Smoking is associated with many different diseases and health problems. It contains more than 60 cancer-causing chemicals, according to the Centers for Disease Control and Prevention and found that 80% of deaths from chronic obstructive pulmonary disease (COPD) are attributable to Chronic Obstructive Pulmonary Disease. Smoking, while it is associated with the death of 90% of lung cancer cases, in addition to its association with cancer of the mouth, throat, pancreas, stomach, cardiovascular disease, and others.  
Despite the many health risks associated with smoking, it is not a cause for despair and surrender to the harms of smoking. Quitting smoking has a positive effect on the health of the individual and reduces the risk of developing the health problems mentioned above almost immediately; For example, after about 20 minutes of quitting smoking, both the temporary rise in blood pressure and the pulse that usually follows smoking reduces, and the proportion of carbon dioxide in the body returns to its normal levels after about 8 hours of quitting smoking, and the chances of cardiac arrest are reduced after passing 24 hours, while the likelihood of death from heart disease caused by smoking is reduced by about 50% within 1-5 years of quitting it, and after ten years, the risk of death from lung cancer for an individual who quits smoking becomes similar to that of people who have not smoked throughout their lives . 
Ways to quit smoking
Some people may have difficulty quitting smoking. Because cigarettes contain the addictive substance nicotine; Cessation of which is accompanied by the emergence of disturbing symptoms on the individual known as withdrawal symptoms to stop smoking, including nervousness, insomnia, headache, increased appetite, craving to smoke, and the inability to concentrate,  It should be noted that good preparation is one of the most important steps that help to successfully quit smoking, by increasing awareness of smoking behavior; Smoking becomes, with the passage of time, an automatic habit that is difficult to overcome, and in order to be able to change all the habits associated with smoking, he must be more aware of them, and to accomplish this he must monitor the times during which he smokes during the day, the environmental conditions and moods that he went through during these times And identifying the smoking incentives that can be targeted during the next stage of treatment, and the smoker should set a specific date to quit smoking and adhere to it, and it is worth noting that there are two different methods smokers resort to in order to quit smoking, namely: 
- Quitting smoking without assistance: This is when the individual quits smoking alone without resorting to any help from specialists in smoking cessation programs, or the use of any drugs or products that help to quit smoking, whether by quitting smoking all at once or gradually.
- Quitting smoking with medical assistance: This is by the individual resorting to a specialist in smoking cessation programs, and / or the use of drugs or products that help to quit smoking.
Medicines to help quit smoking
Doctors may prescribe some medications to people who want to quit smoking. With the aim of helping the individual to reduce and overcome the withdrawal symptoms resulting from smoking cessation, including:  
- Nicotine alternatives: They provide the body with nicotine, and the individual uses them in doses that gradually decrease until they stop them.
- Varenicline: is more drugs to stop smoking effectiveness according to the studies.
- Bupropion is an anti-depressant drug that also helps to quit smoking.
Provide nicotine substitutes body nicotine without the other harmful chemicals found in cigarettes, are available these alternatives in the form of that, tablets sucking, and patches, etc. It should be noted that nicotine generally safe alternatives to all smokers who want to quit smoking; With the exception of pregnant women and adolescents, and of course it is forbidden to use it for non-smokers,  but before starting to use this type of treatment, consideration must be given to adopting the appropriate dose of nicotine replacement, which is usually available in different doses; The selection of the appropriate dose depends on the number of cigarettes the smoker consumes during the day, the more cigarettes the smoker needs, the greater the dose the smoker needs to start treatment, in addition to working to gradually reduce the dose of the used nicotine replacement until he stops using it, As we mentioned earlier, the alternatives to nicotine include many products, and the following is a detail of the most prominent of these drugs and how to use each of them: 
Nicotine gum is available in two different doses: 2 mg and 4 mg. The principle of the action of frankincense is that the cells lining the mouth absorb the nicotine present in them when chewing according to the instructions Where it is recommended to chew a piece of chewing gum slowly until it gives a stinging or stinging taste, after that it is placed between the cheek and the gum until the feeling of stinging disappears, and this process is repeated several times until the stinging taste disappears completely, which usually takes about 30 minutes from the start of chewing, and it should be Note the need not to eat more than one piece of nicotine together at the same time, not to chew it quickly, and not to exceed the chewing period recommended above, as well as not to eat any drinks or foods 15 minutes before taking it and while chewing, especially the acidic ones, and the person desiring To quit smoking by using frankincense for 12 consecutive weeks as follows:  
- The period from the first to the sixth week: Chew a piece of gum every 1-2 hours.
