Quitting Tobacco

Quitting tobacco has immediate and long-term health benefits for people of all ages, even for those who have used tobacco for many years. Benefits include:

• Better breathing
• Improved heart health
• Lower cancer risk
• Improved mood and energy
• Better control of chronic conditions such as asthma, diabetes, anxiety, and depression

There is no safe level of tobacco use. Quitting at any age improves health and increases life expectancy.

Nicotine dependence—sometimes called Tobacco Use Disorder—is a condition in which the body and brain have become used to nicotine. Because nicotine is highly addictive, people may feel strong urges to smoke, vape, or use other nicotine products and may find it hard to stop or cut back, even when they want to.

Nicotine dependence is not a lack of willpower. Nicotine changes the brain, making quitting difficult without support.

Nicotine dependence includes two main parts:

Physical dependence

The body becomes used to nicotine and may develop withdrawal symptoms when nicotine use stops or is reduced. Symptoms can include:

• Headaches
• Trouble sleeping
• Anxiety
• Irritability
• Restlessness
• Low mood

Behavioral dependence

Certain situations, routines, emotions, or social settings—such as stress, boredom, drinking alcohol, or being around others who use tobacco—can trigger cravings.

Nicotine may seem to relieve stress or anxiety, but this effect is temporary. Using nicotine relieves withdrawal symptoms for a short time, which many people mistake for stress relief. This cycle strengthens addiction and is worsened by the high nicotine levels found in many modern vaping products.

Most people make more than one quit attempt before quitting for good. Each attempt helps you learn what works for you.

Research shows:

• Most people try to quit more than once
• People who use coaching or counseling are about twice as likely to quit successfully
• People who use FDA-approved quit medications are up to four times more likely to quit successfully than those who try without medication
• Quitting is a process, not a single event

Whether your last quit attempt was yesterday or years ago, help is available when you are ready.

No form of tobacco or nicotine product is safe. All contain addictive nicotine and harmful chemicals.

Cigarettes

Cigarettes are made by rolling tobacco and chemicals in paper, often with a filter. Cigarette smoke contains more than 4,000 chemicals.

Other types include:

• Bidis: Small hand-rolled cigarettes that deliver higher levels of nicotine, tar, and carbon monoxide
• Kreteks (clove cigarettes): Made with tobacco and cloves; not safer than cigarettes
• Menthol cigarettes: Menthol reduces the harshness of smoke, making it easier to inhale more deeply and more often

Cigars, cigarillos, and little cigars

These products often contain more nicotine than cigarettes and usually do not have filters. Many are flavored and may look similar to cigarettes.

Pipes

Pipe smoking still exposes users to harmful and addictive chemicals.

Vaping (e-cigarettes)

Vaping involves inhaling an aerosol created by heating a nicotine-containing liquid. These products are often marketed as safer, but they contain addictive nicotine and other harmful chemicals. Vaping is the most common form of nicotine use among youth in the U.S.

Nicotine pouches

Nicotine pouches are placed between the lip and gum and contain nicotine but no tobacco leaf. They are very addictive and are not FDA-approved for quitting. They may cause gum irritation, mouth soreness, and receding gums.

Smokeless and dissolvable tobacco

Smokeless and dissolvable tobacco products contain high levels of nicotine, can cause cancer, and damage teeth and gums. Products that look like candy or mints are not safe.

People with mental or behavioral health conditions are more likely to use tobacco. Nicotine can change mood in ways that may briefly cover up symptoms.

Symptoms of nicotine withdrawal—including anxiety, restlessness, and depression—may be temporarily relieved by another dose of nicotine. Many people mistake this withdrawal relief for stress relief, rather than recognizing it as part of the addiction cycle. This pattern is worsened by rising nicotine levels in e-cigarettes.

While tobacco may seem to help stress or anxiety briefly, it is not a healthy solution. Quitting tobacco can be harder for people with mental health conditions, but help is available. People with mental health conditions often benefit from longer treatment and from using medication along with counseling.

While there is no “right” way to quit, using the right medicines in the right way at the right times in addition to counseling can make quit attempts more successful.

Smoking is the leading cause of preventable death in the United States. It causes more than 480,000 deaths each year.

Tobacco use can cause:

• Cancer
• Lung disease
• Heart disease and stroke
• Diabetes
• Eye disease
• Fertility problems
• Dental problems

Tobacco can also make conditions like asthma, anxiety, depression, and migraines worse.

Tobacco and cancer

Tobacco use is the leading cause of cancer deaths. It damages DNA and weakens the immune system.

Tobacco use is linked to:

• Lung cancer
• Mouth, throat, esophagus, and larynx (voice box) cancer
• Kidney, bladder, liver, stomach, pancreas, colon and rectum, and cervix cancer
• Leukemia (blood cancer)

Tobacco and lung disease

Tobacco use can cause:

• Chronic obstructive pulmonary disease (COPD): Making breathing difficult. Learn more about COPD here.
• Lung cancer: Smoking is the main cause. Learn more about lung cancer here.
• Asthma: Smoking can trigger or make asthma attacks worse. Learn more about asthma here.
• Respiratory infections: Smoking increases your risk of respiratory infections, like pneumonia or bronchitis.

Learn more about how tobacco use affects your lungs here.

Tobacco and heart disease

Smoking increases the risk of:

• Heart attacks
• Heart failure
• Stroke

Secondhand smoke also increases heart disease risk.

Learn more about tobacco use and heart disease here.

Tobacco and diabetes

Smoking increases the risk of type 2 diabetes. Nicotine makes it harder for insulin to work in the body. Smoking makes diabetes harder to manage.

