping. To find out more, call 0800 022 4 332 or visit www.smokefree.nhs.uk

National stop-smoking helplines and websitesCalls to these helplines are free from a land line, but not from a mobile phone.

England 0800 022 4 332Lines are open daily, from 7am to 11pm, with specialist advisers available from 10am to 1pm. www.smokefree.nhs.uk

Northern Ireland 0800 85 85 85Lines are open daily, from 12 midday to 7pm. www.spacetobreathe.org.uk

Scotland 0800 84 84 84 Lines are open daily, from 12 midday to 12 midnight. www.canstopsmoking.com

Wales 0800 085 2219Lines are open daily, from 12 midday to 12 midnight. www.stopsmokingwales.com

Other helplines and websitesThe following helplines can offer information and advice on stopping smoking, and support for people who are finding it hard to stop. Calls to these helplines are free from a land line, but not from a mobile phone.

BHF Smoking Helpline 0800 169 1900Lines are open daily, from 7am to 11pm. bhf.org.uk/smoking

Quitline® 0800 00 22 00Lines are open daily, from 9am to 9pm. www.quit.org.uk

QUIT also offers the following language helplines:

Arabic 0800 16 91 300 Saturdays 1pm to 9pm

Bengali 0800 00 22 44 Mondays 1pm to 9pm

Gujarati 0800 00 22 55 Tuesdays 1pm to 9pm

Hindi 0800 00 22 66 Wednesdays 1pm to 9pm

Punjabi 0800 00 22 77 Thursdays 1pm to 9pm

Urdu 0800 00 22 88 Sundays 1pm to 9pm

Action on Smoking and Health (ASH) www.ash.org.uk

No Smoking Day No Smoking Day is the UK’s leading health campaign for smokers who want to stop. Their website has information and resources to help you stop smoking. www.nosmokingday.org.uk

23Preparing to become smoke-free

Preparing to become smoke-freeIf you have been smoking for a long time, by now you will have many daily routines and habits associated with using tobacco. It’s a good idea to become aware of these patterns before you stop smoking, so they don’t catch you unawares after you have stopped.

You may find you smoke at certain times each day due to ‘habit’ rather than a craving. Stopping will be easier if you have taken the time to work out some different ways to cope with these triggers. Here we help you analyse the different times when, and the reasons why, you smoke.

Below are some common prompts to lighting up. Tick which ones apply to you.

When I wake up in the morning

At work breaks

While watching television

After finishing a meal

While talking on the phone

At social events, parties or meals out

During arguments

At times of personal crisis

When working under pressure

When I’m with people who smoke

When I’m having a drink

Others


Now decide on some different things you could do at these times. And try to practise them before your quit date.

Possible replacements for lighting up

Go for a short walk.

Do a word search or a dot-to-dot puzzle.

Call a friend for a chat.

Take a few long, slow, deep breaths.

Sip some water.

Use a strong mouthwash.

Your ideas

Smoking patterns. Keep a recordKeep a record, below, of each cigarette you smoke over the next few days. Understanding when, where, and why you smoke will help you plan what you need to do differently during your first smoke-free week.

Write down each time you smoke and the reason why. Think about what you can do instead when you stop smoking. List all your ideas in the last column.

When you’ve finished filling in your smoking record, you will have lots of information about your personal smoking habits and preferences. You’ll be able to see which cigarettes you’ll miss and, more importantly, which cigarettes you can do without. Perhaps you can start to cut out the ones which are least important to you. This will get you off to a great start. (Remember that you are more likely to succeed if you use nicotine replacement therapy – see pages 44-47.)

Does anything in your smoking record surprise you?


My smoking record

The times when I smoke

How

important

is this cigarette on a scale of 1-5?

Instead of smoking I could:

1 = Not very important > 5 = Essential

Learning from past experiencesLots of people make five to six attempts to stop smoking before they eventually succeed. If you have tried to stop before, don’t let this put you off trying again. This exercise helps you remember what worked or didn’t work last time, and will help you learn from and build on your experiences.


Learning from past experiencesLots of people make five to six attempts to stop smoking before they eventually succeed. If you have tried to stop before, don’t let this put you off trying again. This exercise helps you remember what worked or didn’t work last time, and will help you learn from and build on your experiences.

Times I’ve given up smoking before

How long I stayed stopped

1.

2.

3.

4.

5.

Thinking about the times you stopped in the past, how did you do it? Which strategies were the most successful? List your answers below.

What helped me to stay stopped?

What things got in my way?

31

How did you cope physically during the time that you were off tobacco?

Does anything from your past experience of stopping smoking concern you about your next quit attempt? If so, what is it?

Is stress one of your concerns? Yes No

If your answer is ‘Yes’. Lots of people think tobacco helps them relax and cope with stress, but in fact this is not true. Most smokers are caught in a trap. Nicotine is highly addictive. When they inhale they get a ‘hit’ from the nicotine and feel a rush of adrenaline which makes them ‘feel good’.

