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Quitting Smoking

Smoking negatively impacts a person’s health in a number of ways, including increasing your risk for lung cancer and heart disease. Studies have also demonstrated that smoking worsens ankylosing spondylitis (AS). Research has found that people with AS who smoke have more spinal damage than nonsmokers. In one study, smokers had damage that was 5.5 times greater than nonsmokers with the same level of disease activity. The damage was even worse for men with AS, with men who smoked having 13 times greater damage than women with AS who didn’t smoke.1 Smoking has also been shown to worsen the pain of AS and impact how well medications like biologics work.2

Stopping smoking significantly improves disease activity in people with AS, and smoking cessation is also associated with improvements in physical mobility and quality of life.3 However, quitting smoking isn’t always easy. Smoking is more than a habit – it can be like a friend who has always been there through the good and bad times. But smoking is a friend with a lot of bad qualities, too: this friend makes us spend money, and it feels hard to cut ties even though we know they’re bad for us. Quitting smoking is hard, but with the right tools and preparation, you can free yourself from the habit. A healthier you is possible!

The challenges of quitting

In addition to the physical addictive properties of smoking, smoking is linked with so many of our daily activities, such as smoking with morning coffee, the drive to work, breaks from work, and the drive after work. Things that remind us of smoking are called triggers. It can be helpful to create a list of your triggers before you quit smoking to identify what the hardest times of the day will be and create a plan to help manage those times.

Planning for quitting

When you decide to try quitting, it’s helpful to either avoid each trigger completely, alter each triggering situation in some way, or use a substitute. If one of your triggers is drinking coffee on your front porch, you can avoid the trigger completely by drinking tea instead of coffee. Or, you can alter the situation so that you are drinking your coffee inside, where you aren’t allowed to smoke, or by going to a coffee shop. Another option is to use a substitute. Many people choose lollipops, gum, or keeping their hands busy with a game or activity.

Tips for quitting smoking

Being prepared can boost your chances of success. Try the following to quit smoking and be a healthier you:

  • Pick a date to quit: Studies show that if you pick a date and stick to it, you’ll be more successful! Pick a date and commit to it.
  • Rally support: Before that date, tell your friends and family that you will be quitting. Having support from your loved ones can be so helpful.
  • Avoid alcohol: Try to stop drinking alcohol, at least for a little bit. Alcohol is one of the hardest triggers to beat.
  • Calculate how much money you will save by quitting smoking: Think of small rewards you can give yourself with the money that you save. These rewards could be a small treat at the end of your day, a pedicure each week, a new pair of shoes you’ve been eyeing, or even planning a vacation.
  • Incorporate new, healthy habits: Some people take up new habits during their quit periods. Long walks, yoga, deep breathing, reading or other relaxing activities can help you stay calm and grounded.
  • Focus on the positive: Instead of thinking “I can’t smoke,” think about what you can or will be able to do. When you quit, you will gain more money, you will be able to breathe better, you will feel healthier, and you will no longer be tethered to a habit that’s bad for you.
  • Recognize your progress: If you slip up and smoke, that’s ok! Everyone makes mistakes. Quitting smoking is really hard, and even just trying to quit is a big deal. If you end up smoking, remind yourself of how far you have come, and commit to continuing on your quitting journey. Keep trying. Eventually, it will stick!
  • Try a nicotine replacement therapy: If your doctor gives you the okay, nicotine replacement therapies may help. Many people find their withdrawal is easier to deal with when using the gum or a patch.
  • Prescription therapy: Discuss with your doctor whether you might want to use a medication such as buproprion, to decrease cravings.
  • Go easy on yourself: You might not feel at your best for the first few weeks. Many people feel cranky, tired, or have a cough. The good news is these things are temporary, and in no time, they will be a distant memory! You can do it!
Written by: Emily Downward | Last reviewed: February 2019
  1. Davis J. Smoking worsens ankylosing spondylitis damage. Arthritis Foundation. Available at https://www.arthritis.org/about-arthritis/types/ankylosing-spondylitis/articles/ankylosing-spondylitis-smoking.php. Published 10/29/13. Accessed 2/20/19.
  2. Stopping smoking. National Ankylosing Spondylitis Society. Available at https://nass.co.uk/managing-my-as/living-with-as/stopping-smoking/. Accessed 2/20/19.
  3. Dülger S, et al. How does smoking cessation affect disease activity, function loss, and quality of life in smokers with ankylosing spondylitis? J Clin Rheumatol. 2018 Jul 10. doi: 10.1097/RHU.0000000000000851. [Epub ahead of print] Abstract.