Written for Stock My Medicine and clinically reviewed by Hajra Dhanchora, MPharm (GPhC 2216990).
Stoptober starts on 1 October, and the number behind it is worth knowing: people who stay smoke-free for 28 days are about five times more likely to quit for good. Two weeks out is the right moment to plan, because the attempts that succeed are the ones with a date, a method and a kit ready before the last cigarette, not after it. Here's how to quit smoking in a way that holds, and what your body does once you stop.
How to quit smoking: the plan that works
Three things, in this order. Pick a date a week or two away (1 October is the obvious one) and tell people. Choose your method: the evidence says nicotine replacement therapy plus support from a stop-smoking service makes you around three times more likely to succeed than willpower alone, and combining a patch with a fast-acting product such as gum, a lozenge or the QuickMist mouth spray roughly doubles the odds again. Get the kit before the date: a patch for the background, a rescue product for the ambush cravings. Our guide to choosing your NRT covers the pairing, and how to use patches the details. Vaping helps many people quit and the NHS supports it; prescription tablets such as varenicline are available through a GP or stop-smoking service. Cold turkey works for a minority and fails for most, which is not a character flaw, it's pharmacology.
What happens to your body when you quit smoking
The repair starts faster than people expect. 20 minutes: pulse and blood pressure begin to settle. 8 hours: carbon monoxide in the blood halves and oxygen levels recover. 48 hours: carbon monoxide is gone and taste and smell sharpen, which is why food suddenly tastes better. 72 hours: breathing is easier and energy rises as the airways relax. 2 to 12 weeks: circulation improves; walking and climbing stairs feel easier. 3 to 9 months: lung function improves by up to 10% and coughing and wheezing fall. 1 year: the risk of a heart attack halves compared with a smoker's. 10 years: the risk of dying from lung cancer halves.
How long does nicotine withdrawal last?
Cravings peak on days two and three and most physical withdrawal (irritability, restlessness, poor sleep, hunger, difficulty concentrating) fades over two to four weeks. Individual cravings last only a few minutes, which is the whole point of the fast-acting NRT products. By the end of Stoptober's 28 days the physical dependence is largely behind you; what remains is habit and association, and that's where the planning helps.
Why am I coughing up phlegm, and why so tired?
Both are normal and both are good signs. The tiny hairs that sweep mucus out of the airways were paralysed by smoke and are waking up, so for a few weeks you cough up what they'd been leaving behind; it usually settles within a month, and warm drinks help. Tiredness comes from losing the stimulant you were dosing yourself with every hour, from disturbed sleep in week one, and from the body doing repair work. Eat regularly, walk daily, and go easy on caffeine, which hits harder once you stop smoking. See a GP if a cough lasts beyond a few weeks, brings up blood, or comes with breathlessness or chest pain.
The mistakes that end most attempts
Under-dosing NRT (a light smoker's patch for a 20-a-day habit); stopping the patches after two weeks because "it's working"; keeping a pack "just in case"; and treating one slip as the end. A slip is a data point about a trigger, not a relapse, and the people who quit for good usually needed several attempts to learn their triggers. Ask our pharmacist about dosing if you're on medicines such as clozapine, theophylline or blood thinners, whose levels change when you stop smoking, and see our full stop smoking range.
Nicotine withdrawal day by day
Day 1: cravings every hour or so, irritability, an odd emptiness after meals. Days 2 to 3: the peak. Cravings are most frequent, sleep is broken, concentration is poor and appetite rises; this is where most attempts fail and where NRT earns its keep. Week 1: cravings space out to a few a day, the cough may start as the airways clear, and taste and smell return. Weeks 2 to 4: physical symptoms fade; what's left are cue-driven cravings (coffee, the car, the pub) that last two or three minutes each. Month 2 onwards: occasional cravings in unusual situations, easily managed. At 28 days you've passed the point at which most relapses happen, which is the logic of Stoptober.
Coping with a craving: the four Ds
Delay: a craving passes in a few minutes whether or not you smoke, so set a five-minute timer. Deep breathe: slow breaths in through the nose and out through the mouth, ten of them. Drink water: it occupies the hands and mouth and blunts the urge. Do something else: walk, text someone, tidy a drawer. Add a fifth: dose, with a piece of gum, a lozenge or a spray of QuickMist at the first sign, not once the craving has built.
Stop smoking aids compared
NRT (patches, gum, lozenges, mouth and nasal sprays, inhalator) is available from any pharmacy, safe alongside most medicines, and most effective as a patch plus a fast-acting product; it roughly doubles quit rates. Varenicline is a prescription tablet that blocks nicotine's effect on the brain, taken for 12 weeks, and is the single most effective medicine; cytisine is a newer 25-day course working the same way. Both come via a GP or stop-smoking service. Vapes are supported by the NHS as a quitting tool and outperform NRT in some trials; the aim is to stop smoking first and reduce vaping later. Hypnotherapy and acupuncture have no good evidence but do no harm alongside a proper method. What every method has in common: it works better with support.
Weight, sleep and mood after quitting
Expect a few kilos over the first year unless you plan for it; nicotine suppresses appetite and speeds metabolism slightly, and hands look for a substitute. Regular meals, fruit for the snacking urge, and daily walking cover most of it, and NRT itself delays weight gain. Sleep is disrupted in week one and then usually better than it was as a smoker. Low mood in the first weeks is common and lifts; if it doesn't, or you have a history of depression, tell your GP, because quitting is a known trigger and support is available. Nicotine patches worn overnight can cause vivid dreams; swap to 16-hour ones if so.
What stop smoking services actually do
Free, local, and available through your GP, pharmacy or council: a trained adviser sees or calls you weekly for around 12 weeks, measures your carbon monoxide to show progress, supplies NRT or medicines on prescription, and helps plan around the slips. People who use one alongside medication are around three times more likely to succeed. The NHS Quit Smoking app does a lighter version of the same thing on your phone, including the 28-day Stoptober tracker.
Frequently asked questions
Will I put on weight?
Many people gain a few kilos in the first year, because appetite returns and hands look for something to do. It's far less harmful than smoking, and NRT plus regular meals reduces it.
Is it too late to quit if I've smoked for decades?
No. Heart attack risk starts falling within a year at any age, and lung function improves whenever you stop.
Can I use NRT and vape at the same time?
Yes, and some stop-smoking services recommend it for heavy smokers. The goal is to be off cigarettes; the nicotine sources can be tapered afterwards.
What if I slip during Stoptober?
Note what triggered it, throw away the rest of the pack, and carry on from the next hour. One cigarette doesn't reset the health gains and doesn't have to reset the attempt.