Unfortunately the ‘positive’ effects of nicotine only last a short while. When they wear off, the smoker can start to feel ‘withdrawal symptoms’ – such as irritation, and tension building up in their body – and they interpret these as stress. To reduce the build-up of these stressful feelings, a smoker will light up another cigarette. So round and round it goes, becoming a vicious circle.

Trying to make time and find places to smoke – especially now that public places in the UK are all smoke-free – can also cause stressful feelings. Stop and think about just how much of your time has been taken up by the need to have a nicotine fix.

Preparing to become smoke-free

33

My current thoughts about stoppingYou can adapt these questions if you smoke a pipe or cigars rather than cigarettes.

I started smoking when I was years old.

I’ve now been smoking for years.

Currently I smoke cigarettes a day.

I have probably smoked cigarettes in my life.

I spend up to £ a week on cigarettes.

My reason for being a smoker is:

I’d like to quit smoking because:

I am thinking of stopping on: (add date)

When I have stopped, I hope to feel:

One thing I will no longer have to worry about is:

The people who will be really pleased with me are:

I will be proud with myself because:

It will be worth the effort because:


35

Preparing yourself for possible withdrawal symptomsMany smokers experience problems when trying to quit. One of the main reasons why stopping smoking is difficult is because the body craves the nicotine it used to get from cigarettes.

These strong feelings make people feel irritable and anxious. When you are trying something for the first time, any unexpected symptoms can be frightening. It’s important to be prepared for the withdrawal symptoms and understand how to manage them. Otherwise, you may fall into the trap of thinking that returning to smoking is the only way to ‘fix’ the problem. Using a stop-smoking treatment will greatly reduce the withdrawal symptoms and double your chance of successfully stopping smoking. (For information on these treatments, see pages 41–49.)

When you stop smoking, it is likely that you will experience some strong physical, emotional and psychological changes. These symptoms are caused by nicotine leaving the body and are different for each person. They are positive signals that your body is starting to repair itself and that the recovery process has begun.


We describe and explain some of these below, and suggest some ways of coping with them.

Withdrawal symptom

How it feels and what causes it

Ways to cope –try these simple practical tips.

Craving An intense desire to smoke, which becomes less frequent over the first four weeks. The craving is mainly caused by the withdrawal of nicotine.

Take a few long, slow, deep breaths.Drink a glass of water.Glucose tablets can help too.

Coughing This is often worse in the beginning. It is caused by the body clearing out the tar from your lungs.

A warm drink can ease the cough.Remind yourself that a cough is a good sign, as it shows your lungs are recovering.

Hunger You may feel extremely hungry. This is due to changes in your metabolism, and the fact that food tastes better once you have stopped smoking.

Keep a ‘survival kit’ of fruit, healthy snacks or chewing gum with you.Drink extra water.

Changes inbowel movement

You may get constipation or diarrhoea.

Drink more clear fluids.Take more physical activity.If you get constipated, change your diet to include more fruit and fibre.See your GP if you’re concerned.


Disturbed sleep

You may find that your normal sleeping pattern is disturbed. It should get back to normal within a month. The sleep disturbance is caused by the nicotine leaving your body. However, some people find that they sleep much better after stopping smoking.

Doing more physical activity may help you to sleep better.Try to get some exercise in the fresh air.Cut down on stimulants such as coffee, tea or cola drinks.

Dizziness You may occasionally feel dizzy in the first few days after stopping smoking. This happens when more oxygen starts getting to your brain instead of carbon monoxide. This is a positive sign. Your body will soon adjust and the dizziness usually passes after a few days.

If you have a dizzy spell, sit down and drink some water.

Mood swings, inability to concentrate, or feeling irritable

These are emotional signs of nicotine withdrawal, and show that your body is missing the chemicals and stimulation of smoking.

Try to figure out some coping mechanisms that work for you.Warn your family and friends that you might get these withdrawal symptoms, and ask for their support – but don’t let them persuade you to have a cigarette!

Diet and physical activityWill I put on weight?Many people who want to stop smoking are concerned about the possibility of putting on weight. Most smokers will put on some weight when they quit smoking. However, compared with the risk of continuing to smoke, putting on some extra weight is a very minor health risk.

Some people put off the decision to quit smoking because they worry about gaining weight. But the single biggest danger to your future health comes undoubtedly from carrying on smoking.

Why people can put on weight when they stop smoking

● Nicotine use has suppressed their natural appetite and increased their metabolism.

● They find that food tastes better after they quit smoking, and so they eat more.

● They replace cigarettes with snacks and sweets, or eat more than they used to.

