Fact Buster: Going Cold Turkey to Quit Smoking

Is going 'cold turkey' the most effective way to quit smoking?
A: Probably. It's certainly the method most successful quitters use.

"Quitting smoking is the hardest thing I ever did." It's a statement you hear time and time again, but who's saying it? Real people? Or actors in advertisements for quit smoking aids like nicotine gum, patches and pills?

The idea that it's incredibly difficult to quit smoking is widely held and you'd be forgiven for thinking yourself foolhardy to attempt it alone. But in truth it looks like good old-fashioned willpower could actually be your best option.

"Cold turkey is the way that people don't like talking about but it's overwhelmingly the most popular and successful way that most people quit smoking," says Professor Simon Chapman, director of research at the School of Public Health at Sydney Medical School.

"It's the way that most people who have quit stopped. If you take 100 ex-smokers and ask them how they quit, about 66 to 75 of them will have quit smoking without any assistance at all."
Chapman's views are backed by a Cancer Council Australia suvey presented this month at the Asia Pacific Conference on Tobacco or Health.


Nicotine replacement options
But while cold turkey – either stopping dead or cutting down smoking and then stopping – might be the most common way to success, it's difficult to say for sure whether it's better than alternatives.
That's because there are inherent difficulties comparing "going it alone" with aids like nicotine patches, pills and gum in head-to-head tests.

One problem is that smokers who are given a placebo pill or patch in a trial are likely to be able to tell that they have been given a fake because they won't experience the familiar effects of nicotine, says Chapman. A review of studies found that in almost three quarters of trials people could tell whether they were being given the real deal or not. This makes it harder to tease out how much success is due to the pill or patch itself, rather than simply its effect on a person's motivation.


Only for light smokers?
Nonetheless quitting cold turkey clearly works for many and not just those who smoked relatively few cigarettes to start with, Chapman says. "There are plenty of examples of people who were very heavy smokers who have given up alone."
And it's a method that seems to appeal to Australians. Only about 3 per cent of smokers in this country ever call smoking quitlines, he says, despite the phone number being on cigarette packs and anti-smoking literature and advertising for years.

"[People] don't in the main want to engage with public health professionals to try to quit smoking. They want to do it themselves. And many of them do it. There are far more ex-smokers in Australia than there are smokers now, so many of them have succeeded."
"It's like saying how do most people learn to ride a bike? Do they have a professional from the bike shop give them lessons? No, they just do it."


What works for you?
Quitting cold turkey isn't for everyone though; there are some people who will need assistance, Chapman says. But he'd like to see the alternative – going it alone – put forward as a viable option in public health messages about giving up. (A recent paper he co-authored on this topic was published here:

http://www.cancer.org.au/Newsmedia/mediareleases/mediareleases2010/8October2010.htm

"We need to rebalance the public discussion about how people quit smoking. We need to be honest with people and tell them that most people quit without assistance."
Motivation is key, says Chapman, and public health messages should be changed to encourage people to quit rather than telling them constantly that 'if you quit, it'll be really really hard'.
"We need to tell people that for some it will be hard, but for many people it'll be surprisingly easy. There is some research that shows people who quit smoking look back on the experience and say 'what was all the fuss about it? It wasn't that difficult at all'".

If you don't quit the first time though, don't give up. Research shows it typically takes seven to 12 attempts, although there's plenty of debate about what people mean by a "quit attempt".
As for particular tips on how to give your willpower the best chance? There's little research into techniques such as asking friends to watch out for you or how best to distracting yourself from cravings.

So it's probably best to simply make your own list of tips to try and see which of them works for you.