One morning in 1992, I looked in the mirror. I didn’t like what I saw. I saw a substance abuser. I couldn’t survive without my drug, couldn’t get up in the morning without it, couldn’t be productive, creative, or happy without it. Wherever I went, I had to have a source of my drug nearby. If I didn’t, I’d become anxious, frantic, impossible. Clearly, my need was out of control. I knew it was time to quit coffee. But how?
My wife felt the same way I did. She, too, was a java junkie who wanted to quit. We both loved the warm, rich taste of coffee, but the caffeine made us nervous and irritable and gave both of us insomnia. We decided to quit, cold turkey, and switched to decaf.
It was a very bad idea. We’d heard that quitting caffeine could cause a headache, but we had no inkling how severe and persistent the headache would be. Our withdrawal headaches lasted for days. In addition, we felt sluggish, constipated, befogged, miserable. We couldn’t take it. We ran back to the bean.
Life without java’s jolt
Quitting caffeine didn’t exactly turn me into Buddha, but it lengthened my fuse considerably. I had more patience, especially with my kids.
Shortly after our abortive attempt to quit, the first major study of caffeine withdrawal was published by The New England Journal of Medicine. Johns Hopkins researchers studied sixty-two healthy adults who drank an average of two-and-a-half cups of brewed coffee per day—about what my wife and I consumed. The participants completed a battery of physical and psychological tests and were then placed on a caffeine-free diet (no coffee, tea, coffee-flavored yogurt, caffeinated soft drinks, or chocolate; Excedrin and other over-the-counter drugs containing caffeine were also banned).
Some of the study participants were given caffeine pills in a dosage of 235 mg, the equivalent of about two cups of brewed coffee. The rest were given placebos. When retested after two days and after four days, the group taking the caffeine pills showed no changes in physical or mental function, but the poor suckers who got placebos experienced the same withdrawal effects that had plagued my wife and me: severe, persistent headache, fatigue, constipation, anxiety, and depression.
I found the study reassuring. My wife and I were not wimps. We were not latte losers. We were just addicts—two otherwise normal people up against the withdrawal syndrome associated with an addictive drug. We were like many people who decide to make a positive change in their lives, but don’t know how to do it.
The researchers suggested that people interested in quitting caffeine taper off gradually rather than stop abruptly to minimize withdrawal syndrome. So my wife and I tried again.
We bought several pounds of regular coffee and an equal amount of decaf. We mixed them in five combinations, starting with straight-up real coffee, then one-fifth decaf, then two-fifths, and so on. We drank each blend for a week to ten days. We also drank a couple of cups a day of chamomile tea, which is calming, and took white willow bark, which contains aspirin-like compounds, when we felt a headache coming on.
The result: no withdrawal syndrome at all. Nada. No headache, lethargy, constipation, or mental fog. It was amazing. In addition, toward the end, as we drank very little caffeine and finally none, two unexpected things happened. First, I woke up each morning feeling surprisingly awake and alert. Once freed from the shackles of caffeine, I didn’t need the cup of coffee I’d assumed I couldn’t live without.
Second, friends began remarking on my “new mellowness.” I confess I’ve always been a rather high-strung person. I assumed that it was just my personality— quick-witted but short-tempered. I was wrong. A good deal of my irritability was chemical. Decaf didn’t exactly turn me into Buddha, but it lengthened my fuse considerably. I had more patience, especially with my kids.
Since then, my wife and I have been committed decaf drinkers. Once or twice, at a restaurant, I’ve been served regular by accident. I was up all night. Now I always ask twice. A few times a year, I have a cup of “real” coffee on purpose before I embark on a long drive at night. But there’s a big difference between using a drug therapeutically and being addicted to it. It’s been eight years now, and I’m still glad I’m off caffeine.
I once interviewed a former heroin addict about the challenges he faced quitting the notorious narcotic. “It was rough,” he sighed, “but nowhere near as hard as quitting cigarettes.”
