Chewing tobacco can serve as a stop smoking alternative, too, for some people. A Danish doctor writing in The Lancet reports that, after several unsuccessful attempts to stop smoking by other methods, he was finally able to overcome his heavy addiction to cigars — eight or ten a day — by placing a little wad of chewing tobacco between his gum and his cheek. “This remarkable result,” he says, “shows that the smoking habit can be broken in a surprisingly simple way. The probable explanation is that blood nicotine is kept at the ‘right’ level by absorption through the mucuous membranes of the mouth.”

Nicotine chewing gum is another stop smoking nicotine alternative. Developed in Sweden and called Nicorette, it is already sold in a number of countries, including Canada, England and Switzerland.

A special feature of the gum is that it is buffered; it alkalinises the saliva. And this, as you saw earlier, makes absorption through the membranes of the mouth much easier. The gum, which releases the nicotine slowly for about half-an-hour, comes in two strengths, 4mg and 2mg. The 4mg version gives roughly the same nicotine blood concentration as one high-nicotine cigarette without, however, the peak level. People trying to stop are advised by their doctor to reach for a piece of the 2mg gum instead of a cigarette when they get a strong urge to smoking a year later, compared to 14 per cent of a group that had received only psychological treatment in stopping clinics. Addiction to the gum occurred in no more than 3 per cent of the cases; the gum does not produce the very addictive highs of cigarettes but definitely eases withdrawal pangs.

An abrupt switchover from cigarettes to gum, using the gum for four months, even if daily consumption is low, and then tapering off. He advises keeping an emergency supply on hand for up to a year, in order to avoid falling back into the smoking habit.

These points can be of practical importance to anyone who uses snuff as a stopping aid. They suggest that one should not attempt to cut off the use of snuff too soon if there is a risk of resuming the far more dangerous practice of smoking cigarettes.

Pipe or cigar Would either a pipe or a cigar be a sensible nicotine alternative for somebody trying to kick the cigarette habit? Before answering that question, there are two or three points to consider.

First, how do the two habits — cigarettes on the one hand, and pipe or cigars on the other — compare as to long-range risks? A pipe or cigar smoker of the traditional sort, one who does not inhale, is in much less danger than a cigarette smoker. There is, of course, some hazard, such as that of developing cancer of the mouth or the throat.

However, the big problem is that if you have been a cigarette smoker and you switch to a pipe or cigars, you are likely to continue inhaling unconsciously out of habit. In that case, you really have not made any progress, even if you think of the pipe or cigars as simply a temporary measure. Worse still, if you end up by adopting a pipe or cigar long-term and inhale, then you are just as badly off as you were with cigarettes; inhaled pipe or cigar smoke is every bit as dangerous as inhaled cigarette smoke.

So there is a fundamental difference between the “primary” pipe or cigar smokers — as the medical experts call those who have smoked only a pipe or cigars from the start — and the “secondary” pipe or cigar smokers, who have switched over from cigarettes at some point or other. Because of this, neither pipe-smoking nor cigar- smoking seems to be a good nicotine alternative in a cigarette-stopping effort, unless one is sure not to inhale.

Here is a checklist to use as a guide in getting ready.

Really decide to stop. This may sound simplistic, it is so obvious. But the experts stress that it is an extremely important step to take. From the moment you decide to take it, there should be no turning back; you no longer go around saying that you have absolutely got to stop, or that you simply have to make yourself stop smoking. You are, in fact, in the process of doing so. You have made a conscious and explicit decision.

Make your plans for the stop smoking diet. Search some menus and recipes and see what foods you need to buy. Do as much of the stop smoking diet shopping for the week ahead as you can during this get-ready period.

Decide if you need a nicotine alternative to help you make the break. It can make a measurable difference by easing the whole problem of withdrawal. It may be especially useful if you happen to smoke a lot and have already tried several times to give up smoking, but without ever being quite able to pull it off. If you use a nicotine alternative, be sure to use the stop smoking diet, too.

Get out a pad and pencil and start listing the reasons why you are anxious to stop smoking. Put down every single reason you can think of. Keep the pad, with the list attached, in a handy place where you can get at it at all times. If you think of still more reasons in the course of the next day or so, simply add them to the list. You will be surprised at how many reasons you can muster when you put your mind to it. Here are a few of the main ones that other people often give:

• There are such big health benefits — the greatly reduced risk of lung and other kinds of cancer, a heart attack, emphysema, other chronic diseases. With these benefits, you also have the prospect of many extra years of life, good healthy years. It makes a big difference when you can look forward to a longer, healthier lifespan.
• Being able to stop smoking gives you a greater sense of mastery over your own life. Instead of letting cigarettes get the better of you, you will be getting the better of cigarettes.
• You will also be setting a good example for all the people around you, especially the children, whether they are your own or those of relatives, friends, or neighbours. This is a tremendously important reason for giving up smoking, because it is so difficult to ask teenagers not to smoke when they see the adults around them puffing away.
• There are plenty of aesthetic benefits, as well. Cigarette smoke leaves a stale, unpleasant taste and smell in your mouth, your hair, your clothes, your office, your car, and every room and cupboard in your house.
• Just think of the money you will be saving — hundreds of pounds a year. Think, too, of what you would really like to spend that hard-earned money on. Make a list of all the things you want to buy.

Keep a careful stop smoking diary for at least one working day and one weekend day — say, Friday and Saturday. Be sure to keep track of each of these things:

At what time you have each cigarette.

How important each cigarette is. Score in this order:

1. Most important
2. Quite important
3. Not too important

Jot down two or three words to explain what you are doing at the time you have each cigarette — for example, the cigarette you have right after breakfast.

This smoking diary is essential. It helps you understand your individual smoking pattern. And it makes it much easier for you to reduce your smoking in a methodical manner when you start to taper off; you look at the diary each day and decide which of the remaining cigarettes is the one you can next give up most easily. In this way, you will be able to keep lowering the number of cigarettes you smoke daily, one at a time, with the diary to guide you.

If a person you live with — spouse, relative or friend — smokes, try to get that person to stop, too. This is extremely important. When you are together with someone who smokes, you are constantly exposed to the stimulus, and this makes it much more difficult to stop than it would be otherwise.