Quitting Smoking

Being prepared and making a personal quit plan will help you quit smoking for good.

Eight tips to making quitting easier

1. Make a list

   List all the reasons why you want to quit and keep the list close by for when you are tempted to smoke. Think of your:

   • Family and friends
   • Health
   • Self-image
   • Social life
   • Money

2. Understand your smoking behaviour

   Track your smoking behaviours over a few days using a simple chart. It's a quick and easy way to recognize your smoking triggers.

   Your chart should include the number of cigarettes, time of day, what you were doing at the time and who you were with. Rate, from one to five, how badly you needed the cigarette, with five being really needed it, and why you were smoking.

3. Find healthier substitutes for smoking

   Once you understand your smoking behaviours and why you smoke, you’ll be better able to recognize trigger situations ahead of time and choose something other than a cigarette. For example, take a walk, change your routine and get some fresh air.

4. Change your environment and routine

   Making a few little changes can make it easier to quit. Cut back on caffeine because you may need less as you quit, eat breakfast in a different place and make your home and car smoke-free.

5. Talk to someone

   By telling others that you are quitting smoking, you are more likely to try your best. Telling friends and family also gives them a chance to help you. Let your doctor or pharmacist know you are quitting smoking. They can provide support and may recommend adjustments or changes to medication you are taking as you quit.

6. Learn from the past 

   If you have tried to quit before, use that experience to make your next try a success.

   For example, you started smoking again because:

   • You could not handle the cravings
   • You constantly found yourself in situations that triggered smoking
   • You were with people who smoked
   • You felt you gained weight

   What could you do differently?

   • Talk with your doctor, nurse or pharmacist to help with your concerns
   • Consider stop smoking medications-such as nicotine replacement therapy, bupropion and varenicline as they can double your chance of quitting
   • Tips one through four can help!

7. Set a Quit date

   Pick a low-stress day in the next month and mark it on your calendar. You’re much more likely to start your quit day if it’s written down.

8. Motivate yourself with positive thoughts

   Think about the positive things about quitting and celebrate being smoke-free:

   • “I did not need to smoke when I was out with my friends”
   • “My car is cleaner now that it is smoke-free”
   • "Look at all the money I've saved"

What if I have a set back?

If you have a set back and have a cigarette or two, it is okay. Remember, quitting is a process that often takes several tries and there are many ways to go about it. Research shows that the chances of quitting for good increases with every try.

If you need help call

• Smokers' Helpline (Telehealth Ontario) at 1-866-797-0000 or visit smokershelpline.ca
• Talk Tobacco Indigenous Quit Smoking and Vaping Support 1-833-998-8255
• York Region Access York at 1-877-464-9675 TTY 1-866-512-6228

Quit smoking medications along with support and a quit plan can more than double your chances of quitting success. These medications help by reducing nicotine withdrawal and cravings, which can be intense and uncomfortable.

Before using any medication, talk with your health care provider especially if you are pregnant, breastfeeding, have angina, irregular heartbeat or had a recent heart attack or stroke. If you are on other medications, when you quit or cut down on smoking, the amount of medication you require may change.

Non-prescription medication (over the counter)

Nicotine Replacement Therapy (NRT) is a form of medication that does not require a prescription and is sold at a pharmacy. Tobacco use causes serious health problems; NRT is a much safer option for getting nicotine without the other harmful chemicals found in tobacco. Nicotine Replacement Therapy can be used as long as needed with guidance from a health care provider.

Long acting NRT is a nicotine patch worn on the skin, provides a steady amount of nicotine throughout the day and is replaced every 24 hours. There are patches with different amounts of nicotine and the patch you wear will depend on how much you smoke per day. Ask your pharmacist about which patch is best for you. If you continue to experience episodes of nicotine withdrawal while on the patch, you can also use short acting NRT with guidance from your pharmacist or health care provider.

Common side effects of long acting NRT include skin irritation and sleep disturbance. Speak to your pharmacist to discuss ways to reduce these side effects.

Short acting NRT provides nicotine more quickly and for a short amount of time. It can be found in gum, lozenge, mouth spray and inhaler. Short acting NRT provides nicotine more quickly and for a short amount of time. Some types of short acting NRT can be used in a cut down to quit method. Speak with a pharmacist for details on how to do this.

Common side effects of short acting NRT are hiccups, upset stomach and throat irritation. Reduce side effects by following the directions closely.

