Stop smoking

Our pharmacies are well-stocked with anti-smoking aids to help you quit smoking. We know that quitting smoking is no easy task, so we offer professional help to help you achieve your goals!


Why stop smoking?

It is common knowledge that smoking is bad for your health, but why is this exactly? When people smoke tobacco, either in the form of a cigarette, cigar or pipe, what they are doing is burning the tobacco so that they can breathe it in. Within 10 seconds of your first puff, the chemicals found in tobacco smoke are circulated throughout your body through the blood, reaching vital organs such as your lungs, brain and heart. Tobacco smoke contains over 7,000 chemicals that are harmful to the body, causing immediate damage to your cells and soft tissue, thus increasing your risk of certain conditions. By smoking, you are not only harming yourself, but you are also harming those around you (passive smoking) as they are also subject to breathing in the tobacco smoke. Breathing in even small quantities of tobacco smoke can have a negative impact on your health.


Negative effects of smoking

  1. It impairs blood circulation, resulting in a decreased oxygen supply around the body and a weakened immune system
  2. The reduced blood flow caused by smoking can cause your skin to get less nutrition, ultimately resulting in dryness and premature aging
  3. It results in persistent coughing owing to the damage caused to the airways
  4. It can affect sperm quality and make it more difficult for women to become pregnant
  5. It increases your risk of many conditions such as cancer, chronic respiratory conditions, type 2 diabetes, dental problems, and cardiovascular diseases
  6. Tobacco use causes more than 7 million deaths per year
  7. It reduces your life expectancy by approximately 10 years in comparison to non-smokers
  8. It negatively impacts your mental health, aggravating mental disorders such as anxiety, depression and panic attacks
  9. Tobacco stains your teeth and affects your senses of smell and taste

There is no safe level of smoking. To reduce your risk, the best option is to quit smoking. You will feel the health benefits almost straight away.


Quitting smoking 

Stopping smoking can be challenging as it requires a considerable amount of self-control. The reason why stopping smoking is so difficult is due to the highly addictive chemical, nicotine, which is found in tobacco smoke. When your body is exposed to nicotine, it causes your brain to release the “feel good” chemical, dopamine, which makes you feel happy, gives you energy and helps you concentrate. However, this effect is extremely short term, and as the nicotine levels in your body start to deplete your brain craves more dopamine. The more you smoke, the more dopamine you need to feel good, and the more dependent you become on nicotine. Essentially, you become addicted to tobacco due to its nicotine content – however, as previously explained, tobacco smoke contains thousands of other harmful chemicals which you are also exposed to through smoking. 


When you stop smoking, you are cutting off your body’s supply to the nicotine and dopamine effects, and without it, you will have withdrawal symptoms. These are temporary physical and emotional changes that begin a few hours after your last cigarette and can last for about 2-4 weeks. For most people, such symptoms are usually strongest within the first week, and may include 

  • Irritability, anger, anxiety, crying, sadness or depression
  • Increase in hunger or weight gain
  • Restlessness or difficulty concentrating
  • Sleeping difficulties and sleep disturbances
  • Urges to smoke 

For this reason, before attempting to stop smoking, it is important to set up strategies to help you succeed. Take a look at our recommended tips below!


1. Write down your reasons for quitting

Writing things down can have a powerful effect on your brain, requiring it to pay close attention and consequently, result in a more focused action.


2. Make a plan to quit 

Set a date and let people know that you are going to stop smoking. If you have been unsuccessfully in the past in stopping smoking abruptly, then a gradual cutting back might be better for you. Delaying your first cigarette of the day, gradually increasing the time interval between cigarettes and smoking only half of your cigarette might be useful ways for you to cut down.


3. Avoid smoking triggers

Recognise places and situations that make you want to smoke and avoid them. Take a look at some examples below: 

  • Drinking alcohol is a trigger for most smokers, so try avoid it completely especially in your first few weeks of stopping smoking 
  • If you have created the habit of smoking after a meal, change the habit to something else such as drinking a tea instead. 
  • Keep busy during times of boredom which may tempt you to smoke – go for a run instead! 
  • Hang out with people who don’t smoke or who also want to quit to avoid any temptation.
  • Practice saying “No thanks, I don’t smoke” 


4. Find a new way to unwind

Most people smoke because they say the nicotine helps them relax. As previously explained, this is only a short-term effect, however, nevertheless you will need to find new ways to unwind. Taking up a new sport, listening to your favourite music, treating yourself to a massage and connecting with friends are all viable options to do so! Try avoid stressful situations during your first few weeks of smoking to avoid falling back on the bad habit of smoking to overcome the stress. 


5. Spring clean 

Make sure to get rid of any cigarette packets, rolling paper, ashtrays and lighters in your house and/or car and clean any clothes or fabric which might smell of cigarettes. It’s vital to completely eliminate anything that reminds you of smoking. 


6. Seek help 

Did you know that you are 4 times more likely to stop smoking if you seek help? Our pharmacists can offer advice and guide you on the range and use of nicotine replacement therapy products, and refer you to a doctor for prescription-medicines, if required. 


