Dear Alice,

I quit smoking cigarettes seven days ago. I've quit before and I understand that this horrible loneliness and depression are just some of the withdrawal symptoms, but I don't know how to lessen the depression. Most of my friends are smokers, so I'm not going out much and I live alone. Is there a treatment for this kind of depression? How long does this last? It lasted over a month the last time I tried to quit smoking.


Dear Reader,

Congratulations! Quitting smoking — even simply deciding to quit — is not easy. According to the American Lung Association, it takes the average smoker two to four attempts at quitting to successfully kick the habit, and the process usually isn't a pleasant one. Withdrawal symptoms can include headaches, sweating, intestinal pain, respiratory pain and congestion (as a result of the lungs clearing themselves out), irritability, mood swings, insomnia and, as you've seen all too clearly, depression. The good news is that there are millions of happy, healthy ex-smokers as living proof that those symptoms will eventually pass.

You can begin to deal with your depression by reminding yourself of all the wonderful benefits that you will gain for you and your health — your risk of lung and other cancers and heart disease will decrease; your blood pressure might be lowered; your immune system will become stronger; your lung capacity will increase, and you'll have more physical strength, energy, and stamina; foods will begin to smell and taste better (and so will you!)... the list goes on and on! You might benefit by examining what you have gained, rather than lost, by quitting smoking.

Depression is a physical problem, as well as a psychological one, and sometimes positive thinking might not be enough. Nicotine replacement therapy in the form of patches, gums, nasal sprays, and lozenges, when properly used, can reduce withdrawal symptoms. Healthier food choices and activities, such as exercise, carrots, and gum, can help. If you're not sure which method is best for you, speak with your health care provider about a plan of treatment. Stick with it! Research shows that not cheating on the first day of nicotine replacement can increase the chance of quitting permanently tenfold.

You may also want to consider that the sadness you're feeling isn't just a withdrawal symptom, but a pre-existing condition. Some smokers use nicotine to self-medicate depression, either knowingly or, more often, unconsciously, and quitting can bring those old symptoms back to the surface. If nicotine replacement therapy isn't enough to cure your blues, you need to consider speaking with a counselor. A therapist can help you decide if talk or cognitive therapy would be helpful and if you are a good candidate for an anti-depressant medication. Treating post-quitting depression bolsters the chances of successfully kicking the habit. Leaving it untreated causes many people to start puffing again. Most importantly, being depressed, in and of itself, is no light matter. It's best to seek out someone with whom to talk. 

As far as not being able to hang out with your friends who light up, perhaps you could involve yourself in some other activities you enjoy. Possibilities include going to the gym, volunteer work, joining a club that interests you, going on long walks, or whacking a few buckets of balls at the local driving range. Getting outside as much as possible helps since being "cooped" up might be a factor to your post-quitting blues. It can be helpful to keep your schedule busy, but it can also help to enjoy time with people you like and feel comfortable with. Don't feel as though you have to dismiss your friends' company altogether, even if they are chimneys. Talk with them about your desire to quit smoking. Ask them if they would try not to smoke as much around you, especially during the first few weeks/months of your non-smoking life. One night, you could suggest where to meet, and make it at a location that does not have a smoking section.

Check with your health service for tobacco cessation programs. Take a look at to find more information and locate resources near you.

It is a challenge to beat smoking. You've already taken the first step toward a lifetime of better, smoke-free health. Keep it up and you'll be thanking yourself and inspiring others for years to come!


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