Cigarette smoking remains one of the leading preventable causes of illness and death worldwide. According to the World Health Organization (WHO), the tobacco epidemic claims over 7 million lives each year and causes widespread disability. For health practitioners, nurses, doctors and general-readers alike, the pathway out of dependence is both clinical and behavioural. In this article I will talk about why people smoke, why quitting is so challenging, the harms of cigarettes, benefits of quitting and offers a structured step-by-step approach (including for the African context) to help smokers quit for good.
Why people smoke and why stopping is hard
Smoking often begins as a social habit, a method of stress relief or simply a learned behaviour. But over time, addiction to nicotine develops; nicotine causes changes in the brain’s reward pathways, and the combination of chemical dependence and habitual cues (for example after meals, with coffee, or during socialising) makes cessation difficult.
Beyond the biological dependence, other factors complicate quitting:
- Social and environmental triggers (friends who smoke, work breaks associated with smoking)
- Mis-beliefs such as “just one won’t hurt” (yet even low-intensity smoking carries elevated risk)
- Lack of access to cessation support or medications, especially in low- and middle-income countries. For instance, a review of eight Sub-Saharan African countries found that successful tobacco cessation was more likely among wealthier and better educated individuals.
- Poor recognition of risks: although many smokers know smoking causes lung cancer, fewer recognise its links to diabetes, blindness or dementia.
In short, quitting requires overcoming addiction, rewiring habits and navigating social, economic and health-system barriers.
How cigarette smoking harms you and those around you
The harms of smoking extend to nearly every organ system. Some of the key effects include:
- Cardiovascular disease: Smoking can raise blood pressure, increase heart rate, damage the lining of blood vessel walls and promote atherosclerosis (plaque build-up).
- Respiratory and lung disease: Chronic obstructive pulmonary disease (COPD), emphysema, lung cancer—smoking is the principal driver.
- Cancer beyond the lung: Smoking is associated with cancers of the mouth, throat, esophagus, bladder, pancreas, and more.
- Immune and other systemic effects: Tobacco smoke weakens the immune system, raises risks of infections, digestive disorders (such as ulcers), hearing and vision loss, dementia, joint problems and more.
- Second-hand smoke and exposure of others: Non-smokers exposed to cigarette smoke are at elevated risk for cardiovascular and respiratory disease.
- There is no safe level of smoking. Even people who smoke 1–10 cigarettes per day face substantially higher risks of early death compared to never smokers.
- Given this breadth of harm, quitting smoking is one of the most effective single actions someone can take for long-term health.
Why you should quit smoking now
Stopping smoking yields health gains almost immediately and continues over years. Some of the benefits are:
- Reduction in risk of heart attack, stroke and lung disease begins quickly after quitting.
- Longer life-expectancy: smokers tend to lose around a decade of life compared to non-smokers.
- Better quality of life: improvements in lung function, circulation, immune health, and reduction in risk of complications.
- Protection of family and friends from second-hand smoke exposure.
- Economic benefits: lower health-care costs, less absenteeism, less spending on tobacco.
For health-care professionals especially, encouraging cessation can yield large gains across patient populations. The WHO notes that brief advice from trained health professionals can increase quitting success by up to 30 %, and more intensive counselling might raise it to 84 %.
In sum, quitting is both feasible and highly worthwhile at any age or stage of smoking.
Step-by-step guide to quitting smoking
Here is a structured approach combining international best practices and an adaptation that has shown to work in our African settings.
Step 1: Prepare and set a Quit Day
Choose a date within the next one to two weeks when you will stop smoking entirely. This gives you time to prepare without losing motivation.
In preparation:
- Write down your reasons for quitting (health, family, finances)
- Tell friends, family, colleagues about your plan and ask for their support
- Remove cigarettes, lighters, ashtrays from your environment
- Review your usual smoking triggers (with coffee, after meals, while commuting) and plan alternatives
Step 2: Get support and develop skills
You don’t quit alone: use the help of others and tools.
- Seek counselling or join a quit-smoking group; even phone/text quit-lines are effective.
- Identify a “quit buddy” (someone who is also quitting or supports you).
- Use behavioural strategies: delay the urge by five minutes, distract yourself, do a deep-breathing exercise.
In African settings, where dedicated cessation services may be less available, health centres can integrate brief counselling and referrals. A guideline in Ghana emphasises training workers in tobacco-cessation techniques within health facilities.
Address structural barriers: low-income smokers may have less access to support; ensuring clinics provide free or low-cost cessation help can improve equity. (Potential problem gap that needs to be filled)
Step 3: Use pharmacotherapy if appropriate
Medications increase the chance of quitting by reducing withdrawal and cravings. The WHO’s first clinical guideline for tobacco cessation (2024) recommends:
- Nicotine Replacement Therapy like nicotine gum, patches, sprays
- Varenicline
- Bupropion
- Cytisine
When combined with behavioural support, these options markedly improve outcomes.
In practice: consult a clinician to determine suitability and local availability in your country. Some African settings may lack access; in these cases, behavioural support remains essential.
Step 4: Manage Quit Day and early abstinence
On the Quit Day:
- Do not smoke—not even one puff.
- Stay busy: go for walks, chew sugar-free gum or hard candy, drink water.
- Avoid triggers: for a while, skip the usual coffee-smoke break, avoid social situations where friends smoke, stay away from smoking zones.
- Stay positive: remind yourself that urges are temporary and will pass. Reward small milestones—24 hours, 1 week, etc.
Step 5: Handle relapse and maintain abstinence
Many people need several attempts before quitting fully. Relapse does not mean failure—it means learning.
When a slip occurs:
- Acknowledge what triggered it and revise your plan
- Re-commit to a new quit date
- Continue using support, medication, and behavioural strategies
In African contexts, weaker cessation infrastructure means relapse may be higher; emphasising ongoing support and follow-up is critical.
By way of conclusion quitting cigarette smoking is one of the most impactful actions a person can take for their immediate and long-term health. The harms of smoking are widespread and well-documented; the benefits of quitting begin quickly and grow over time. While addiction, habit and social factors make quitting challenging, a structured approach—preparation, behavioural support, medication when appropriate, coping strategies and follow-up—greatly improves the likelihood of success. In African settings, additional attention to access, education and integration within health systems will enhance outcomes. For health professionals, supporting patients through each step of quitting is a crucial role. Now is the time to act.
FAQ
Q: Is it too late to quit smoking?
No. Even people who quit later in life still benefit substantially. Although earlier quitting yields larger gains, stopping at any age reduces risk of disease and death.
Q: My patient smokes only a few cigarettes a day—is quitting still important?
Yes. There is no safe level of smoking; even low-intensity smoking carries much higher risks of early death compared to never-smokers.
Q: What if there are no dedicated quit-smoking programs locally?
You can still use brief advice during any health visit (which improves quit rates up to ~30 %). Combine that with self-help, peer support, simple behavioural strategies and if possible medications.
Q: Are e-cigarettes a safe way to quit?
Evidence remains limited. Many authorities still recommend established cessation medications and behavioural support instead.
Q: How many quit attempts does a person normally need?
There is wide individual variation. Many require multiple attempts before successful long-term abstinence. Each attempt can inform the next one.