Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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Quitting Tobacco

If you smoke or use tobacco products, quitting is the best thing you can do for your health and the health of your loved ones. Good planning, support, and the latest quit tobacco medications can help you succeed.

The Importance of Planning

Even if you feel ready to quit right away, taking some time to plan will help you be more successful in the long run. And if you don't feel ready right now, some of these steps may be useful in increasing your knowledge of how tobacco fits into your life, as well as improving your confidence and readiness to quit. Kaiser Permanente has resources that can support you in exploring your readiness or creating a quit plan.

Build a comprehensive plan

Everyone is different, but most people find a combination of strategies works best for them. Despite what many of us may wish, there's no one strategy or medication that will make quitting quick, easy, and painless. In fact, depending on a single strategy, like relying solely on medication, may leave you more likely to relapse. On the other hand, if you build a plan with many strategies, you'll be that much more prepared to face challenging situations when you quit. If one strategy doesn't work, you'll have another one to try instead of starting to smoke again.

Learn from past quit attempts

Any past attempts to quit are valuable sources of information. Think back over past attempts and ask yourself:

  • What helped me not smoke or use tobacco (even for a short period of time)?
  • What situations (triggers) really made me want to smoke? Were some more difficult to overcome than others?
  • What strategies did I use to help me cope? Did some work better than others?
  • What tripped me up?
  • If I could go back in time, what would I do differently? 

When you evaluate your past quit attempts this way, you may find that they are not failures but provide opportunities that can really help your next attempt. Use the information you learn about what works and what doesn't to make a stronger plan for next time. 

Pull it all together in a quit plan

Just writing down your motivations and strategies can be helpful when you are thinking through your plan. Consider writing down:

  • Your motivations for quitting
  • Your quit date
  • What you'll do to get ready to quit
  • The challenges you anticipate and what you'll do to overcome them. This includes triggers and how you'll cope with them
  • The types of support you'll look for from your peers, a counselor, or a quit tobacco hotline
  • The type of quit tobacco medications you plan to use and how you'll use them
  • How you'll reward yourself for success

Sign it at the bottom if you'd like: This is a contract with yourself to do your best to quit tobacco.

Additional References:

Understand Why and How You Use Tobacco

One of the most helpful things you can do to get ready to quit is to become more aware of the way you use tobacco, how it fits into your daily routines and your life in general. This information helps you choose which strategies will support you when you take tobacco out of the picture.

Track your packs

Many people have been smoking for so long that it has become automatic. If asked when or why they smoke, they might say, "I don't know, I just smoke." A smoking log or "pack track" can help you become more aware of when and why you smoke throughout the day. You can print and make notes in one of our pack tracks or use your own paper. Some people attach the log to their pack of cigarettes so they always have it on hand. You can also use your mobile phone. If it's a smart phone, there are apps available that can help with this.

Keep a record of the tobacco you use on one weekday and one weekend day. When you track your cigarettes, note:

  • The time you smoke.
  • Where you were and what you were doing.
  • Whom you were with.
  • How you were feeling.
  • How much you needed that tobacco. A lot? Some?  Not much at all? 
Change your tobacco routines

Another way to increase awareness of your tobacco use is to change your daily tobacco routines. Not only will you learn more about the way you smoke; you'll find smoking less convenient and automatic than it once was.

  • Buy your tobacco somewhere new, especially if it's somewhere inconvenient for you to go every day.
  • Buy by the pack instead of by the carton.
  • Keep your pack of cigarettes in the trunk of your car. You can still smoke as many as you need, just make yourself get them one at a time from the trunk. If you're driving, you'll have to pull over and get one when you need it. If you smoke at home, you'll need to leave the house to get them.
  • Stop using your favorite brand and start using one you find distasteful. 
Additional References:

Identify Triggers and Coping Strategies

Addiction to nicotine is a big part of why a person will want to use tobacco again and again throughout the day. However, certain situations, moods, or activities can "trigger" the need to smoke. If you always have a cigarette after a meal, you'll probably find yourself wanting one after you quit, even if your body isn't craving nicotine.

Some triggers to use tobacco are more common than others:

  • Waking up in the morning
  • Having coffee
  • Drinking alcohol
  • Driving
  • Managing stressful situations at home or at work
  • Relaxing
  • After a meal
  • After sex
  • When you're with friends
  • If you feel sad or depressed 

Observe your smoking habits and make a list of your triggers. Your "pack track" is one way to help you do this. Once you have the list, start thinking of what you'll do in those situations when tobacco isn't an option anymore.

