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Giving up smoking

‘Cutting down’, unsuccessful attempts and trying again

Rather than trying to go ‘cold turkey’ when they give up smoking, some people decide that it might be better to gradually wean themselves off by reducing their cigarette consumption over several weeks. This seems a gentler way to give up, and to fit with people’s observation that they don’t really ‘need’ or enjoy many of the cigarettes they are smoking. However, we did not meet anyone who had been able to logically progress from smoking less to quitting for good in such a straightforward way.
 

Tom explained that going from 20 a day to 2 a day was easier than quitting altogether.

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But it was still a long time. I think I kind of, I had a lot of sort of false starts with trying to give up. I’d have a lot of, ‘I’m not going to smoke this week’, or ‘I’m not going to smoke at work.’ ‘I’m just going to smoke in the evenings and at weekends’ you know, and kind of trying these things that were...It would kind of last for a while, and then I, there would eventually be a way back. And there, so there’s always, there’s always some event that I’d go, oh fuck it, I‘m going to have a, I’m going to go and buy a packet of cigarettes and smoke most of them.

So that was kind of, yeah there was then a sort of period of years of kind of having cut down a bit, and I always used to say, going from like 20 a day to 2 a day, was easier than going from 2 a day to none at all, and kind of just completely quitting altogether. I think for a while I sort of fooled myself that I could get to a point where I had an occasional one, which, I don’t know, maybe some people can. I know people that have. They used to be regular smokers and now they just do it occasionally, but I’ve learnt over time that was not going to be the case for me.

So why was it easier going from twenty to two?

Because it was, it was still there. I could say right OK, ‘I’m not going, I’m not going to smoke all day like I used to, but I can still have a cigarette after work, I can still have one in the evening’. And I just, I can look forward to that, but then even within that there’d be some days where I’d go ‘well, maybe I’ll just have a couple more than two or three’ and then…so some days there would be more. But it was the reason it was easier was, it was still there, it was still something I could do, even if I was saying to myself ‘don’t do it quite so much.’ That was easier than saying ‘right, you can’t do this at all anymore. This thing that you still enjoy.’ Because I did still enjoy it. It did still kind of…it did still make me feel nice to have a cigarette.
 

Val tried cutting down, which she now thinks is a big mistake. After a week of being bad tempered she was back to her normal amount.

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Age at interview: 71
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I tried to cut down, which is big mistake, ‘cause I don’t think anybody can cut down. I think you’ve got to stop completely. And I’d stopped for a week; I’d be evil, nasty, bad-tempered, and in the end, I’d end up having another cigarette and then [exhales] off you go again on the same roundabout, you know.

And would you get any support for your attempts?

Oh yeah, ‘cause my children don’t smoke. Well my daughter is very anti-smoking, and when I used to, when I went to stop with my daughter, I used to walk down to the seafront to sit on a bench because she could smell a cigarette from ten miles. “Mother are you smoking?” And it made me feel so guilty, but I still couldn’t do anything about it.

And I mean, did you ever sort of try and hide smoking from anybody?

Oh God, yes, yes.

Tell me about that?

I used to have a crafty puff and then spray the house with scented spray and, open the windows and, wash the ashtray up, and that was when my partner thought I’d packed in.

So how much were you smoking when you were telling him you’d packed up?

Probably not so many but it didn’t last long.

Did he catch you?

No, not really. I used to go and sit on the bench behind the garage, there’s a bench, and you can’t see it from the house, and I used to go there, and bury the cigarette ends in me tubs, in me flower tubs. And then suck mints.

So you had it covered?

But I don’t think he was fooled for a minute because if you don’t smoke you can smell it on people, can’t you?
Keith, and others, managed to stop smoking during the day or while they were at work. One of the problems with cutting down the number of cigarettes is that it can lead people to watch the clock and inhale very deeply when they did smoke. This could undermine their attempt to stop since it meant that they started to really enjoy the few cigarettes they were having. Rukmini could have a few ‘social’ cigarettes without smoking every day but few people seem able to maintain this controlled level of smoking. Sarah didn’t understand people who could be ‘social smokers’.
 

Cassie is finding it really hard to cut down and her smoking varies between 2 and 8 cigarettes a day. She isn’t doing well since she has yet to have a day without a cigarette.

