Hollings Cancer Center expert on smoking cessation offers top five tips

December 19, 2018
Matthew Carpenter
Dr. Matthew Carpenter is a tobacco researcher at Hollings Cancer Center. Photo by Sarah Pack

If you or a loved one smokes and you’ve given up hope, press pause.

In a given year, more than 40 percent of smokers make no attempt to quit. For those who do, it can take many tries - estimates vary from six to 30 - before they succeed, if they ever do. That’s why researchers at Hollings Cancer Center at the Medical University of South Carolina want to understand more about what is creating the barriers.

Given how many cancers are linked to smoking and how it can even affect the effectiveness of cancer treatment for patients, it’s worth the effort to keep trying, says Matthew Carpenter, Ph.D., who is senior author on a study about cessation fatigue that was published in the Journal of Consulting and Clinical Psychology.

Locations of cancers caused by smoking
Locations of cancers caused by smoking.

Carpenter and colleague Bryan W. Heckman, Ph.D., found that cessation fatigue leads to emotional exhaustion and reduced coping resources due to attempts to quit smoking or trying to sustain the effort. Interestingly, that fatigue level seems to be increasing just as other important predictors of relapse, such as withdrawal symptoms, are abating. Knowing and monitoring this level offers a novel target for intervention strategies and helps identify those who would be most likely to benefit from those interventions, the study finds.

"I don't think this is just about addictions and smoking," says Carpenter. "This is about health behavior change. Think about anything that anybody tries to do that's hard. It takes time. To say that you're going to be one hundred percent committed on every day of your life in that attempt is folly. It's a process. It takes a toll on you. Now we can look at this as a process and quantify that fatigue over time and see how it matters."


Carpenter, program co-leader of Hollings Cancer Center’s Cancer Control Research Program, offers his top tips for how to make the next attempt to stop smoking more likely to succeed.

1. Get help – Most smokers don’t use medications when they try to quit, and in doing so, they lower their chances of success.  Only about 5% of smokers who try to quit on their own will succeed.  A number of FDA-approved medications can significantly improve these odds.  These medications are safe and effective when used correctly.  Evidence shows that either 1) combination nicotine replacement therapy (NRT, both patch and gum or lozenge) or 2) varenicline are the most effective to help smokers successfully quit.

2.  Disrupt your routine – So much of smoking is about habit and automaticity.  Change it up.  Don’t keep cigarettes near you.  Find a substitute for your favorite cues and contexts of smoking.  Drink lots of water.  Use mints after a meal. Alter your morning rituals.

3. Your identity matters – Don’t think of yourself as a smoker who is trying to quit.  Think of yourself as an ex-smoker.  Be mindful, and imagine your life without smoking: better short-term health, better long-term health, better role model for others, and able to do new things.   

4. If you lapse and have a cigarette, don’t give up - Do your best to avoid any lapse, but if you do slip up, keep your quit attempt going.  Don’t give up on your medications – use more.  A lapse does not have to lead to full relapse.  You can still be an ex-smoker.

5. What about vaping? – Many smokers might consider an electronic nicotine delivery system (e-cigarette) as a substitute for smoking.  These products are safer than combustible cigarettes but not completely safe.  And remember, all non-smokers, youth in particular, should completely avoid e-cigarettes , as these can be very addictive and may lead them into smoking.

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