Change your routine

Changing your routine is one helpful way to break the connection between a certain behavior or trigger and your decision to use tobacco. Ideas for changing your routine include:

  • If you often smoke first thing in the morning, try leaving your cigarettes someplace less convenient (like in your car) or decide to get right out of bed and brush your teeth or get into the shower where you can't smoke.
  • If you use tobacco on your drive to work, make plans to take public transit or carpool with someone. If that's not possible, try driving a different way to work. Concentrating on an area you don't know as well can help keep your mind off your cigarettes. 
Avoid triggers

Sometimes you can cope with a trigger by simply avoiding the trigger altogether. Try to:

  • Make a plan to avoid or limit alcohol for the first few weeks after you quit.
  • If coffee feels incomplete without a cigarette, try switching to tea or an energy drink. 

These examples may be helpful, but you are the best judge of what would work best for you.

Additional References:

Plan to Use Quit Tobacco Medications

Quit tobacco medicines are drugs that help people quit smoking. They can ease the cravings and other symptoms you might feel as your body withdraws from nicotine, the addictive drug in cigarettes and other tobacco products. This allows you to focus on your other strategies for living life without tobacco.

Types of medications

There are 2 main types of quit tobacco medications: those that contain nicotine (such as the nicotine patch or nicotine gum) and those that do not contain nicotine (such as Bupropion or Chantix). Both types have been proven to increase the chances of successfully quitting, and studies have shown that using more than one type of medication at one time may bring even more success. E-cigarettes have not been proven to be a safe or effective product to use as a cessation aid.

Some people shouldn't use medications

There may be reasons not to use quit smoking medications. If you don't smoke every day or if you smoke fewer than 10 cigarettes per day, these medications may not be as effective in helping you quit. Some quit tobacco medications might not be right for you if you're pregnant, breastfeeding a baby, or have certain health. Ask your doctor about what may be right for you.

Additional References:

Get in Some Practice: Schedule Your Tobacco Use

Changing the way you smoke can be a helpful step toward quitting. One effective way to do this is to schedule when you will smoke (and when you won't). Here's how it works: choose certain times of the day when you allow yourself to smoke and times when you don't. How you do this is up to you, but some people decide to smoke during even hours of the day. This means they can smoke at 2:00, 4:00, and 6:00 but not at 1:00, 3:00, or 5:00. Other people might say they can smoke early in the morning and afternoon, but not from 10:00 am to noon, or from 3:00 pm to 5:00 pm. This can be even more effective if you choose to cut down the amount of tobacco you use over several weeks, all the while scheduling when you can use it.

Why this method is effective

This can be more effective than cutting down without scheduling. One reason may be that you are allowing yourself to practice not smoking without pressuring yourself to give it up all together. During the times you have told yourself you are not allowed to use tobacco, you have to employ some strategies to deal with cravings or trigger situations. You have the opportunity to test out your strategies – if deep breathing doesn't keep you from smoking, you'll have to try something else the next time. As you find what works for you, you may also find that your confidence and skills needed for successfully quitting are growing, too.

Just like any other part of quitting, what works best is unique to you. Still, evidence shows that practice can increase your success.

Support Yourself

Support can come from many places. You may ask your family, friends, and coworkers to support you during this time. There are also a number of resources available to help – classes, online tools, and individual counseling.

Phone services
  • Kaiser Permanente Wellness Coaching can help you explore, create – and stick with – a plan for reaching your goals.  You don't even have to leave home. You and your coach talk one-on-one by phone at a time that's convenient for you. Call 1-866-251-4514  to make a phone appointment with a coach. Coaching sessions are provided at no charge to Kaiser Permanente members.
  • California Smoker's Helpline at 1-800-622-8887. Counselors are available to provide information and counseling. Assistance is available in Spanish and other languages. There is no fee for this service.
  • Nicotine Anonymous: 1-800-642-0666. 
Classes and in-person counseling
  • Contact your local Health Education Center or visit to find a Freedom from Tobacco Series or Quit Tobacco Workshop class that's convenient for you. 
Online options and programs
  • Use our Quit Tobacco Medications online tool to review your options in quit tobacco medications. Finding the right combination of medications can be a key to successful quitting.
  • Visit HealthMedia Breathe, an online program to explore your reasons and readiness for quitting, and get a tailored guide for next steps.
  • and provide online chat and information for quitting successfully. 
Community resources

Local chapters of the American Lung Association, the American Cancer Society, or the American Heart Association can provide written materials, self-help smoking cessation guides, ongoing classes, and helpful online programs.

Additional References:

Related Health Tools:

Classes and Coaching
Interactive Programs

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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