To avoid putting on weight after you stop smoking, try to keep to your normal diet and avoid high-calorie or fried foods. You are less likely to put on weight if you eat a balanced diet from the beginning and avoid starting new habits.

TipTo avoid putting on extra weight, imagine yourself at your ideal weight. Each time you are choosing what to eat, ask yourself “Will eating this help or hinder me in keeping to my current weight?” Keep a range of healthy snacks within reach so that, when the desire to eat strikes, you can grab something tasty that won’t cause weight gain.

39

The hard factsA small amount of weight gain is a minor health risk compared with the risks of continuing smoking. If you eat healthily and keep physically active, you are unlikely to put on too much extra weight. Once you have stopped smoking for a while, hopefully you will find it easier to lose any extra weight.

Can physical activity help?Stopping smoking can slow down your body’s metabolism, so it’s very important to do some form of regular physical activity. Physical activity has also been shown to reduce the body’s cravings for nicotine and has the additional benefits of reducing stress and low moods and improving your fitness.

Thirty minutes’ moderate-intensity activity a day will help to keep the extra pounds off and improve your fitness level. (Moderate-intensity activity means working hard enough to make you breathe more heavily than normal and become slightly warmer than usual.) If you’re not used to doing much physical activity, phase it in slowly – for example, by having two 15-minute walks.

You don’t have to join a gym to get the benefits. Building physical activity into your everyday life, such as walking, will be as effective. Add variety to your route and, as you get used to this level of activity, try to walk more. Walking will clear your mind and help you feel more positive.

If you have a heart condition or high blood pressure, or if you are taking medication for these conditions, check with your doctor before you start any new activity.


41Methods people use to stop smoking

Methods people use to stop smokingIf you have tried to stop smoking before and have started smoking again, it is vital to keep trying. Many people are not successful the first time. Fortunately there are many things you can do to increase your chances of becoming an ex-smoker.

People use a variety of methods to quit smoking. Some people stop smoking completely. Others try to cut down gradually and then stop. There is now a wide variety of medical products available to help people stop. And across the country there are stop-smoking services offering one-to-one or group sessions, as well as free telephone helplines and websites (see pages 20 and 21).

Research shows that the people who are most likely to stop smoking successfully are those who use a stop-smoking treatment and also get professional support.

Professional support includes, for example, using one-to-one support from a stop-smoking adviser, or going to a stop-smoking group. We explain more about these in this section.

43Methods people use to stop smoking

Cold turkey

The phrase ‘going cold turkey’ means abruptly stopping smoking. In other words, if you smoke a pack of cigarettes today, you are ‘going cold turkey’ if, from tomorrow, you smoke none at all. If you have tried this method but are still smoking, don’t let this put you off trying again. Try stopping smoking again, but this time ask your doctor or pharmacist about medical products that can help you as well as getting some professional support. (See Licensed medical products on pages 44–49.)

Cutting down

This means reducing the number of cigarettes you smoke over a period of time. If you want to try cutting down, it is important that, each week, you set yourself a definite goal for the number of cigarettes you will cut down to. It’s also important to set an eventual quit date, after which you will not smoke at all.

If you plan to stop smoking by cutting down, you are much more likely to be successful in stopping smoking if you use a nicotine replacement product while you are cutting down, to help you manage the cravings and reduce the withdrawal symptoms. We explain more about these products on pages 44–47.

Licensed medical productsThere are two types of licensed medical products which can help people stop smoking:

Nicotine replacement therapy, or NRT for short. There are several forms of nicotine replacement available – gum, patches, microtabs, lozenges, nasal spray and inhalator. These products are all available on prescription. You can also buy them over the counter from pharmacists, and many types are available from supermarkets and retail outlets.

Non-nicotine treatments. These are medicines that do not contain nicotine. They include bupropion (trade name Zyban) and varenicline (trade name Champix). These are only available on prescription.

These products have been proven to greatly reduce the symptoms of withdrawal. Ask your doctor, pharmacist or local stop-smoking service for information on which type will best suit you and your medical condition.

Nicotine replacement therapy (NRT)

How does nicotine replacement therapy (NRT) work?Nicotine replacement therapy acts by providing a ‘clean’ alternative source of nicotine that the smoker would otherwise have received from tobacco. NRT provides nicotine in a slower and less satisfying – but safer and less addictive – way than cigarettes. It has been shown to double a person’s chance of successfully stopping smoking. Unlike tobacco smoke, NRT does not contain tar or carbon monoxide.

Most people, including those who have a history of heart disease, can normally use NRT products safely. However, if you have had a heart attack or stroke within the past few weeks, or if you have unstable angina, or if you are taking medication for a problem with your heart or circulation, you must ask your GP or cardiologist (heart specialist) about when you can start using NRT. Pregnant women can also use NRT, but you should check with your GP or pharmacist before starting it.