Watch these "How to" videos:

• How to use the nicotine patch
• How to use the nicotine inhaler
• How to use the nicotine gum
• How to use the nicotine lozenge
• How to use the nicotine mouth spray

Prescription medications

Discuss the options available with your healthcare provider. Prescription quit smoking medications can help reduce nicotine withdrawal and cravings and/or to reduce the pleasurable effects of smoking and reduce cravings. These medications are typically started before your quit date. Your health care provider will advise how long you should take the medication, the dose you require and the common side effects

E-Cigarettes

There is some evidence emerging that suggests the use of e-cigarettes (vaping) may be a helpful tool for smoking cessation, especially when combined with behavioral counselling. While vaping is not without some health risks, switching to e-cigarettes will significantly reduce the harms associated with combustible tobacco. Research is ongoing to determine further recommendations on using e-cigarettes most effectively as a cessation aid.

Cytisine is a natural health product. It comes in capsule form and can be obtained from select pharmacies, natural health shops and directly online from the manufacturer. It has a specific dosing schedule to follow for 25 days. The most common side effects are stomach upset and sleep disturbance. For more information and to see if this product is right for you speak with a pharmacist.

Other Quit Smoking Methods

There is no clear evidence that using herbal, laser or hypnosis therapies help to quit smoking. It is recommended to research these options before using them.

Smoking Cessation Resources

These resources list local smoking cessation services. All listed services are provided at no cost, although some have eligibility requirements.
Cost-Free Tobacco Intervention Services in York Region

STOP On The Net Program

STOP on The Net is an online program to help you quit smoking cigarettes. Join today from the comfort of your home and receive a 10-week supply of free nicotine replacement therapy (NRT) patches and gum/lozenges mailed to your address. You must be 18 years of age, an Ontario resident and have a valid email address to join. For more information and to enroll visit: Join STOP on the Net | Nicotine Dependence Services (nicotinedependenceclinic.com).  STOP on the Net is an initiative of the Smoking Treatment for Ontario Patients (STOP) Program and is funded by the Ontario Ministry of Health.

STOP Programs

Any York Region resident may be eligible to receive up to 26 weeks of nicotine replacement therapy and counselling as part of the Smoking Treatment for Ontario Patients (STOP) program in partnership with the Centre for Addiction and Mental Health at the following sites:

Vaughan Community Health Centre

• Vaughan site: 9401 Jane St., Ste. 206, Vaughan (Phone: 905-303-8490)
• Keswick site: 716 Queensway South, Keswick (Phone: 905-476-5621 Ext.1)

Patients of Participating Family Health Teams, Community Health Centres, Nurse Practitioner Led Clinics and Addictions Agencies offering the STOP program

If your health care practitioner is part of one of these organizations, you may be eligible to receive up to 26 weeks of nicotine replacement therapy and counselling as part of the Smoking Treatment for Ontario Patients (STOP) program in partnership with the Centre for Addiction and Mental Health.

• Georgina Nurse Practitioner Led Clinic
• Southlake Academic Family Health Team
• Newmarket-Aurora Family Health Team
• Carefirst Family Health Team in Richmond Hill
• Markham Family Health Team
• Woodbridge Family Health Team
• Addiction Services Central Ontario

Ottawa Heart Institute

Offers 6 weeks cost-free NRT including patches and lozenges for anyone in Ontario age 18+. Clients are initially screened over the phone by a nurse, then follow up phone calls are made throughout the program. Call 1-888-645-5405.

The Health Canada Non-Insured Health Benefits (NIHB) Program

Provides First Nations and Inuit clients up to 3 courses of nicotine replacement therapy treatment over a 12-month period. Prescription medications to reduce cravings are also available. Speak to your pharmacist for more information.

Ontario Drug Benefit Program

The Ontario Drug Benefit Program (ODBP) covers one 12-week treatment of prescription stop smoking medication once a year. Talk to your health care provider about getting a prescription. Some pharmacists may also be able to prescribe quit smoking prescription medications and also provide quit smoking counselling for those who receive ODB. For more information, talk to your pharmacist or visit the Pharmacy Smoking Cessation Program.

Private Health Insurance Benefits

Those who receive private health insurance benefits through their workplace may be eligible for cost-free smoking cessation medications and support. Call your insurance provider for more information.

For Health and Social Service Providers

Brief interventions from a health care provider along with quit smoking medications including nicotine replacement therapy, varenicline or bupropion can increase the chances of quitting success.

While quitting tobacco use provides the greatest health benefits over time, not all clients are ready or have the confidence to quit. Therefore, exploring the feasibility of cutting down tobacco use gradually over time is a recommended strategy as an alternative to abruptly quitting on a set date. This may help to build the client confidence and motivation to eventually quit.

