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26: Trying to Quit for 7th Time

Nov 19, 2019

Mitch circles the gas station a third time, trying his hardest not to go in and buy a pack of smokes. Smoking is bad, but quitting is hard. Dr. Clint Allred sits down with Mitch to explain the best strategies to quit smoking and get through those really intense craves.

Episode Transcript

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

We All Know Smoking is Bad

These days, we all know smoking is bad for your health. Cardiologist Dr. Clint Allred lists a few of the major health problems associated with tobacco use:

  • Increase in cardiovascular disease including stroke, heart disease, and an aneurysm
  • Increase in respiratory disease including COPD, emphysema, and embolism
  • Significant increase in risk of developing cancer
  • High blood pressure
  • Vascular disease
  • Increase in infections
  • Difficulty breathing

When it comes to improving your health and working on those Core 4+1 More, smoking is not only detrimental to your quality and length of life, it can prevent you from making progress in your other health goals.

But quitting nicotine can be one of the hardest things a person can do. Luckily Dr. Allred has some of the best-researched methods to quit smoking successfully.

How Mitch Became a Smoker

According to Dr. Allred, one of the first steps for a person to successfully quit smoking is to understand their relationship with nicotine/tobacco. The more insight into their own health and how they smoke can lay the foundation for success.

Who Cares producer Mitch’s story of smoking is one that Dr. Allred hears time and time again. Mitch began smoking in college. He began by having an occasional cigarette or two when he went to concerts and parties. It was a social activity he would indulge in after a beer or two. It seemed harmless enough.

Over time, Mitch’s tobacco use slowly began to escalate. He began to light up every time he drank. Would go out and share a couple smokes with his friends that smoked. When Mitch was faced with the stress of university finals, he went and bought himself a pack to help calm his nerves.

A few years later, Mitch found himself a habitual smoker with a real addiction to nicotine. He started smoking every time he drove. Starting his days with a cigarette after breakfast. Bundling up in winter wear to step outside to smoke during the cold winter months. All the things he swore he’d never do.

At 30, Mitch has been a smoker for 10 years. He is currently on his 7th attempt and hoping to make it his last.

Why Is it So Hard to Quit Smoking?

For people who have never smoked, it can be hard to understand why smoking is so hard to quit. Mitch says quitting nicotine is the hardest thing he’s ever tried to do - and staying off nicotine is just as hard. Dr. Clint Allred explains that smoking is extremely addictive and extremely difficult to quit. This is because smoking has three qualities that make it difficult so hard to stop using:

  • Nicotine is chemically addictive. The human body responds to nicotine by releasing a surge of endorphins. This pleasure chemical makes cigarettes and vape vapor physically addictive.


  • Smoking is socially enjoyable. Smoking can be an extremely social activity. Stepping out to have a smoke can be enjoyable, relaxing, and many smokers end up smoking around people they enjoy being around.


  • Smoking is habitual. Many parts of smoking can become a habitual behavior. Smoking at specific times of the day, smoking during activities like driving, even the repetitive motion of lifting your hand to your mouth, can all become ritualistic habits. These repetitive habits can become “triggers” that can start a craving for a cigarette.


Trying to quit smoking doesn’t only require a person to overcome the physical addiction to nicotine, but also adapt their social behaviors and resist long-term habitual triggers.

Vaping is Not A Good Alternative to Smoking

Mitch is currently working to quit vaping. A few years ago, in an attempt to quit smoking cigarettes, he switched to vaping because he believed it would be a better alternative to tobacco. Unfortunately, recent scientific evidence is showing that switching from tobacco to vaping is not as effective or safe it was once believed to be.

First, vaping is often much more addictive than cigarettes. The level of nicotine in many e-liquids and pods is as high or higher than a pack of cigarettes. Additionally, vaping has a greater chance of becoming habitual because it is so much easier to consume throughout the day with fewer of the drawbacks of tobacco use, like smelling of smoke and needing to go outside to light up.

So if you’re trying to quit nicotine, vaping is not the best method.

There are a lot of news stories coming out about cases of severe lung injury and death related to vaping use. Troy has seen first hand a few of these severe cases in the ER. These cases are shining a light on the potential dangers of vaping.

These news stories are one of the main reasons Mitch is quitting his vape. He wants to get healthy, but he his nicotine addiction is standing in the way of that. He wants to be able to run without having a coughing fit. He wants to wake up without having severe cravings first thing in the morning. He wants to know he’ll still have functioning lungs in the next 10 to 15 years. He wants to take control of his health back from nicotine.