All forms of NRT are equally effective as each other, so you can make a personal choice of which one to use. It is important to follow the manufacturer’s recommendations. For your best chance of success, make sure you take the full course, and don’t try to under-dose yourself.

45

Nicotine gumComes in 2mg and 4mg doses.Nicotine is absorbed through the lining of your mouth when you chew the gum. A chew-rest-chew technique is best, because any nicotine you swallow is wasted. Leave the gum in your cheek between chews. People who smoke more than 20 cigarettes a day should start on the 4mg dose. People who smoke less than 10 cigarettes a day should start on the 2mg dose. You can use up to 15 pieces of gum a day.

Nicotine patchesComes in 16-hour and 24-hour patches. A 12-week course.Nicotine patches give you a constant supply of nicotine while you wear them. Apply one new patch each day to any non-hairy part of the body. To help prevent any skin irritation, put the patch on a different place each day. Patches are suitable for people who smoke more than 10 cigarettes a day. People who smoke within half an hour of waking up should use the 24-hour patches. The patches come in several strengths – from 25mg to 5mg – so that you can gradually reduce the dose over the 12-week course.

Microtabs2mg nicotine-based sub-lingual tablet (‘Sub-lingual’ means under the tongue.)You place the microtab under your tongue, where it slowly dissolves, and the nicotine is absorbed through the lining of your mouth. You should not suck, chew or swallow the microtab, as this will reduce the amount of nicotine you get from it. You can use up to one microtab per hour. (However, if your craving to smoke is very strong, you can use two tablets at a time to start with, and reduce this to one tablet as the craving becomes less strong). You should use no more than 20 tablets in any one day.

Nicotine lozengesThe nicotine lozenge is like a sweet that you suck slowly. As it dissolves, it releases nicotine. You must not crunch or chew it, but instead allow it to dissolve slowly in your mouth. Any nicotine that you swallow is wasted and can cause some indigestion. You should use no more than 15 lozenges in any one day.

Methods people use to stop smoking

Nicotine nasal sprayA 12-week courseNicotine nasal spray is the strongest form of NRT available. Nicotine taken in this way gets absorbed fast, so the nasal spray is especially suitable for people who are heavy smokers. It also helps people who get severe withdrawal symptoms. The spray can irritate the nose at first, but this passes after a day or two. For this reason, don’t use the spray while you’re driving or operating heavy machinery. You can use up to two doses an hour. (One spray is one dose.) The amount used is normally reduced over the 12-week course.

Nicotine inhalatorThe nicotine inhalator is a plastic device, shaped like a cigarette holder, into which a nicotine cartridge is fitted. Sucking on the mouthpiece releases a nicotine vapour, which gets absorbed through your mouth and throat. Inhalators are preferred by people who miss the hand-to-mouth action of smoking. You should suck on the inhalator for 20 minutes each hour. After three 20-minute sessions, the cartridge will need to be changed. An average smoker uses three to six cartridges a day.

Nicotine replacement therapy – questions and answersAren’t NRT products as dangerous as smoking cigarettes?Compared with smoking, NRT products are very safe. They don’t cause cancer or heart disease. Damage to the health of a smoker is caused by the tar, carbon monoxide, and chemical compounds found in cigarette smoke, and you get none of these if you use NRT. There is no evidence that NRT increases the risk of heart attacks. Ask your GP for advice on which is the best nicotine replacement product for you to use.

Can I use NRT to cut down on smoking rather than to stop altogether?Smokers who are not ready to stop completely can use nicotine gum, microtabs, lozenges, nasal spray, or the inhalator (but not nicotine patches) to help them cut down their cigarette consumption. The evidence shows that using NRT in this way can increase people’s confidence to stop smoking altogether.

47

Won’t using NRT just keep me craving nicotine? No. The amount of nicotine that you get from NRT is just enough to beat the craving to smoke, but not enough to keep you addicted. By following the step-down plan that the manufacturers recommend, your body learns to reduce your nicotine intake until you no longer need it. NRT is not a replacement for will power, but it helps you manage the physical changes that are going on in your body. The best way to use NRT is to combine it with structured support – the sort that you can get from your local NHS Stop Smoking Service (see page 20).

I have coronary heart disease and I get angina. I’ve been told it’s OK to use NRT. Is that true?If you are taking medicines for any condition, but particularly if you have heart disease, you should always speak to your doctor, pharmacist or a trained stop-smoking adviser before taking NRT. Although it is usually safe to take NRT with other medicines, NRT itself can cause your heart rate to increase. However, taking NRT is better for you than smoking cigarettes, because of all the other harmful chemicals they contain. Getting expert advice means you will be given the NRT that is most suited to your condition.

I have recently had a heart attack. Can I use NRT?It is advisable not to use NRT for the first month after a heart attack unless your doctor specifically prescribes it for you. You can use it after the first month, but you should check with your GP or cardiologist (heart specialist) before you start using it.