There are more nicotine addicts than heroin addicts. According to the U.S. Substance Abuse and Mental Health Services Administration, about 540,000 Americans use heroin. But 48 million Americans—about one in four—smoke. Smoking is the nation’s leading cause of preventable death. Surveys also show that 74 percent of smokers want to quit, and that 70 percent have tried, without success.
As hard as quitting is, 1.2 million smokers (2.5 percent of the total) quit for good each year, according to the U.S. Centers for Disease Control and Prevention. How do successful quitters do it?
Ex-smoker Tom Ferguson, M.D., has some sage advice: “To smokers, I would say: ‘Don’t give up. Don’t whip yourself for being a ‘failure’ for all the times you’ve tried to quit but weren’t able to. Keep trying.’ To friends of smokers, I would say: ‘Don’t nag. Support the smokers you know to find their own way out.’ ”
Back in the mid-1980s, Ferguson attended a medical meeting on smoking cessation and was appalled to hear speaker after speaker demonize smokers as bad people for not quitting. When he argued that smokers needed support, he was met by blank stares. So he spent several years researching nicotine addiction and quitting. Ferguson then wrote The No-Nag, No-Guilt, Do-It-Your-Own-Way Guide to Quitting Smoking (Ballantine, 1989).
Ferguson points out that not only is nicotine physically addictive, but the act of smoking offers several unrecognized benefits. It’s relaxing. It provides a break from daily responsibilities. It helps the smoker deal with stressful situations. It relieves pain. And it focuses the mind, improving concentration.
So the challenge for aspiring quitters is not just to break nicotine’s chemical grip, but to replace its benefits with equally beneficial—but healthier—alternatives.
Ferguson suggests starting the process by adopting a healthier lifestyle. This may seem like a contradiction in terms— becoming a “healthier smoker.” But smokers who adopt other good health habits do cut their risk of developing smoking-related diseases, even if they continue to smoke.
A successful quitter’s advice
Here are author Ferguson’s tips for staying healthy while you work up the determination to quit:
• Exercise. Start by walking for thirty minutes a day, and work up to forty-five to sixty minutes at a brisk pace. Exercise conditions the heart and blood vessels, which reduces the damage smoking causes. It also provides stress relief, mood elevation, and personal time.
• Eat more fruits and vegetables. Try to eat at least five servings a day: a piece of fruit with breakfast, fruit snacks during the day, a salad and vegetable with lunch and dinner, and vegetable snacks (carrots, celery, cherry tomatoes, cucumber slices). Fruits and vegetables contain antioxidant nutrients (notably vitamins A, C, and E) that help prevent smoking-related cancers and heart disease. They also make your diet lower in fat, which helps control weight—and minimize post-quitting weight gain.
• Manage stress. Exercise is one path to stress relief, but there are many others: deep breathing, meditation, yoga, playing music, spending time in nature, or in religious observance. Many smokers feel that having a cigarette gives them some calm time to themselves. You can enjoy those same islands of calm without lighting up.
• Get support. Smoking is often a social activity. Smokers frequently enjoy cigarettes with one another. Replacing the fellowship of group smoking with other types of social support can be an important step toward quitting.
Once you’ve become a healthier smoker, the next step is to cut down. Addictions make people feel that they’re controlled by their drug. Reducing the number of cigarettes proves that you’re not helpless.
When you’re ready to quit for good, Ferguson suggests setting a “quit date,” announcing it to your support network, and arranging lots of dates, phone calls, and fun activities during the first month, probably the toughest period.
Once you quit, you’re still not out of the woods. Many ex-smokers say they felt powerfully tempted to start smoking again for years after quitting. It’s important to become familiar with the moments when you feel tempted to light up. If you give in, that’s a shame, but again, it doesn’t mark you as a failure; it only means that you need to analyze what made you relapse and how you can avoid doing so in the future.
Herbs for quitters
Although herbs haven’t been tested in clinical trials as smoking-cessation aids, natural health practitioners often turn to them. Why? Because nicotine quells anxiety; habitual smokers know they can light up and experience relief from this symptom. Quitters often experience heightened anxiety. Herbal sedatives have a long history of safe use; some have research that documents their effectiveness in reducing anxiety, though not specifically in the context of quitting smoking.
