First, some points to clarify:
1) This blog isn't a debate on whether or not you should quit cold turkey, nor a response to anti-NRT theorists. The author doesn't work for tobacco companies, nor any tobacco product manufacturers or distributors, and QuitNet receives no revenue from the sale or advertisement of NRT or other quit-aids.
2) In 18 years as the world's first and largest quit-smoking website, we've had a lot of experience with what works best for the most, and what theresearch indicates -- and that's what we speak to here. If you can quit cold turkey, you should -- the sooner the better.
Twenty two years ago, before the patch and other quit-aids were available without prescription, I quit smoking cold turkey (CT). Three times, in fact (the third time being, as they say, a charm). And after many years of easy access to over-the-counter quit medicines like NRT, i.e., the patch, gum, lozenge, etc, most smokersstill try to quit cold turkey. CT is defined as any treatment method which does not include medicinal control of withdrawal symptoms, i.e., the smoker stops smoking, either abruptly or with a plan, and doesn't employ any chemical interventions to minimize detoxification. Hypnosis, acupuncture, and other alternative treatments are also considered CT because they do not directly address physical withdrawal, or detoxification.
So you won't ever catch me saying cold turkey is a bad way to quit, or that it won't work work for you. I'm living proof that it can and does work. But it's also important to address the most common misconceptions about CT quitting, so you can make the best choices for your next quit.
Myth #1. Cold Turkey is the most effective way to quit.
Decades of research repeatedly demonstrate that only 3-6 CT quitters, out of every 100, will succeed during any given quit attempt. This makes cold turkey the least effective of all treatments, even less so than medication placebos. The primary reason for these low numbers is that the physical, mental and behavioral parts of withdrawal sometimes prove too much to handle, and can negatively impact everyday life even for the most determined quitter.
However, this doesn't necessarily mean that any single quitter won't be able to quit using CT, only that, individually, other methods provide better odds.
Myth #2. Cold Turkey is the safest way to quit.
Quitting smoking is rarely dangerous, and almost never more dangerous than continuing to smoke, but a slower, measured withdrawal from nicotine usually provides a more comfortable path to tobacco freedom. The sudden onset of cold turkey detox among the heaviest smokers can trigger fluctuations in heart rate and blood pressure, cold sweats, and 'the jitters'. Changes in metabolism can adversely affect prescription medication doses. CT quits can trigger acute depression and suicidal ideation among those with mental health challenges, and/or trigger massive chemical/hormonal rearrangements in the body.
Additionally, CT quitters are more likely to transfer smoking addiction to sugar, caffeine, or other addictive substances, causing acute or chronic difficulties with weight gain, depression and anxiety -- all of which contribute to higher rates of slips and relapses.
Myth #3. Cold Turkey is the fastest way through withdrawal.
The longest, most intense detoxifications are usually suffered by CT quitters (depending on the level of addiction). Three days is commonly referred to as the make-or-break timeline for CT withdrawal, but CT quitters can experience moderate-to-severe detox symptoms for weeks after quitting. Again, this is not to say you will suffer such withdrawal if you quit cold-turkey -- that's largely determined by your current addiction/smoking level and metabolism -- only that you're more likely to than if you detox more slowly with NRT.
Myth #4. The intensity of a Cold Turkey quit inhibits relapse.
Though many CT quitters claim that their quit is/was so horrific that they never want to go through it again, there's no solid research demonstrating that past withdrawal experiences influence current quit-success, or that a bad past experience keeps one quit. What we often find instead is increased resistance to the idea of quitting because of past difficulties, and higher rates of slips and relapses during intense detoxes.
Myth #5. Most smokers quit Cold Turkey.
This one is not a myth. Though quit-aids are about 20% more commonly used now than a decade ago, CT is still the most widely-used method, largely because it’s the easiest, and free. But most CT smokers will also relapse during the first weeks of any individual quit. This is why smokers are increasingly turning to quit-aids first, or after trying and failing with CT.
All that being said, cold turkey quitting may still best the way for you to quit. If you're a middle-aged man or post-menopausal woman, have successfully quit smoking before without medicinal intervention, and/or aren't being treated for depression or a bi-polar condition, your odds of quitting CT are better than average. If you're pregnant or breastfeeding, weigh less than 120 lbs., or smoke less than half a pack a day, you probably should quit smoking CT. In any event, a CT quitter is wise to beef up their support network--which increases the chances of any quit succeeding.
But if you know, or fear, that severe withdrawal will negatively impact your life, or haven't been able to get through the withdrawal process unaided in the past, don't worry. There are more effective treatment methods available to you!
Good luck, visit QuitNet for help, and KTQ.
Alan Peters, CTTS-M
Regarding public health perspectives on cold turkey quitting: This blog is about CT quitting for individual smokers. Public health officials often, and should, promote CT treatment to large populations, because that's more cost-effective than offering, distributing, and supporting compliance with quit-medicines on a large scale.
No QuitNet authors or experts receive research funding or other renumeration from pharmaceutical companies.