Is it OK to use two NRT products together?

Yes. You can use more than one form of NRT at the same time. For example, you might want to wear a nicotine patch to provide a steady delivery of nicotine, and combine this with an oral product, such as the nicotine gum, microtab, lozenge or inhalator. Using a combination of two NRT products in this way can give relief from any breakthrough urges or cravings that may arise during the day.

I’m worried about putting on weight. Will NRT help?People can put on weight when they stop smoking, because nicotine suppresses your natural appetite and makes your body burn calories faster. NRT products provide you with some nicotine, so this will help you to keep your weight under control while you’re taking the NRT. For more on controlling your weight, see pages 38 and 39.


Non-nicotine treatmentsThere are two medicines which do not contain nicotine and which have been licensed to help people stop smoking. They are:

● bupropion – trade name Zyban, and● varenicline – trade name Champix.

Using one of these medications can more than double your chance of stopping smoking.

Bupropion (Zyban)A two month courseBupropion is a non-nicotine treatment licensed to help smokers who are motivated to quit. Bupropion works directly on the brain to help reduce the cravings for cigarettes and the withdrawal symptoms associated with quitting.

Bupropion is only available on prescription. It comes in tablet form and a full course lasts two months. Smokers should start taking bupropion while they are still smoking, and set a date for quitting during the second week of treatment – for example, on day 8 of taking the tablets. Tablets are usually taken once a day for the first six days, and then twice a day – one in the morning and one in the evening – for the rest of the two-month treatment course.

As with any medicine, some people may get side effects while taking bupropion. The most common ones are difficulty sleeping, a dry mouth and headache. These side effects are usually mild and generally disappear within the first few weeks. Many of these effects can also be due to your body adjusting to being without nicotine.

Bupropion is not suitable for some people. You should not take it if you suffer or have ever suffered from seizures (fits) or eating disorders. Before starting on bupropion, your doctor will need to check your full medical history. Bupropion is a safe medication when it is prescribed appropriately.

49

Varenicline (Champix)Usually taken as a 12-week courseVarenicline is a prescription-only tablet, specifically developed as a stop-smoking medication. People usually take it as a 12-week treatment course, but if you feel vulnerable to relapse you can take it for longer. The most common side effect is mild or moderate nausea, which subsides over time. If you are taking varenicline, you should not drive until you are sure that it does not affect your driving ability.

You can’t use varenicline if you are pregnant or if you are under 18. If you have suffered from mental illness in the past, you should discuss with your GP whether you should start taking this medication. Varenicline use has been linked to depression and suicidal thoughts. You should stop taking varenicline immediately if you or your family notice that you become agitated or depressed, or if there are changes in behaviour that are of concern to you or your family.

Alternative therapiesSome people claim to be helped by alternative therapies. However, the effectiveness of alternative therapies remains unproven. The two most popular forms are hypnotherapy and acupuncture. If you decide to try alternative therapy, it is important to find a registered practitioner. Contact one of the organisations below. They can both offer information on the services available and details of local practitioners.

Institute for Complementary and Natural MedicineCan-Mezzanine32-36 Loman StreetLondon SE1 0EHPhone: 0207 922 7980www.i-c-m.org.uk

The British Complementary Medicine AssociationPO Box 5122Bournemouth BH8 0WGPhone: 0845 345 5977www.bcma.co.uk

The British Heart Foundation will not accept responsibility for referrals or advice offered by either of these organisations. You are strongly advised to satisfy yourself about the competence, registration, insurance and background of any complementary therapists.


51Preparing for your quit date

Preparing for your quit dateWhen you stop smoking, it is really important to have a clear plan of action. If you know what you are going to do from the beginning, you are less likely to get caught out.

53Preparing for your quit date

Fill in this page using the information on pages 23–39 and record your ideas and plans.

My quit date is:

I have chosen it because:

The people who are going to support me are:

My emergency ‘phone a friend’ numbers are:

I am going to tackle my withdrawal symptoms by: (See pages 35–37.)

If I get tempted to smoke I will distract myself by: (See page 25.)

It was one of the biggest decisions of my life, especially because two years after I’d stopped I was allowed to have a gastric bypass which would have been too risky if I was still smoking. I’ve lost eight stone and feeling healthier has helped me to exercise properly and lose more weight. I do more walking and climb hills I would never have managed before. We’ve even saved money on our home and life insurance now I’m a non-smoker!