All of the following herbs are safe for healthy adults in the amounts recommended. But if you’re pregnant or nursing or taking any medication regularly, consult your physician before using them.
St. John’s wort (Hypericum perforatum). The success of the antidepressant bupropion (Zyban) in smoking cessation programs strongly suggests that St. John’s wort may help smokers quit. Zyban boosts two of the same brain chemicals that nicotine elevates—dopamine and norepinephrine. It also made patients feel better. St. John’s wort is involved in the same biochemical systems in the brain, but exactly how it works is not fully understood. To use this herb, buy a standardized extract and follow the package directions. Be patient. It often takes a few weeks to feel mood-elevating benefits. Do not take St. John’s wort in combination with Zyban—or any other prescription pharmaceutical—without consulting your doctor.
Lobelia (Lobelia inflata). When taken as an infusion or tincture, this herb may help smokers quit. Lobelia contains a compound, lobeline, that some research suggests binds to nicotine receptors and helps reduce cravings for tobacco. Unfortunately, lobelia has a nasty reputation that’s largely undeserved. In doses much larger than recommended, it may cause vomiting and possibly even death. The Food and Drug Administration has called lobelia “poisonous.” But it’s usually safe when used cautiously in recommended amounts. If you want to be extra cautious, consult a qualified herbalist or doctor experienced with herbs before using lobelia in your smoking cessation program.
To make a lobelia tea, steep 1/4 to 1/2 teaspoon of dried herb per cup of boiling water for ten minutes. Drink up to 3 cups per day. If you’d rather take a tincture, use 6 to 10 drops up to three times per day. If you develop any stomach distress, stop using lobelia.
Kava-kava (Piper methysticum) Many smokers light up to deal with stress. Mild herbal tranquilizers can help calm smokers so they feel less tempted to reach for a cigarette. Kava is the South Pacific’s contribution to herbal medicine. In recent years, it has become a top choice among tranquilizing herbs. For centuries, Polynesians from New Guinea to Tahiti have used kava the way Americans use beer—as a mildly intoxicating social beverage.
Starting about a decade ago, kava began attracting attention among American herbalists because of European (mostly German) studies showing that at doses lower than those used in the South Pacific, the root produces little or no euphoria, but acts as a tranquilizer. Many studies show that kava is an effective treatment for stress and anxiety. At the Medical College of Virginia, researchers gave either a placebo or kava (240 mg) to sixty adults suffering from stress and anxiety problems. After four weeks, the placebo group showed no significant change in anxiety symptoms, but the kava group did—fewer interpersonal problems, fewer anxiety symptoms, and less stress. Those taking kava experienced no side effects.
If you can find powdered root, steep 1 to 2 teaspoons per cup of boiling water for ten minutes. Drink up to 3 cups a day. Most Americans use commercial capsules. Look for a standardized extract containing 60 to 75 mg of kavalactones per capsule. The dose used in most studies is 300 mg/day of a standardized extract in divided doses (the equivalent of about 200 mg of kavalactones). Follow package directions. Don’t mix kava and alcohol; don’t take kava or other tranquilizing herbs if you take pharmaceutical tranquilizers or sedatives.
Passionflower (Passiflora incarnata). For centuries, European herbalists have used passionflower as a mild tranquilizer. Modern science has confirmed this use. Passionflower contains passiflorine, which is chemically similar to morphine, but not addictive. Like kava, passionflower can help calm the anxieties that spur aspiring ex-smokers to reach for cigarettes. The Commission E approves the use of passionflower for nervousness and restlessness. For a pleasant-tasting infusion, use 1 teaspoon of dried leaves per cup of boiling water. Steep for ten to fifteen minutes, then strain and drink up to 3 cups a day. If you’d rather use a tincture, take 1/4 to 1 teaspoon up to three times a day. If nicotine cravings interfere with your sleep, drink a cup of tea just before bedtime. When using commercial preparations, follow label directions.