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Age at interview: 22
Sex: Female
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Yes, you know it varies by day. Each day I wake up and you know I don’t really know what’s ahead but I know I’m going to try. And sometimes, you know, I’ll go to bed thinking tomorrow I won’t smoke at all. I always did. I wake up and then I’ve told myself the night before, no cigarettes at all today. And then I think, well I really like the morning one. So I have the morning one, and then the morning one just kinds leads into the rest and then I miss the next two, and then I think I’ve waited long enough so I will smoke. I have yet to go a day when I haven’t had like when I’ve had none. But you know, the lowest I’ve probably gone to is about two and then the highest about eight on an average day, and it makes me really sleepy, really sleepy. I was sleeping 15 hours a day, like when I wasn’t smoking, and I loathed it. I didn’t like that very much that I was sleeping so much. I’m not sure why it happened. But I just felt like I was missing out on my life and I’d rather have a cigarette that wakes me up and keeps me awake during the day then to be falling asleep at 6 o’clock and the waking up like 10 o’clock the next day. Because you know, that’s not ideal.

I don’t think, I think, I’m not doing as well as I could be. That’s the honest truth and I have to be honest with myself.
 

Raf would compensate for not smoking in daylight hours during Ramadan by smoking intensively during the evening.

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Age at interview: 40
Sex: Male
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I’d like, at the time I’d say, right I’m going to stop. Today I’ll give it a go, I’ll try to stop, and I think knowing all too well that it won’t last more than a few hours, and I’d just like start smoking again and wouldn’t even think about it again.

Would there be any other times that you couldn’t smoke for a longer period of time? Did you ever stop smoking in Ramadan or anything like that?

No, I didn’t, because, because of my illness I can’t actually fast. And so it never really came to a point of actually even trying to stop smoking during then, even when I was fasting, I’d spend the majority of the day in bed, and I’d wake up or get out of bed a couple of hours before the fast was actually open, and I’d like stick it out for them two hours and then as soon as the fast was open I’d have the bare minimum to eat, and I’d get up and I’d walk outside and light a cigarette up and smoke a cigarette. And between the fast opening and keeping the fast the following morning, I’d smoke 20 cigarettes in the space of like six, maybe seven hours. So I’d like basically make up for the time of not smoking in them few hours in between.
The danger of ‘just one cigarette’

After they had quit, some people occasionally allowed themselves to smoke something different, such as a cigar on a special occasion, or thought that they could handle having ‘just one’ cigarette.
 

Despite quitting successfully with the help of her GP and bupropion, after 9 months Carol had one cigarette and started smoking again.

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Age at interview: 54
Sex: Female
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I tried various methods of giving up smoking. And, it was about five or six years ago, when Zyban first came into being used by GPs, that I decided maybe I’m going to give this a go. And went to my GP and asked him if I could go on Zyban and he gratefully said, you know, “Yes, absolutely, we’ll do anything we can to support you.” And I actually, that time stopped smoking for nine months, but I don’t think I was in the right head space, because, I, obviously started smoking again, and I didn’t. It’s very much like an alcoholic. You know, once you have your first cigarette, if you’ve stopped smoking, you’ll carry on smoking. You can’t have that first cigarette, and as long as you understand that, that you must never have that first cigarette, I think you’ll always stop smoking. And I now know that, as much as I sometimes thing, oh I’d love a cigarette, I know I must never have that first cigarette, because I’ll be straight back, because the little, the little goblins that go all through your head will say, you know, let’s go. You know, we’re going back to situation normal. Whereas you can’t, you can’t do it at all.
In the days when people were allowed to smoke in public places, in pubs and on trains it was easy to get hold of a cigarette or cigar in a weak moment.
 

During the Christmas period, Andrew bought a single cigar at the pub, and was soon back on 20 cigarettes a day.

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Age at interview: 32
Sex: Male
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And I’m not complaining I’m stressed. It wasn’t that. But it would have been hard, I’d hard day, I’d gone down the pub, I might have had a cigar because you can, I don’t know why. I don’t think, because it was kinda because it’s Christmas or because you can buy one cigar in a pub, which you can’t buy a cigarette. You can buy a cigar and also because I think it was not associated… it’s not a cigarette. So it’s not, it’s not the same. And it was definitely a, you can have one and be all right, one will be all right. It won’t matter.