55

These are the rewards or treats I will give myself

After 1 day

After 1 week

After 1 month

After 3 months

At my 1 year anniversary

Tip for successSaying NO to cigarettesDuring the first week you will be aware of your decision to stop smoking on almost an hour-by-hour basis. You may also have to battle against any ‘little ideas’ that pop into your head about how nice it might be to smoke again and how just one couldn’t hurt. This takes will power. It is really important to recognise that, even if you have ‘just one’ cigarette, this feeds the nicotine addiction and within a few hours you will be back in the same place, except that this time you will be smoking. You have set a goal to stop smoking. You can do it. In the days ahead it will get easier, but if you give in at this stage, you will have to go right back to the beginning and start again.

I will respond to the urge to smoke by telling myself:

Preparing for your quit date

57

The stop-smoking contractYou can adapt this contract if you use a different form of smoking to cigarettes.

I (add name) have decided to stop smoking.

I am going to commit myself to the following actions

I will stop smoking on (add your quit date)

After this date, I will never accept another cigarette.

I will tell my family, friends and work colleagues of my decision.

After stopping, I will never buy another cigarette.

Signed

Witnessed by

Witnessed by

Witnessed by

59Tips on managing the first week

Tips on managing the first weekWhen you stop using tobacco, be prepared to make changes in both the way you think and the way you act. Tick those changes that you will be able to make.

61Tips on managing the first week

Remove as many temptations as possible:

Plan to keep your quit day as stress-free as you can make it.

Don’t keep any cigarettes, chewing tobacco or loose tobacco near you.

Get rid of all ‘smoke reminders’ such as ashtrays and lighters.

Enlist support from people around you:

Talk to an ex-smoker. Find out how they stopped. If they did, so can you.

Talk to a friend or family member about stopping. Explain how important it is to you.

Find a friend or relative who also wants to quit and support each other.

Change your usual routine:

Keep yourself busy. Begin a project, or finish something you have been putting off.

Avoid standing in areas where smokers meet to have a smoke, either at work or when you are out socially.

Get outside and take a walk in the fresh air as often as you can.

Coping with the urge to smoke:

Remember that each craving to smoke will pass in a few minutes.

Try to sit still for a few moments and take slow breaths in and out.

Talk about these feelings with someone you trust.

Change the way you think about smoking:

Recognise that smoking ‘just one’ cigarette will undo all your work.

Take the process one day at a time. Don’t worry about tomorrow or next week. Today is happening now.

Remind yourself why you decided to stop and the amazing benefits.

Remember that you are choosing not to smoke. No-one is making you do anything.

Develop healthy habits:

Limit or avoid coffee and other caffeinated drinks.

Reduce or avoid alcoholic drinks.

Drink lots of water each day, to help remove the toxins from your system.

Avoid sugary sweets or snacks. Choose fruit or sugarless gum instead.

63

What if I get tempted to smoke?Some people find it difficult to be successful in stopping smoking for good. Even with all the expert help and support on offer, there may be times when you feel really tempted to use tobacco again.

What if I get tempted to smoke?

Here are some of the most common reasons people have given for their relapse:● They were not aware of their ‘triggers’ for

smoking and got caught out.● They didn’t have an alternative strategy when

they got tempted.● They didn’t seek professional advice to help

them stop.● They didn’t find an alternative means of

handling pressure.● They thought they could have ‘just one’ cigarette.● They went through a ‘bad patch’ and smoking

seemed the answer.● They found it difficult to cope with weight gain.● They still thought of themselves as smokers.

65What if I get tempted to smoke?

You may have already learnt a great deal from your past attempts to stop smoking. If so, this will make it easier to spot situations which could make you relapse. There are some obvious ‘danger’ situations. You know yourself better than anyone else. So think ahead about which situations are likely to tempt you. Fill in the chart below, and be realistic about your answers.

Situations that are likely to tempt me

What I will do immediately if I light up or if I am tempted to light up:

My main reason for stopping smoking is:

Remember that stopping smoking will:

● reduce your chances of developing cancer and coronary heart disease

● increase the oxygen supply to your heart and help you breathe more easily

● help you cope better with sudden exertion, like running for a bus● increase your chances of living a longer and healthier life.

Prevention strategiesMost smokers are well aware of their tobacco ‘hot spots’ – the times when they feel most tempted to smoke. Sometimes, people look for an excuse to start again, especially if staying stopped is becoming difficult. People who smoke are famous for ‘setting up’ a situation to give them a ‘good excuse’ to light up. The next exercise will help you assess your chances of relapse and help you avoid any self-sabotaging thoughts.

67What if I get tempted to smoke?

Answer the following questions honestly.

What would I gain from starting smoking again?

If I’m honest, the things I need to be concerned about are:

I plan to manage these concerns by:

I can ask the following people to help me by:

My strategy to avoid getting caught out is:

What I need to say to myself if I ever consider smoking again

Slipped up? Getting back on trackLife isn’t always fair and may not respect the fact that you are in the process of doing something really important for yourself. Due to past conditioning, you may accidentally respond to a situation with an old instinct and have an urge to smoke. If you follow this ‘gut reaction’ and give in, the ‘urge to smoke’ will come back within a couple of hours.