Skullcap (Scutellaria lateriflora, Scutellaria baicalensis). Skullcap is another mild tranquilizer that can help keep smokers from lighting up. For centuries, Chinese physicians have used Asian skullcap (S. baicalensis) as a tranquilizer and sedative and treatment for convulsions. The Western herb (S. lateriflora) is not as potent, but it, too, has some calming action. It’s an ingredient in many over-the-counter sleep preparations in Europe. Steep 1 to 2 teaspoons of dried herb per cup of boiling water for ten to fifteen minutes. Drink up to 3 cups a day. Skullcap tastes bitter; adding honey, sugar, and lemon or mixing it with other herbs will improve flavor. Or use 1 teaspoon of tincture up to three times a day.
Chamomile (Matricaria recutita). Among its many uses, chamomile is a mild tranquilizer that soothes jangled nerves, so it’s a likely herb to turn to for help in resisting the temptation of a cigarette. Japanese researchers worked with chamomile oil vapors in a study of animals under stress. In those exposed to the chamomile vapor, stress hormone levels fell significantly. To make a tea, steep 2 to 3 heaping teaspoons of flowers per cup of boiling water for ten minutes. Drink up to 3 cups a day. If you prefer a tincture, use 1/2 to 1 teaspoon up to three times a day.
Catnip (Nepeta cataria). In the 1960s, some people smoked catnip thinking that it was a marijuana-like intoxicant. It isn’t. But today, smokers can use catnip to help keep them away from tobacco. German researchers report that the chemicals (nepetalactone isomers) responsible for cats’ intoxication are similar to the natural sedatives (valepotriates) in valerian. This finding supports catnip’s traditional use as a mild tranquilizer and sedative, and it tastes and smells much better than valerian. To make a pleasant, minty tea, steep 2 teaspoons of dried herb per cup of boiling water for ten minutes. Drink up to 3 cups a day. If you prefer a tincture, take 1/2 to 1 teaspoon up to three times a day.
Lemon balm (Melissa officinalis). Animal studies show that lemon balm oil has tranquilizing properties. In Germany, lemon balm is widely used as a tranquilizer and sedative. The German Commission E approves lemon balm for the treatment of insomnia. To make tea, steep 2 teaspoons of leaves per cup of water for ten minutes. Drink up to 3 cups per day. To use lemon balm in a tincture, take 1/2 to 11/2 teaspoons up to three times per day.
Coffee and tea. It may seem odd to tout caffeine as a smoking-cessation aid. But caffeine has some mood-elevating action that may prove useful to aspiring ex-smokers. You can always quit caffeine later if you want; it’s much easier than quitting smoking. Sip for sip, regular coffee is the herb with the most caffeine. However, many smokers strongly associate coffee and cigarettes, and coffee may tempt them to light up. In that case, try tea or caffeinated soft drinks.
While herbs can help ease the body’s chemical passage out of tobacco addiction, taking them in tea form provides another important benefit to aspiring quitters. Making and drinking tea replaces the ritual of smoking. It gives your hands and lips something to do instead of smoking.
When you quit smoking, your risk of smoking-related ailments declines. Heart disease risk plummets rapidly. After three to five years, ex-smokers face no greater risk of heart disease than people who have never smoked. Lung cancer risk remains higher much longer, but it, too, slowly declines.
But for most ex-smokers, the main benefits of quitting are the ones you feel: enhanced vitality and greater self-confidence and joie de vivre. You look in the mirror and see a winner, a victor who has conquered a powerful chemical, a person who can do just about anything. That’s a great feeling.
Smoking is the nation’s leading cause of preventable death. Surveys show that 74 percent of smokers want to quit, and that 70 percent have tried without success.
Michael Castleman is a widely published health and medical writer based in San Francisco. His book, The New Healing Herbs, an update of his million-selling book, The Healing Herbs, will be published by Rodale Press this spring.
The reference list for this article is extensive. If you would like a copy, please send a self-addressed, stamped envelope to “Quitting,” Herbs for Health, 243 E. Fourth St., Loveland, Colorado 80537-5655, or e-mail us at HerbsforHealth@HCPress.com.