Why it is hard
Nicotine reaches the brain within seconds, and the brain adapts by expecting it. Modern vapes make this worse, since a single high-strength pod can hold about as much nicotine as a pack of twenty cigarettes, and a device that can be used indoors all day has no natural stopping point. Irritability, restlessness, poor concentration, bigger appetite and broken sleep peak in the first three days to a week and fade over two to four weeks. Individual cravings are intense but short, and most pass within a few minutes whether or not you give in.
What actually works
The FDA has approved seven quit aids. Nicotine patches, gum and lozenges are sold without a prescription. A nicotine inhaler, a nasal spray and two non-nicotine pills, varenicline and bupropion, require one. Using a patch for steady background relief with gum or lozenges for sudden cravings works better than either alone. Follow the label, and ask a pharmacist which strength to start on. The common mistakes are stopping the medication too early and chewing nicotine gum like ordinary gum, when it is meant to be bitten and then parked against the cheek. E-cigarettes are not approved as quit aids. Most insurance plans, including Medicaid, must cover cessation medication and counseling, often with no copay.
A plan for the first month
- Pick a quit date within the next two weeks and tell the people you live with.
- List your triggers, such as coffee, driving, drinking, stress and boredom, and decide in advance what you will do in each one.
- Throw out every device, pod, pack, lighter and charger the night before, including the spare in the car.
- Start your medication as the label or your prescriber directs, which for the pills means a week or more before the quit date.
- Meet each craving with a ten-minute delay, a glass of water, a short walk or something to occupy your hands.
- Go easy on alcohol for the first few weeks, because it is the most common setting for a relapse.
What you get back
Heart rate drops within twenty minutes of the last cigarette, and carbon monoxide in the blood returns to normal within days. Coughing and shortness of breath ease over the following months, and the risk of heart attack falls sharply within a year or two. Most people who quit for good needed several attempts, so a failed one is ordinary.
Tip The National Cancer Institute runs free text-message quit programs for adults and for teenagers, and the counselors at 1-800-QUIT-NOW can point you to a program built for people who vape.