Learning any new skill can take practice. If you do light up and smoke, try following these steps:

1. Remind yourself why you wanted to stop.● Speak to someone you trust, to help you get back

on track.● Change your surroundings to leave the situation.● Go outside for a brisk walk.● Throw away any remaining tobacco or cigarettes.

2. Think about the experience.● What happened that led up to this lapse?● Where were you?● Who were you with?● What were you doing/feeling/thinking?3. Think about how you felt when you lapsed.● What was it like when you smoked again?● Did it match your expectations?● Did you feel better, or worse?● Did it make the problem go away?● Can you now find another way to cope?

69

4. Decide!

Think of all your reasons for not smoking and imagine yourself handling this situation again, but this time without a cigarette. If the same situation arises again, how will you handle the problem?

5. Don’t feel guilty!

Learn from the lapse and let it go. People make mistakes. Don’t let a mistake lead you to give up trying. Remember that you haven’t failed. You just need more time to succeed. You can do it!

6. Contact your stop-smoking adviser.

Finally, think of three or more qualities about yourself that you expect to improve by stopping smoking. (For example, you will be able to see yourself as smoke-free, healthier and more in control of your life.) Focus on how good you will feel to have managed the change.

What if I get tempted to smoke?

71Achieving lasting success

Achieving lasting successAs time passes it’s possible to forget the effort you put into stopping the smoking habit. Breaking an addiction is something to be proud of. You really deserve lots of support and congratulations. If you can do this, doesn’t it make you wonder what else you can achieve?

73

This exercise is designed to help you take stock of where you are now and build on your learning and success.

My effort to stop smoking was worthwhile because:

Since I stopped smoking my life has changed in the following ways:

I can now look forward to:

What does successfully stopping smoking say about me?

The qualities and strengths that have helped me stop smoking are:

If I can stop smoking, I should also be able to:

Achieving lasting success

How the British Heart Foundation can help youWe are the nation’s heart charity, dedicated to saving lives through pioneering research, patient care, campaigning for change, and providing vital information.

You might find some of the following resources helpful:BookletsOur heart health catalogue For you, for family and friends, for health professionals

Get active, stay activeEnjoy being active and keep your heart healthy

Be active for lifeOver 50? Keep your heart healthy with physical activity

Physical activity and your heartFor people who have a heart condition or are at risk of developing heart disease

Put your heart into walkingIt’s easy, it’s free, it’s great for your heart

Coping with stressHow to manage stress and help your heart

Take control of your weightSafe ways to lose weight for heart health

Eating wellHow to keep food fun and good for your heart

Cut down on saltIt’s easy to do and good for your heart

75How the British Heart Foundation can help you

DVD

Risking itThis DVD follows five ordinary people, all of whom have one or more risk factors for coronary heart disease. They have decided to start taking responsibility for their health and take positive action.

For information on other BHF booklets and DVDs ask for a copy of Our heart health catalogue.

How to order our resourcesTo order any of our booklets or DVDs:

● call the BHF Orderline on 0870 600 6566● email [email protected]● visit bhf.org.uk/publications

You can also download many of our publications from our website.

Our booklets are free of charge, but we would welcome a donation so we can continue our vital work. (Turn the page to see how you can make a donation.)

Heart MattersHeart Matters is our free, personalised service to help you live with a healthy heart. Join Heart Matters today to access benefits including heart matters magazine, a HelpLine and an online members’ area with recipes, articles and lifestyle tools. Register online at bhf.org.uk/heartmatters or call 0300 330 3300 (calls are charged at a similar cost to 01 or 02 numbers).

We need your help… to continue our life-saving workAs a charity we rely on the generosity of people like you to fund our vital work. Thousands of people with heart disease turn to us for help every year and even more will need us in the future. We want to be there for them.

Please donate today and together we can beat heart disease for good.If you would like to make a donation:

● please call our donation hotline on 0300 330 3322, ● contact us through our website at bhf.org.uk/donate● or fill in the form on the next page and post it to us at the

address on the back cover.

Other ways you can helpThere are many other ways you can play a crucial role in our efforts to beat heart disease:

● Become a volunteer and help run our shops, events or services for local communities. To find out more, call 0845 130 8663 or visit bhf.org.uk/volunteer

● Have fun on a sponsored run, bike ride or walk. For more on this, call 0844 477 1181 or visit bhf.org.uk/events

● Join our Heartstart initiative and learn to save lives with the skills of emergency life support. Over 2.3 million people already have. For more information contact [email protected]

● Donate goods to your local BHF shop. To find out where your nearest BHF shop is, call 0844 412 5000.

● Give in celebration by offering your party guests the chance to donate to us instead of buying gifts, for example for your wedding anniversary or birthday. Visit bhf.org.uk/celebrate for more information.