Nicotine-replacement therapy 

Nicotine replacement therapy (NRT) is the use of nicotine-containing products that assist the quitting process by reducing the withdrawal feelings from nicotine cessation. This is achieved by giving you a controlled amount nicotine without any of the other dangerous chemicals that are found in cigarettes.  Although the full effects of NRT therapy on the body is not fully known (and undoubtedly may have some risks, as with all other medicines), it is still considered far safer to smoking cigarettes. NRT is a useful means to cut cigarette cravings and increase your chances of success, especially in the first few weeks after stopping smoking. 


NRT therapies come in many different forms, which can be categorised into:

1. Long-acting

The 24-hour steady release of low levels of nicotine comes in the form of a patch, that is often attached to your upper arm and is absorbed through the skin. The advantage of this dosage form is that it is simple to use, has a 24-hour effect and is a lot more private as it can be easily covered under clothing. The patch exists in 2 different doses, for which it is important to select the correct dose based upon the number of cigarettes that you smoke.


2. Short acting (gum, mouthspray and inhaler)

If your nicotine cravings come in bursts, not the steady sort of withdrawal that demands the patch, then the gum, mouth spray and inhalator might be right for you. These dosage forms are designed to provide a surge of relief within a few minutes. The choice between them is based on personal preference: for e.g. if you happen to miss inhaling smoke, the inhaler might be the more suitable option for you.


When selecting a form of NRT, there is evidence to suggest that combination NRT yields higher abstinence in comparison to use of one NRT alone. Combination NRT is the use of a long-acting NRT in combination with a short-acting NRT (gum, mouthspray and inhaler). The reason for this is owing to the fact that monotherapy provides an insufficient concentration of baseline nicotine in the bloodstream that is required to cut cravings during the craving phase.



Frequently asked questions


Can I get addicted to NRT?

Many people have concerns that NRT can be addictive since it contains nicotine, the main addictive substance and component of a cigarette. However, the amount of nicotine present in NRT is much lower than that which is found in a cigarette, which ultimately means that a longer time is required for this nicotine to reach the brain and give you a nicotine “hit” (that pleasurable, relaxed feeling when inhaled). Since NRT does not give you as many “hits” that a normal cigarette does, one does not usually become dependent on them, making it far easier to stop using NRT than it is to stop smoking.


Does nicotine cause cancer?

As previously mentioned, tobacco does not only contain nicotine, but also thousands of other chemicals, many of them which, particularly tar, are carcinogenic – meaning that they have the potential to cause cancer. Because NRTs deliver nicotine without many of these carcinogens, they’re thought to pose less of a cancer risk than smoking tobacco. Although abstinence is the only method that completely eliminates the cancer-related risk of tobacco, if one abides by the recommended treatment plan (usually 2-3 months) of NRT, the risk is still far less than that of a normal cigarette. Keep in mind that the ultimate goal of NRT is to taper down the nicotine gradually until one is ready to stop it completely, reaching a state of eliminated risk.


Is NRT safe?

NRTs is classified as a medicinal product, therefore, as with all other medicines, it needs to pass strict safety standards set by the medicines regulatory authorities before it can be sold on the market in Malta. NRT is safe to use for most people who want to quit smoking, except for some groups in the population, such as pregnant women, teenagers or those suffering from high blood pressure. It’s best to discuss NRT use with one of our pharmacists before starting it.


What about side effects?

As with any other medicine, NRT is not free from side effects and can also have an effect on the body.

  • A fast heart rate (palpitations)
  • Dizziness
  • Hiccups
  • Indigestion/heartburn
  • Insomnia
  • Irritability
  • Loss of appetite
  • Raised blood pressure

Many of the above drug-induced effects (excluding an increase in heart rate and blood pressure) are usually mild and short-lived, and often result from the incorrect use of NRT. For example, adopting a ‘park and chew’ method of chewing the nicotine gum is important, not only as it ensures that the NRT works to relieve craving and withdrawal symptoms, but also to limit the amount of nicotine that is swallowed, which can upset the stomach. In addition to this, when using the spray, it is important to spray the liquid under the tongue and not at the back of the throat, to avoid irritating the throat. Make sure to speak to one of our pharmacists for the correct use of NRT before starting it.


How long should I take NRT?

Generally, NRT use is recommended for 2-3 months after smoking cessation, however, longer treatment is also acceptable for individuals at high risk of relapse owing to the fact that NRT is much safer than continuing to smoke. NRT can also be used while a person is still smoking.


What happens if I have a smoke while I’m wearing a patch?

It’s very common to slip up a puff or a cigarette during a quit attempt – this does not mean you should stop trying to quit. If this happens, you do not need to remove the patch, just continue as is. However, keep in mind that this might also be a sign that you aren’t using enough NRT to fight those cravings, so in such a circumstance, it is best to speak to one of our pharmacists or your doctor to help you determine what dose and frequency of NRT you should be using. If you have returned to your previous regular smoking habit, stop the NRT and re-start it when you are ready to try quit smoking again.