Quitting Smoking Tips for Women

WebMD Feature

June 5, 2000 -- Samantha Schoech and her fiance took an early vow last summer: to quit smoking. He chose the nicotine patch. She joined Weight Watchers. Her doctor also gave her a prescription antidepressant that doubles as a stop-smoking aid. The couple's different approaches to beating the same addiction reflect a growing understanding of how men and women smokers differ.

One difference is that women smokers often have a tougher time quitting than men. The next hurdle scientists face is figuring out why. One study, published December 1999 in the journal Nicotine & Tobacco Research, found that men are more apt to be physically driven by nicotine, in terms of the satisfied feeling they get from smoking, whereas women smoke to reap psychological rewards, such as spending time with friends who also smoke.

As researchers continue to investigate the role gender plays in nicotine addiction, early studies, such as the one above, offer clues women smokers can use today to successfully quit.

• Time your quitting to coincide with the end of your period. Research suggests that women who stop smoking 15 days after or before menstruating have more success than those who quit in the latter half of their cycle. The idea that PMS aggravates withdrawal symptoms, such as irritability and depression, may not be a surprise to those who suffer from the monthly malady. But if quitting by the calendar ups the odds of success, it's certainly worth a shot.
• Accept that a little weight gain isn't the end of the world. It's true, many women put on 5 pounds when they kick the habit, but don't let that keep you from trying. Rest assured those few extra pounds are a lot better for your body than smoking.
• Don't diet while quitting. The double dose of deprivation is a one-way ticket to failure. Instead, focus on eating three healthy meals a day and curbing snacks. When Schoech first tried to quit, her weight spiraled out of control. "I wasn't paying attention to what I put in my mouth," she says. "I gained 20 pounds in four months." It's the snacking that gets most women, not bigger meals, says Kenneth Perkins, professor of psychiatry at the University of Pittsburgh, an expert on women and smoking. Stock your kitchen with low-calorie munchies that mimic the action of smoking, such as carrot and celery sticks.
• Seek support. Although few studies address how men and women quitters differ in their need for support, Perkins' experience shows women do benefit from a shoulder to lean on. "Women seem to rely more heavily than men on informal social ties for all things," he says. Schoech admits she couldn't have done it without her fiance. "We really had to dedicate ourselves to it together. That made a huge difference," she says. And support isn't limited to a spouse or partner. Jill McCain of Conshohocken, Penn., who quit after 13 years of smoking, took comfort in a chat room designed for ex-smokers.

  Online resources that offer smoking information and cessation programs, besides WebMD, include the American Cancer Society, the American Lung Association, and Nicotine Anonymous.

Try nicotine replacement therapy (NRT), such as the nicotine patch or nicotine gum. The patch delivers a steady stream of nicotine automatically through the skin and into the blood. Easy to use, the patch is a popular choice for both men and women. Those who give in to cravings and smoke while using the patch, however, put themselves at risk for heart attacks (from a potential overdose). Nicotine gum helps to alleviate cigarette cravings by releasing nicotine into the bloodstream when chewed. Many women try both before settling on one. McCain felt sick after just five minutes on the patch and switched to nicotine gum. "The gum is very helpful because, like smokes, I see it as a reward," she says. The trouble with nicotine gum is that many people don't chew enough to quell their withdrawal symptoms, says Perkins. "Gum was a pale substitute for cigarettes," says Schoech. "It didn't lessen my cravings at all."

But don't abandon quitting altogether if a nicotine replacement therapy doesn't work for you. Research shows that women are fueled more by "smoking cues" than by the nicotine itself. In other words, you're more likely to crave a cigarette if you get a whiff of smoke from your favorite brand or if you go out for drinks with friends who smoke. Make a list of things that spark your cravings and try to avoid them.

Get moving (preferably at a pace that precludes smoking). Adding a fast walk or a brisk swim to your daily routine not only staves off nicotine cravings but also burns excess calories. Try funneling the money you save from cigarettes (which can be sizable if you sit down and do the math) into a gym membership. If smoking left you feeling lethargic, don't overdo it. Perkins recommends walking one or two miles a day to start. A self-described non-athlete, Schoech made exercise an important part of her smoke-free routine. "When you're smoking you know that you're already doing the worst possible thing you can to your body, so you care less about eating junk food and not exercising," she says. "When I quit smoking, I wanted to become more healthy overall." Now, she walks 40 minutes a day three to five times a week and has improved her lung capacity and stamina.

Talk with your doctor about prescription cessation aids. Drugs such as Zyban and Wellbutrin are antidepressants that ward off nicotine cravings. Both can be combined with NRTs to boost the likelihood of success. Women smokers are twice as likely as men to have a history of depression, according to a January/April 1996 review article in the Journal of the American Medical Women's Association. Therefore, prescription antidepressants can be especially helpful, says Perkins. Zyban also helps prevent weight gain, which makes it an appealing option for many women, he says.

The most important thing is not to get discouraged, especially if success doesn't come immediately. Quitting is a combination of timing and technique. Don't hesitate to try several different cessation methods before settling on one or a combination. Also, consider joining a local smoking cessation program or study. Both will enhance your odds of success.

QUESTION

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Catherine Guthrie is a freelance writer based in San Francisco. Her work has appeared in Health magazine.

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