How to Quit Smoking 5 Cigarettes a Day
You should quit completely using a combination of pharmacotherapy (varenicline or combination nicotine replacement therapy as first choice) plus behavioral counseling, even though you smoke only 5 cigarettes daily—there is no safe level of smoking, and the health benefits of complete cessation far outweigh any risks from treatment. 1
Immediate Action Plan
Set Your Quit Strategy
- Choose a definite quit date within 1-2 weeks and commit to complete abstinence on that day—gradual reduction is less effective than stopping completely 1, 2
- You have three evidence-based approaches to consider:
- Option 1 (Recommended): Start medication 1 week before your quit date, then stop completely on the quit date 1, 2
- Option 2: Start medication first, then pick a quit date between days 8-35 of treatment 3
- Option 3: If unable to quit immediately, reduce smoking by half during weeks 1-4, to one-quarter during weeks 5-8, then to zero by week 12 3
Start Pharmacotherapy Immediately
First-line medication options (choose one): 1, 2, 4
Varenicline (preferred): Most effective single agent with 21.8% six-month quit rate versus 9.4% for placebo 4
- Dosing: Days 1-3: 0.5mg once daily; Days 4-7: 0.5mg twice daily; Day 8 onward: 1mg twice daily 3
- Take after eating with a full glass of water 3
- Continue for minimum 12 weeks, consider extending to 24 weeks 2, 3
- Caution: Assess for psychiatric history and suicide risk before prescribing; may cause mood changes, agitation, or suicidal thoughts 1, 3
Combination NRT (equally preferred): Nicotine patch PLUS short-acting NRT (gum, lozenge, inhaler, or nasal spray) 2, 4
Even at 5 cigarettes per day, pharmacotherapy significantly improves your chances of permanent cessation. 1
Behavioral Support (Essential Component)
Initial Counseling Session
Schedule at least 10-30 minutes with a healthcare provider who will: 1, 2
- Review your past quit attempts: Identify what helped and what hindered previous efforts 1
- Develop problem-solving strategies: Remove all tobacco products from home and work before quit date; plan for high-risk situations (alcohol, stress, social triggers) 1
- Teach coping skills: Deep breathing for relaxation, changing routines where smoking occurred 1
- Arrange social support: Tell family and friends; find a quit partner 1
Follow-Up Schedule
- Week 1 after quit date: First follow-up visit (critical) 1
- Weekly visits for at least 4 weeks 2
- Minimum 4 sessions during each 12-week pharmacotherapy course 2
- Alternative if in-person not possible: Telephone quitlines, text messages, or internet-based support are effective 2, 4
Why You Must Quit Completely (Even at 5 Cigarettes/Day)
- Cardiovascular risk: Nearly 20% of cardiovascular deaths are tobacco-attributable; quitting reduces coronary heart disease death risk by 50% after just 1 year 1
- Cancer risk: 30% of all US cancer deaths are smoking-attributable, with causation proven for 16 cancer types 1
- Diabetes risk: Even light smoking increases type 2 diabetes risk by 30-40% 1
- No safe level exists: Even secondhand smoke increases cardiovascular disease risk by 30% 1
- Rapid benefits: Risk reduction begins within 6 months of cessation 1
- Life expectancy: Quitting can add up to 10 years of life 4, 6
Common Pitfalls to Avoid
- Don't try to quit without medication—pharmacotherapy nearly doubles your success rate, and "most quitters quit unassisted" is a misleading statistic that ignores the much higher failure rate 1
- Don't skip follow-up appointments—relapse is most common in early weeks; average smoker makes 6 quit attempts before achieving long-term abstinence 4, 7
- Don't stop medication too early—minimum 12 weeks required, with better outcomes at 24 weeks 2, 3
- Don't underestimate nicotine dependence—even at 5 cigarettes daily, you maintain brain nicotine levels and will experience withdrawal 1, 7
- Don't fear weight gain—average 5kg gain occurs, but health benefits of cessation far outweigh risks from modest weight increase 1
Expected Outcomes
With combined pharmacotherapy and counseling: 15.2% six-month quit rate versus 8.6% with brief advice alone 4
Relapse is normal—if you slip and smoke, don't give up; most successful quitters required 3-4 attempts before permanent cessation 1