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The Importance of the First Week of Quitting Smoking

Just one week of being smoke-free increases your patients’ chances of quitting smoking by 9x.

What are the challenges of the first week?

As their physician, you can help patients get through this crucial time period by:

Referring patients to smoking cessation resources

Why is the first week so critical?

icon of a person thinking about cigarettes

Withdrawal symptoms and cravings are at their strongest during the first week1,2

icon of a person smoking

The risk of relapse is shown to be highest during the first 8 days after a quit attempt3

icon that says 9X

Getting patients through the first week increases their chances of quitting by 9X4

What makes the first week so difficult?

Difficulty quitting may be due to nicotinic receptor upregulation. Using SPECT imaging, Cosgrove et al. showed that abstinent smokers (vs. non-smokers) had significant β2-nicotinic acetylcholine receptor (β2-nAChR) upregulation in multiple brain regions that persisted 1 month after abstinence. This was correlated with a greater urge to smoke. Receptor levels only returned to normal by 6-12 weeks.5

Availability of the nicotinic acetylcholine receptor containing the β2 subunit: nonsmokers vs. tobacco smokers

Image of brain regions using SPECT imaging

From Cosgrove KP, et al.

Strategies to support your patients during the crucial first week and beyond

REDUCE TO QUIT® Consider REDUCE TO QUIT® for patients who want to quit, but are not ready to quit entirely
  • Produced similar quit rates to abrupt cessation
  • NRT increases the chances of success by helping to manage cravings and withdrawal symptoms
NRT Offer NRT to all patients - even those not ready to quit:
  • Most smokers want to quit and are looking to their HCP for advice6
  • The offer of NRT has been shown to spur a quit attempt7,8
  • A review of 12 clinical studies showed that oral NRT, like Nicorette®, significantly reduced withdrawal symptoms, such as irritability, anxiety and withdrawal discomfort2
  • Remind patients that NRT needs to be used beyond the first week for at least 10 or 12 weeks to be effective
Proven Strategies Offer proven strategies to prevent and manage relapse during the first week
  • The highest dose patch available in the NICODERM® range is 21 mg9
  • Continuing NRT patch treatment during a relapse was shown to significantly increase the likelihood of recovery at 6 and 10 weeks10
Practical Tips Provide practical tips to help them get through the first week:
  • Remind them that cravings are temporary. A 5-minute distraction (e.g., playing a game on their phone) is often enough to get past it.
  • Have them write a list of reasons for quitting and keep it visible. Looking at it can help them get through challenging times.
  • Explain that their brain will try to rationalize having a cigarette (e.g., “It’s OK to smoke when I drink”). Have a plan to manage this.
  • Suggest drinking water when a craving hits to keep the mouth busy.
  • Advise changing up their routine, which can be tied to smoking (e.g., a new route to work; avoiding certain people/places for a few days).

Remember: your role is vital
NRT + strategic advice from an HCP was shown to increase a smoker’s quitting success by 4X vs. going cold turkey.11

Download these strategies to support your patients during the crucial first week

Learn about counselling techniques

See the benefits of combination therapy


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