So what’s the best way he can do that?

Best Researched Ways to Quit Smoking for Good

As we’ve explored, quitting nicotine is hard. In fact, it often takes a person a few times to quit. It usually take a person anywhere from 7-10 quit attempts to finally quit and stay off tobacco. Mitch is on his seventh try and is hoping to make it his last. To help him and all smokers, Dr. Allred shares some of the most effective methods to quit smoking according to research.

  1. Coaching and Behavioral Support
    One of the most important elements of successfully quitting is having external emotional and psychological support. Most smokers experience “moments of weakness” or extreme nicotine cravings while trying to quit. For example, Mitch has had cravings so strong, that he finds himself in his car circling a convenience store debating whether or not to go in and buy cigarettes.


    To help get through those extreme cravings, a person can - and should - turn to a supportive friend or loved one to help remind the smoker of the reasons they want to quit.

    There are also resources available to everyone that can get a person connected to a professional quit coach at no cost. Through resources like the National Quitline and apps online, smokers can reach out by phone or text to get coached through their intense cravings.

  2. Nicotine Replacement Therapy (NRT)
    Nicotine replacement therapy or NRT is one of the two most effective methods a person can use to quit smoking. With NRT, over the counter patches, gums, and lozenges are used to deliver nicotine in a safe and controlled method to minimize withdrawal symptoms and curb cravings.


    Nicotine Replacement Patches provide a baseline of nicotine throughout the day to help minimize withdrawal symptoms and cut most cravings. Patch NRT often takes 6-10 weeks. Smokers begin with a patch with relatively high amount of nicotine, stepping down their dosage every few weeks, slowly tapering their nicotine levels down to zero.

    The second type of NRT available is the “short-acting” or “rescue agent” methods. Nicotine gum, lozenges, inhalers, and cartridges are all available to provide the former smoker a fast-acting dose of nicotine to help work through intense craving episodes. When a quitter feels a craving coming on, they can use these agents to get through the cravings and prevent slip-ups.

    NRT is most successful when used in combination with one another. That means using a patch along with a fast-acting rescue agent like gum. The patch provides a stable dose throughout the day to keep withdrawal at bay, and the gum is available to quell the breakthrough cravings when they occur.

    Nicotine replacement therapies do not require a prescription and can be bought over the counter at any pharmacy.

    There are some side-effects related to NRT. Nicotine is a stimulant, so when taken it can affect blood pressure, pulse rate, and mood. Mitch has experienced difficulty sleeping and body temperature fluctuation while on NRT. If you are experiencing any of these short-term side-effects, consider speaking with your doctor.

  3. Prescription Medications
    If you’re trying to quit smoking, consider asking your doctor if a prescription medication may be right for you. Varenicline, trade name Chantix, is a medication that has shown to be as effective as combination NRT to help people successfully quit nicotine.


    Chantix acts on the body in a similar way to nicotine, but blocks nicotine receptors much more effectively. As such, it minimizes withdrawal symptoms, cuts cravings, and reduces the positive physical sensation of nicotine.

    Chantix requires a prescription from a medical professional and can be cost-prohibitive for some patients.

For people that have a long history of smoking or who have smoked more than a pack of cigarettes a day, the most effective strategy to quit nicotine is to combine all of the therapies above. Work with your doctor to take the medication in combination with patches and gum to calm those troublesome cravings. Then, use coaching and support to help keep on track when those cravings get particularly bad.

How You Can Help Others Quit Nicotine

If you have someone in your life who is trying to quit, it’s important to be supportive. Find out the reasons why they are quitting and remind them of their goal when they are struggling. Help them find a specific goal and keep them focused on it. If they are trying to quit to save money for a vacation or trip, remind them of how much money they’ll be saving and how much fun they’ll have when they get there.

For people trying to quit, remember that while it is hard, the struggle is temporary. There are few things better you can do for your health than quitting. In fact, research has found that over time, after quitting, a person’s body can heal itself to a point that you couldn’t tell they had ever smoked in the first place. So the earlier you quit, the better.

To find resources available in your area, including potential free NRT products and to get in touch with a quit coach, call the national quitline at 1-800-QUITNOW (1-800-784-8669) or

Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Troy is thinking about ancient garbage and the historical implications of a person’s trash. Meanwhile, Scot, a man who considers himself pretty tech-savvy, fails a phishing scam test.

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