And it don’t work like that, well it don’t work like that for me. That’s why I had one. I can’t remember, it was like really the next night, oh I’ll have another cigar. I thought oh that’s it the landlord said, “Are you sure?” Because he smoked heavily. I think he knew you’ve given up for ages. He said, “Are you sure?” I said, “Yes, it’ll be all right. It will be all right. It’s only a cigar. It won’t hurt.” And that was it. And it was just, you know, then it was like two cigars the next night as well. I was crashing fags off people and then I was just smoking again. And I’d started again.

And so did it sort of go back up to 20 a day, quite quickly?

Yes. Yes. I was smoking 20 a day. I’m sure it went back quite quickly from what I can remember. I was just back doing exactly what I’d done before. So it was just the same.
 

Roger absent-mindedly helped himself to cigarette from a stranger’s packet on a train, and then started smoking again.

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Age at interview: 66
Sex: Male
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So I went for a job interview in Southampton. And I was on the train going down and there was a sailor on the, on the train, who was sat in the table, opposite me at the same table. And he had got a packet of Marlboro. Well at the time I smoked Marlboro cigarettes occasionally. On top of the packet of cigarettes was a red throw away lighter, exactly like the one I had. And, I was feeling a bit like I needed a cigarette, and the next thing I knew was, I was sat there in the chair with the cigarette, with a Marlboro in my mouth half smoked, with the carriage going ‘round and ‘round and ‘round, I was feeling really queasy, and then all of a sudden I heard this voice say, “I hope you enjoyed that mate.” And it was the guy from the Royal Navy. And I said, “What do you mean?” And he said, “Well you’ve just helped yourself to one of my cigarettes.” So then I thought ‘oh my God.’ So I explained probably why I’d done it, because I’d mistakenly connected his cigarettes with mine. I associated myself with the cigarettes and just felt like one, and then picked up like you do when you’re a smoker. And he was a lovely guy and he meant well, but I hate him for what he did. Because what he did was he reached into his back, into his bag, huge big bag, took out a carton of Marlboro, took 40 out in two packs of 20 and a disposable lighter and passed them across the table. He said, “There you are mate. I know what it’s like.”

So I was set up then for the whole day with cigarettes. I got rid of 15 on the way to Southampton. So that was a waste of time. It was 12, no £6 a session for the hypnosis, so eighteen quid, but at least I saved money on the fags, ‘cause I didn’t have to pay for them.
 

Professor Aveyard talks about whether cutting down the number of cigarettes smoked is an effective way to help stop. Professor Aveyard talks about whether cutting down the number of cigarettes smoked is an effective way to help stop.

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Well we used to believe that cutting down altogether wasn’t really a great idea and that the best way to stop was to smoke as normal and then have a quit day and then take it from there. And to be honest that probably is still the best way to go for most people. But if you feel you can’t do that, then it isn’t necessarily and I think we can say now, it is helpful in fact, to cut down.

So some people will cut down more slowly, some people will cut down vigorously. I think in the end people have got to come to a realisation that what they are going towards is a quit day where they smoke their last cigarette and then don’t smoke again.

One of the things that’s really important for people for people is understand, we call it the ‘not a puff rule’. But what that really means is once I pass this quite day, whatever the day that is I’ve set myself, I will not smoke again. It’s a bit like becoming a vegetarian. You don’t eat meat because that’s who you are. You are a vegetarian. It’s part of your sense of self, and your values and so on, and if you can set that rule for yourself that’s great. 

So the danger about cutting down is that it’s always hard to get to that day where you think right that’s the day that they’ll be zero, because you can, I was cutting down and then I’ve had another one. What happens is people have the odd one as they’re trying to stop, is often but not always that will increase again, just as you manage to cut them down. So cut them down by all means but in the end realise there has to be a day which is a quit day. 

The other thing we know about cutting down is when you cut down without any kind of support for example, medication in particular is what I’m thinking about, you tend to smoke the remaining cigarettes more intensively without really noticing that’s what you’re doing. And that doesn’t do a lot then for the amount you’re smoking, and won’t necessarily make that day after quit day easier. So using nicotine replacement to help you cut down – there’s advert on the TV at the moment as we speak about doing it one day at a time I think it is, but whatever the slogan is. But it’s advertising nicotine replacement. And the reason they can do that, the reason that they are allowed to do is we know from randomised trials again that cutting down that way, will tend to give people a better chance of being off cigarettes and long term, than cutting down without that kind of nicotine replacement.
​Last reviewed August 2018.
 
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