- The period from the seventh to the ninth week: Chew a piece of gum every 2-4 hours.
- The period from the tenth to the twelfth week: Chew a piece of gum every 4-8 hours.
As for how to choose the appropriate dose for the smoker, it depends on the daily smoking rate, and the following is an explanation: 
- 2 mg dose: recommended for smokers who consume less than 20 cigarettes during the day, or people who light up the first cigarette after more than 30 minutes have passed since waking.
- 4mg dose: Recommended for smokers who consume 20 or more cigarettes per day, or people who light their first cigarette within the first 30 minutes of waking up.
Nicotine lozenge tablets are similar in principle to their nicotine gum, but they do not need a lot of chewing and do not stick to the teeth like gum, and these tablets are available in two doses, the first 2 mg and the second 4 mg, and choosing the appropriate dose depends on the daily smoking rate just like gum Nicotine, and in this context it is referred to the necessity not to chew, swallow or earring the nicotine sucking tablets, but rather it should be placed between the cheek and the gum and let it dissolve on its own and move it from time to time from side to side, as it usually takes about 20-30 minutes to dissolve completely. The necessity not to take more than one tablet at a time, and it is recommended to use them for 12 consecutive weeks, usually and to reduce the amount consumed gradually, as is the case when using nicotine gum.  
Nicotine patch) to produce a constant small amount of nicotine throughout the day.These patches are available in several doses. The selection of the appropriate dose depends on body weight and the number of cigarettes consumed during the day, but it is often recommended that smokers start using patches containing higher doses of nicotine, which usually ranges from 15-22 mg during the first month of starting treatment, and then use the patches containing On the lower doses, which range from 5-14 mg for a month as well, it should be noted that these patches also differ in the length of their use, there is a type that is applied for 24 hours continuously, and it is preferred to use it for people who suffer from nicotine withdrawal symptoms since waking up in the morning so that they get They receive doses of nicotine during sleep, and they do not feel withdrawal symptoms upon waking, while there is a type that is applied for 16 continuous hours, but it does not usually provide the body with nicotine during sleep, and with regard to the method of use,The patch is placed on a clean, hair-free spot of the skin covering the parts between the neck and the waist, then pressed lightly with the palm of the hand for 10 seconds, and replaced every day at the same time, and according to the Food and Drug Administration, the treatment period with nicotine patches ranges from 3-5 months,   It must be noted that the use of nicotine patches may cause some side effects, and the following are the most common of these symptoms and how to reduce them: 
- Irritation and redness of the skin, and this symptom can be reduced by choosing a different spot of the skin each time the patch is applied.
- Nausea, which can be overcome by using patches containing lower doses of nicotine.
- Sleep disturbances , and in the event that this occurs, the patch that covers 16 hours of the day can be used instead of the patch that covers 24 hours.
There are other forms of nicotine replacement, which can be explained as follows:  
- The nicotine inhaler device , the principle of the work of this device is to provide a small dose of nicotine when taken according to the attached instructions, and it is worth noting that the device must be placed in the mouth and the nicotine emitted from it is locked for a few seconds, and it should be noted that the nicotine nasal spray is an alternative Which need a prescription to dispense.
- Nasal sprays nicotinic , which is used through the nose, and is the principle of his work in the delivery of a small dose of nicotine to the body through the cells lining the nose, characterized this method as fast - acting compared Ballban, lozenges, and the device inhalation, in In contrast, it may cause some side effects, such as nose and sinus irritation, sneezing , and coughing, and it should be noted that nicotine nasal spray is one of the alternatives that need a prescription to dispense it.