Certain stop smoking medications can be used to support quitting abruptly, smoking reduction or cutting down towards quitting.

For clients who are not yet ready to make any changes, encouraging the use of NRT as required to see whether their tobacco use naturally decreases without the pressure to set a quit date could be a helpful strategy. This might include wearing the patch to see if it leads to smoking less or using short acting NRT occasionally when the urge to smoke arises. Varenicline can also be used to help the client gradually cut-down over time.

Source: CMAJ Medical Journal

Use "The Three A's Brief Intervention"

Two thirds of individuals who smoke want to quit in the next six months. Clients expect their health care providers to ask them about their tobacco use. Without intervention, quit rates range from two to three per cent per year but brief intervention alone can increase quit rates by another one to three per cent every year. It only takes one to three minutes to:

Ask about tobacco use.

• If your client uses tobacco, ask about whether they have thought about or are currently thinking about quitting

Advise clients that not using tobacco is the most important thing they can do to improve or maintain their health.

• Talk to the client about the health benefits of quitting in the short, medium and long term

Arrange support and offer resources for quitting. NRT or prescription medications can be recommended if appropriate to help the client quit or cut down. Arrange for follow-up and/or refer for support.

• Cost-free cessation medication options available in York Region

Measuring Success

Quit rates are not the only measure of success in stop-smoking interventions. The process of quitting is significant. Slips and relapses are normal.

Success is:

• Clients reflecting on why they smoke, their health and the health of those around them
• Making a quit plan
• Cutting down to quit (gradually reducing smoking or tobacco use before stopping)
• Readiness to make another quit attempt

Provider Resources:

• York Region Care Pathway for Cost-free Smoking Cessation options - York Region Public Health has created smoking cessation resources for health and social service providers to connect clients with smoking cessation services locally. All listed services are provided at no-cost, although some have eligibility requirements.
• Centre for Addiction and Mental Health E-Cigarettes and Vaping – an evidence informed clinical guidance resource for healthcare providers to help support adults and youth 15-27y who want to quit vaping.

Brief interventions from a health care practitioner along with quit smoking medications including nicotine replacement therapy, varenicline or bupropion can increase the chances of quitting success.

While quitting tobacco use provides the greatest health benefits over time, not all patients are ready or have the confidence to quit. Therefore, exploring the feasibility of cutting down tobacco use gradually over time is a recommended strategy as an alternative to abruptly quitting on a set date. This may help to build the patient’s confidence and motivation to eventually quit.

Certain stop smoking medications can be used to support quitting abruptly, smoking reduction or cutting down towards quitting.

For patients who are not yet ready to make any changes, encouraging the use of NRT as required to see whether their tobacco use naturally decreases without the pressure to set a quit date could be a helpful strategy. This might include wearing the patch to see if it leads to smoking less or using short acting NRT occasionally when the urge to smoke arises.

Varenicline can also be used to help the patient gradually cut-down over time.

Source: CMAJ Medical Journal

Use “The Three A’s Brief Intervention”

Two thirds of individuals who smoke want to quit in the next six months. Patients expect their health care providers to ask them about their tobacco use. Without intervention, quit rates range from two to three per cent per year but brief intervention alone can increase quit rates by another one to three per cent every year. It only takes one to three minutes to:

Ask about tobacco use.

• If your patient uses tobacco, ask about whether they have thought about or are currently thinking about quitting

Advise patients that not using tobacco is the most important thing they can do to improve or maintain their health.

• Talk to the patient about the health benefits of quitting in the short, medium and long term

Arrange support and offer resources for quitting. NRT or prescription medications can be recommended if appropriate to help the patient quit or cut down. Arrange for follow-up and/or refer to Smokers’ Helpline (1-877-513-5333) for additional counselling and support.

• Health care professionals can refer patients for support through the Smokers’ Helpline Quit Connection
• York Region Public Health offers Stop on the Road smoking cessation workshops each month in local communities
• Provide eligible patients with cost-free cessation medication options available in York Region

Measuring Success

Quit rates are not the only measure of success in stop-smoking interventions.

The process of quitting is significant.

Slips and relapses are normal.

Success is:

• Patients reflecting on why they smoke, their health and the health of those around them
• Making a quit plan
• Cutting down to quit (gradually reducing smoking or tobacco use before stopping)
• Readiness to make another quit attempt

Practitioner Resources:

York Region Care Pathway for Cost-free Smoking Cessation options - York Region Public Health has created smoking cessation resources for health and social service providers to connect patients with smoking cessation services locally. All listed services are provided at no-cost, although some have eligibility requirements.