Learn more about diabetes here.

Tobacco and eye disease

Smoking increases the risk of:

• Cataracts
• Macular degeneration
• Glaucoma

These conditions can cause serious vision loss.

Learn more about how tobacco use can affect your vision here.

Tobacco and fertility

Tobacco use can:

• Make it harder to get pregnant
• Damage reproductive organs
• Harm sperm DNA
• Increase pregnancy risks

No tobacco product is safe during pregnancy. Nicotine can harm fetal development.

Learn more about the health effects of tobacco on reproductive health here.

Tobacco and dental health

Tobacco damages the mouth, teeth, and gums. It can cause:

• Gum disease
• Tooth loss
• Mouth cancer
• Stained teeth

Healing is slower in people who use tobacco.

Learn more about tobacco use and dental problems here.

The most effective way to quit tobacco is to combine coaching or counseling with FDA-approved medications.

Coaching or counseling can help you:

• Identify triggers
• Learn coping skills
• Build a quit plan
• Stay motivated through challenges

Approved medications include:

Nicotine replacement therapy (NRT): Nicotine is the addictive substance in tobacco. Nicotine replacement therapy provides a small, controlled amount of nicotine—without the harmful chemicals found in tobacco smoke. This helps reduce cravings and withdrawal symptoms.

FDA-approved nicotine replacement products include:

• Nicotine patch
• Nicotine gum
• Nicotine lozenge
• Nicotine inhaler
• Nicotine nasal spray

Some people benefit from combining medications. A doctor, nurse, or pharmacist can help choose the safest and most effective option.

• Nicotine replacement therapy is available without a prescription. Many people find it helpful to use more than one form of nicotine replacement, for example, wearing a nicotine patch daily and using gum or lozenges when cravings occur.
• Varenicline (generic of Chantix, Champix): Varenicline is a prescription medication that helps reduce tobacco cravings and withdrawal symptoms. This medication can be helpful even if you are not ready to fully quit yet, as it may reduce cravings and make quitting easier when you are ready.
• Bupropion (generic of Zyban): Bupropion is a prescription medication that helps decrease the desire to use tobacco.

Some people benefit from combining medications. Your doctor, nurse, or pharmacist can help you choose the option that is safest and most effective for you.

If you are ready to quit, visit Quitline NC or talk with your care manager.

You can get:

• A personal quit coach
• Support by phone, text, or chat
• Help setting a quit date
• Free Nicotine Replacement Therapy

That’s okay. You can still use Nicotine Replacement Therapy to help reduce use and avoid tobacco where it is not allowed. You can also ask your prescriber if you are a candidate for prescription medications that help people quit. These medicines can be started without quitting.

If you are looking for another way to get NRT today, you can also check the list below to find the location closest to you. Click the link to get directions through Google Maps.

Cumberland County

• Cumberland County Health Department (Click here to get directions)
• Recovery Resource Center (Click here to get directions)

Durham County

• Durham County Department of Public Health (Click here to get directions)

Harnett County

• Harnett County Health Department (Click here to get directions)

Johnston County

• Johnston County Health Department Behavioral Health Division (Click here to get directions)
• Johnston County Public Health Department (Click here to get directions)

Orange County

• Orange County Health Department-Southern Human Services Center (Click here to get directions)
• Orange County Health Department-Whitted Human Services Center (Click here to get directions)

Wake County

• Southern Regional Center (Click here to get directions)
• Sunnybrook Health & Human Services-Sunnybrook (Click here to get directions)
• Wake County Health & Human Services Eastern Regional Center (Click here to get directions)
• Wake County Northern Regional Center (Click here to get directions)
• Wake County Services Center at Departure Drive (Click here to get directions)
• Western Health & Human Services Center (Click here to get directions)

Alliance partners with QuitlineNC and Quit For Life to offer free tobacco cessation tools, resources, and counseling for Tailored Plan Members.

• QuitlineNC: If you’re uninsured and use tobacco, you can get FREE support to help you lower or stop your use including coaching and Nicotine Replacement Therapy (gum/patches/lozenges). Your provider or Tailored Plan care manager can refer you to QuitlineNC, or you can contact them directly by calling 800-QUITNOW or visiting their website.
• Quit For Life is a free program offered to Alliance Tailored Plan Members and offers personalized coaching and a variety of supports, online resources, and Nicotine Replacement Therapy. To learn more visit their website or call 866-784-8454.

Alliance Community Trainings:

• Breathe Easy NC: Becoming Tobacco Free
• Respiratory Disease Management
• Keeping your Heart Healthy: Cardiovascular Disease Management
• Diabetes Basics: Living With and Managing Your Diabetes

Durham Network of Care

• Interactive Tool: How Does Smoking Affect Your Lifespan?

Wake Network of Care

• Interactive Tool: How Does Smoking Affect Your Lifespan?

Wake Network of Care

Durham Network of Care

Centers for Disease Control and Prevention (CDC)

• Smoking and Tobacco Use
• Tips From Former Smokers
• How to quit

American Lung Association

Breathe Easy NC

Food and Drug Administration (FDA): Tobacco Use and Nicotine

The Truth Initiative: Quitting Smoking and Vaping

National Alliance on Mental Illness (NAMI): Smoking

Resources For Parents and Caregivers:

Centers for Disease Control and Prevention (CDC)

• Resources to help youth quit
• Protecting Youth From the Harms of Vaping
• Resources to Help Youth Reject or Quit Vaping

American Lung Association

• Helping Teens Quit
• Tips for Talking to Kids About Smoking