The varenicline medications contribute to quit smoking, and is the principle of his work to bring about a similar effect of nicotine, through its association with receptors acetylcysteine nerve associated nicotine,  It should be noted that it is not recommended to give varenicline for children under Age 16 years; Since its effectiveness has not been proven for this age group, This medication is available as an oral tablet that is taken first once a day and then twice a day. One in the morning and another in the evening, with a glass of water and after eating, and at an almost constant time every day, it should also be noted that varenicline is an effective treatment for quitting smoking, but it may take a few weeks until the individual feels its effectiveness, and therefore patience and completion of the treatment should be done even if The individual felt a desire to smoke and smoked a cigarette after the time he specified to quit smoking, and the treatment period continues for 12 weeks. If the individual finds the treatment successful in helping him to quit smoking, it is recommended to use it for an additional 12 weeks so that the total treatment period becomes 24 weeks, and in this context It is noteworthy that there are different ways to quit smoking using varenicline, which is to start using the drug and set a date to quit smoking after a week or 8-35 days from the first day to start taking the drug, but if the individual finds it difficult to determine A specific smoking cessation day that can start using the medication with gradual smoking cessation. The number of cigarettes is halved within 1-4 weeks of starting to take it, then reduced to a quarter during the 5-8 week of starting it, and then the number of cigarettes consumed during the day is reduced as much as possible by the 9-12 week; So that you quit completely by the end of the 12th week or earlier.
Bupropion is included in the anti-depressant medication, and is used to help to quit smoking as well.  It should be noted that this drug requires a week of time until it reaches steady blood concentrations, and therefore the doctor usually recommends starting to use it a week before the date of quitting smoking; So that the person continues to smoke, provided that he stops it during the second week of treatment with bupropion, and often needs to continue taking it for a period of 7--12 weeks, and it is likely that the effect of bupropion in treating the cravings for smoking and other withdrawal symptoms of nicotine by increasing the levels of some substances Chemical in the brain, and it should be noted that the use of this drug requires the supervision and follow-up of the specialist doctor, It is noteworthy that the drug bupropion may cause a change in the taste in the mouth, including changing the taste of cigarettes, and this in itself may make a person feel uncomfortable when smoking and thus aversion. 
There are other medicines that studies indicate for their potential effectiveness in helping to quit smoking, but they have not yet been approved by the Food and Drug Administration for use in this field, and in this context it should be noted that these medicines are not prescribed by prescription, and are not given to pregnant women, adolescents, or people. Those who consume less than 10 cigarettes a day: 
- Medicine Nortriptyline: , is Alnorcrabbtelin drugs anti-depressant , also contributes to reduce the withdrawal symptoms of smoking cessation, but should be alert to prevent the use of Nortriptyline without medical follow - up with a physician prescription, and should be noted that the doctor reduces the dose Gradually before stopping its use; Due to the side effects it may cause if it is stopped suddenly. 
- Clonidine: It is one of the medicines used in the treatment of hypertension, but it may be prescribed by the doctor to help quit smoking, and the doctor usually reduces the dose gradually before stopping its use. To avoid any side effects resulting from sudden stopping the medicine, such as: rapid rise in blood pressure. 
Tips to help quit smoking
The smoking cessation stage includes the following:  
- Controlling smoking triggers: through the following:
- Remove all smoking-related items, such as lighters, cans and ashtray, before the scheduled smoking cessation time.
- Changing daily routine; To break the link between different daily activities and smoking, for example it is possible to take another way to go to work other than the usual way, and it is also possible to change the usual place to spend rest time at work.
- Avoid spending free time and resting with smoking friends, especially during the initial period of starting a smoking cessation program.
- Dealing with the urgent need for smoking: by following the following techniques:
- Engaging in various physical activities.
- Weight loss caused by smoking cessation.
- Control stress and negative emotions that increase the urge to smoke.
- Practice various relaxation techniques.
