If quitting smoking were a breeze, then 1.3 billion of us wouldn’t still be using tobacco. The truth is that stopping is tough. But with the additional threat of the coronavirus, there are more reasons than ever to try to quit — and stick with it. Some early data suggested smokers were less likely to get COVID-19, but recent data points to smoking and COVID-19 elevating risk factors for severe illness and mortality. Smokers who get COVID-19 and have to be hospitalized are at risk for increased severity of disease and death, according to a recent scientific review and meta-analysis by the World Health Organization.
And while there are lots of tools in the medical arsenal — from popping pills to snapping your way through packs of nicotine gum to help ease cravings and withdrawal symptoms — there are also natural approaches that may help. “Quitting is a challenge — it often takes a multipronged, integrated approach to succeed,” said Dr. Amit Sood, executive director of the Global Center for Resiliency and Wellbeing. Go ahead and mix and match these all-natural approaches to kicking butt for good.
Switch up your diet
Certain foods make cigarettes tastier — and others not so much. Researchers at Duke University asked smokers to list the foods that made them savor the flavor of cigs — 70% reported that red meat, coffee and alcohol enhanced lighting up. On the flip side, about half the group said good-for-you foods, like fruits, vegetables, juice and milk, made cigarettes taste lousy. "Loading up on fruits and vegetables even before quitting might help cigarettes seem less appealing," said F. Joseph McClernon, director of Duke's addiction division in the department of psychiatry and behavioral sciences. Can't hurt to have your taste buds on your side.
Some of the gnawing hunger that quitters have for cigarettes may be a hankering for something else. "Perhaps as much as 30% of a smoker's cravings are actually for carbohydrates rather than nicotine," said Jonathan Foulds, a professor of public health sciences and psychiatry at Penn State College of Medicine. Studies show that sucking a few glucose tablets — the type drugstores sell for diabetics — helps to satiate the longing. Anecdotally, Foulds said, patients list Jujubes as the candy of choice — they're long lasting and low cal (120 calories per 1.5-ounce box). As he puts it, "It's not that sugar is good for you, just that smoking is worse."
Get a move on
Working out works for cravings, too. Research at Brown University showed that women who exercised vigorously — at around 80% of their maximum heart rate — improved their quit rates (19% versus 10% at the end of the 12-week program) and had a longer string of no-relapse days than non-exercisers. The researchers suggested that exercise may help prevent depression, relieve tension and reduce weight gain in women trying to kick the habit. In addition, research at the University of Exeter in the UK suggested that exercise triggers changes in brain activity. In that study, smokers who cycled at a moderate pace had fewer cravings than non-cyclers after abstaining from nicotine for 15 hours, as measured by MRI reactions to cigarette images.
There's strength in numbers when it comes to quitting. After analyzing the quit rates of 1,000 people in treatment programs — some who met one on one and others who met with a group — researchers at the University of Medicine and Dentistry of New Jersey School of Public Health found the group quit rate at six months was 41% (12 points higher than the one-on-oners). Other UMDNJ research concurs. Forty to 50% of people who attended six group meetings at their workplace — sharing stories, laughs, compassion — were successful quitters six months out.
Talk the talk
It sounds too simple to be true: Talking to your doctor about smoking increases the chances you'll quit. A review of 31,000 smokers in the UK found that even brief doctor-patient chats increase the odds of quitting by 3% — for up to a year. How you talk to yourself counts, too. "Stop, quit, give up — so much of the language of quitting is negative," said Janet Konefal, an acupuncturist and assistant dean of complementary and integrative medicine at the University of Miami Miller School of Medicine. "We tell people to talk positively to themselves when they're ruminating about a cigarette. Something simple like 'I can do this' can be remarkably powerful."
Stick it to cravings
Anecdotal evidence suggests that acupuncture, the ancient Chinese medicine practice, can help reduce cravings. The clinical evidence is more limited. A meta-analysis of 33 studies of acupuncture and related techniques found that acupuncture was less effective than traditional nicotine-replacement therapy — but it also found that many of the acupuncture studies were themselves flawed. Konefal notes that research shows acupuncture enhances the production of serotonin in the brain, which smoking cessation decreases. "For this reason, we believe acupuncture works best if you get treatment the day you quit or within the first 72 hours," she said. "We use ear, or auricular acupuncture, and have found that a total of six treatments increases quit rates by 30%."
Give yourself a hand
While most massages are whole-body, full-hour affairs, two minutes of self-message can have a powerful anti-smoking effect. In a small study at the University of Miami, researchers found that when smokers gave themselves a two-minute ear or hand massage every day for a month, they lit up less. "It makes sense since we know from acupuncture that the ear is a microsystem of the body," said Konefal. There's also the added benefit that your hands are doing something other than striking a match.
Put your mind to it
Listening to mindful meditations may turn up the volume on quitting. A pilot study of longtime smokers at the University of Wisconsin School of Medicine and Public Health found more than half — 56% — stopped smoking after eight group sessions teaching meditation and daily practice listening to mindful meditations. Those who spent an average of 45 minutes a day meditating did better than those who spent 20-something minutes per day. All together now: Ommmmm.
An earlier version of this story was published on Oct. 28, 2013. A version of this story originally appeared on iVillage.