Thank you.

77Heading

Your support will help us prevent early deathsHere is my gift to help more people recover from heart problems £10 £15 £20 Other £ Please make your cheque / postal order/ CAF voucher payable to the British Heart Foundation.

Title (Mr/Mrs/Miss/Other) First name Surname

Address

Postcode

Email

We would like to keep in touch with you, to let you know your support has made a difference. By supplying your email address you agree that the BHF may use this to contact you about our work.

OR please debit the above sum from my:

AMEX CAF Card MasterCard Visa / Delta Maestro

Card number (Maestro only)

Valid from / Expiry date / Issue no

(Maestro only)

Signature Date / /

Make your gift worth almost a third more – at no extra cost to you!

Are you a UK taxpayer?If you are a UK taxpayer please tick the first box so we can claim back up to 28p for every £1 you give at no extra cost to you.

* To qualify for Gift Aid, you must pay an amount of UK Income Tax and/or Capital Gains Tax at least equal to the tax that the BHF will reclaim on your donations in the appropriate tax year. Your donation must be of your own money and cannot be a collection.

GA1 Yes, I am a UK taxpayer and would like the BHF to reclaim the tax on any of the donations I have made in the last six years and any future donations I may make.*

Date

GA2 No, I am not a UK taxpayer.

Please tick here if you do not wish the British Heart Foundation to contact you. (MP0059)

From time to time we allow other similar organisations to write to our supporters. If you do not wish to be contacted by them, please tick here. (MP0060)

The British Heart Foundation is the nation’s heart charity, registered in England and Wales (225971) and in Scotland (SC039426).

10BS00 CC05CC 1411–50030–5D01

Please send this form to:

British Heart FoundationGreater London House180 Hampstead RoadLondon NW1 7AW

Thank you.

79Index

Indexactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49advisers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20–21alternative therapies . . . . . . . . . . . . . . . . . . . . . . . . 49benefits of stopping smoking . . . . . . . . . . . 11bupropion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48carbon monoxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Champix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36contract: stop smoking contract . . . . . . . 57cost of smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15coughing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36counsellor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20–21craving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36cutting down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38gum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45helplines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20–21hunger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

hypnotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49inhalator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46irritability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37lozenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45microtabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45mood swings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37nasal spray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46nicotine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7passive smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7patches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39quit date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51–57record: smoking record . . . . . . . . . . . . . . . . . . . . 27relapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63–69second-hand smoke . . . . . . . . . . . . . . . . . . . . . . . . . . 7tar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7varenicline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38–39withdrawal symptoms . . . . . . . . . . . . . . . . 35–37Zyban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Have your say

AcknowledgementsThe British Heart Foundation would like to thank all the individuals and organisations that have given their time and support to developing this resource.

1Heading

Have your sayWe would welcome your comments to help us produce the best information for you. Why not let us know what you think? Contact us through our website at bhf.org.uk/contact. Or, write to us at the address on the back cover.

Kids and Schools

Do you want the kids in your family to be more active and eat healthier?Help them make some changes now by encouraging them to visit the following websites:

cbhf.neta website for 7-11 year olds

yheart.net and yoobot.co.ukwebsites for 12-19 year olds

Do any of the teenagers in your family have a heart condition?Visit yheart.net/meet

You can also order resources from Our kids’ and schools’ catalogue: visit bhf.org.uk/publications, call 0870 600 6566, or email [email protected]

British Heart FoundationGreater London House180 Hampstead RoadLondon NW1 7AWPhone: 020 7554 0000Fax: 020 7554 0100Website: bhf.org.uk

© British Heart Foundation 2010, registered charity in England and Wales (225971) and in Scotland (SC039426)

G11

8/09

10

British Heart FoundationGreater London House 180 Hampstead Road London NW1 7AWT 020 7554 0000 F 020 7554 0100

bhf.org.uk

Information & support on anything heart-related Phone lines open 9am to 5pm Monday to Friday Similar cost to 01 or 02 numbers

Heart Helpline 0300 330 3311 bhf.org.uk

© B

ritis

h H

eart

Fou

ndat

ion

2011

, reg

iste

red

char

ity

in E

ngla

nd a

nd W

ales

(225

971)

and

in S

cotla

nd (S

C039

426)

Pr

int c

ode:

G11

8/07

11

2011 is the British Heart Foundation’s 50th birthday. Since 1961, we have been the nation’s heart charity,

dedicated to saving lives through pioneering research, patient care, campaigning for change

and by providing vital information. But we urgently need your help. We rely on your

donations of time and money to continue our life-saving work.

Because together we can beat heart disease.

Documents

Stop smoking · 2013. 5. 8. · Stopping smoking. It may not be easy – but it is possible! People who plan and prepare to stop smoking are much more likely to be successful. The