- Distracting yourself from thinking about smoking and trying to find new ways to fill your spare time, for example, you can plan to meet with many friends during the weekdays.
- Occupying your hands and mouth when you feel an urge to smoke, such as holding a pen or eating some snacks.
- The help of people who want to help get through this stage.
- Avoid alcohol, as it may stimulate the urge to smoke. 
- Additional tips for dealing with the withdrawal symptoms of smoking: by following the following tips:  
- Get enough rest.
- Doing moderate exercise, relaxation exercises, and deep breathing; To relieve insomnia, feelings of depression, irritability and constipation.
- Increase your water intake.
- Eat healthy foods, especially foods rich in fiber.
- Avoid a lot of caffeinated drinks.
- Divide food into small meals throughout the day instead of just three meals to reduce feelings of increased hunger and appetite.
- ↑ "Health Effects of Cigarette Smoking" , www.cdc.gov , Retrieved 19-10-2019. Edited.
- ^ A b "Quit Smoking the Today" , Www.khcc.jo , Retrieved 18-10-2019. Edited.
- ↑ "Smoking Cessation Benefits" , www.webmd.com , Retrieved 19-10-2019. Edited.
- ^ A b t "How To Quit Smoking To the Plan - 8 Steps , To Quitting For Good" , Www.addictionsandrecovery.org , Retrieved 22-10-2019. Edited.
- ^ A b v "Kicking The Habit For Good: cognitive For the Behavioral Therapy Smoking Cessation" , Www.findapsychologist.org , Retrieved 22-10-2019. Edited.
- ↑ "Smoking - Medicines To Help You Quit" , www.fda.gov/consumers , Retrieved October 23 , 2019 . Edited.
- ↑ "Stop smoking treatments" , www.nhs.uk , Retrieved 12-05-2019. Edited.
- ^ A b T w "Nicotine Replacement Therapy For Quitting Tobacco" , Www.cancer.org , 12-1-2017, Retrieved 19-10-2019. Edited.
- ^ A b "Nicotine Replacement therapy , " , Medlineplus.gov , Retrieved 21/10/2019. Edited.
- ^ A b t "Quit-Smoking Products: Your chance , your Boost Of Success" , Www.mayoclinic.org , 18-2-2017, Retrieved 23-10-2019. Edited.
- ↑ "Using Nicotine Gum to Quit Smoking" , www.verywellmind.com , 27-1-2019, Retrieved 19-10-2019. Edited.
- ↑ "Mayo Clinic NDC Tobacco Dependence Treatment Medication Summary *" , www.mayo.edu , Retrieved 19-10-2019. Edited.
- ↑ "Nicotine Lozenges" , www.drugs.com , 5-5-2019, Retrieved 19-10-2019. Edited.
- ↑ "Nicotine Transdermal Patch" , medlineplus.gov , 15-10-2015, Retrieved 22-10-2019. Edited.
- ↑ "Nicotine Replacement Therapy: What to Know" , www.webmd.com , 23-11-2018, Retrieved 19-10-2019. Edited.
- ↑ "CHANTIX" , www.rxlist.com , Retrieved 23-10-2019. Edited.
- ↑ "Chantix" , www.webmd.com , Retrieved 22-10-2019. Edited.
- ↑ "Varenicline" , medlineplus.gov , 15-7-2017, Retrieved 19-10-2019. Edited.
- ↑ "Bupropion (Zyban)" , www.stop-tobacco.ch , Retrieved 19-10-2019. Edited.
- ↑ "ZYBAN" , www.rxlist.com , Retrieved 23-10-2019. Edited.
- ↑ "bupropion" , www.rxlist.com , Retrieved 02-05-2020 . Edited.
- ↑ "NORTRIPTYLINE HYDROCHLORIDE" , www.rxlist.com , Retrieved 23-10-2019. Edited.
- ↑ “Prescription Drugs to Help You Quit Tobacco” , www.cancer.org , Retrieved 23-10-2019. Edited.
- ↑ "How to Quit Smoking" , www.helpguide.org , Retrieved February 5 , 2020 . Edited.